ISSN: 2167-0420
Charles Runels1*, Alexandra Runnels2
Accepted treatments for female sexual dysfunction (FSD) are currently limited to psychological, hormonal, surgical, and psychopharmacologic interventions. There are no FDA-approved pharmaceutical interventions that directly affect the female genitalia to improve female sexual function other than prasterone for dyspareunia. Botulinum neurotoxin type A (BoNT) has been shown to improve erectile function in men by increasing arterial blood flow and possibly by increasing parasympathetic tone. In all previous studies in women, BoNT has only been used to improve sexual function by either attenuation of sensation or of muscle contraction and never to accentuate sensation, desire, orgasm, lubrication, or satisfaction directly. This pilot study was undertaken to test the effects, if any, of the clitoral injection of BoNT on female sexual function. The female sexual function index (FSFI) was used as a measure. Our data indicate that the treatment enhances sexual function in women in multiple domains—including desire, arousal, lubrication, orgasm, satisfaction, and overall sexual function. The benefits to overall sexual function improved by an additional 50% when the BoNT was combined with platelet-rich plasma (PRP) rather than saline alone. Our population was small, and placebo effects are possible; but the effects of treatment resulted in improvements in FSFI greater than previously reported after treatment with any of the currently FDA-approved drugs for female sexual dysfunction. The extended safety profile of BoNT for women of reproductive age at the dosages used, the known regenerative properties of BoNT and PRP, its positive effects on circulation and the autonomic nervous system, and the lack of any FDA-approved therapies that directly affect the female genitalia to improve sexual function warrant offering this innovative treatment to women suffering sexual dysfunction unresponsive to other means.