Laboratory Studies

Laboratory workup should include the following:

Complete blood count (CBC)
Chemistry panel
Hormone panel
Vitamin B-12 and folate levels

Most of these tests can be performed in a primary care office. More specialized assessments, which require referral to a specialist, include vaginal pH and local vascular function assessment using photoplethysmography and vagina thermal clearance.^[24]

A CBC and serum chemistry panel (including electrolytes, blood urea nitrogen [BUN], creatinine, glucose, and liver function) are recommended to confirm a clinical suspicion of an underlying systemic issue (eg, renal and liver disease, inflammatory disease, malignancy, or nutrient deficiency). A CBC and vitamin B-12 and folate levels must be checked to rule out a peripheral neuropathy.^[18]

An informative hormone panel should include the following:

Thyroid test (thyroid-stimulating hormone [TSH] and free T4) to rule out hyperthyroidism or hypothyroidism
Estradiol to rule out decreased estrogen levels
Follicle-stimulating hormone (FSH) and luteinizing hormone (LH); both greater than normal and lower than normal levels correlate with sexual dysfunction
Prolactin to rule out hyperprolactinemia
Testosterone (total and free) only in monitoring testosterone therapy; baseline levels do not correlate with sexual disorders in women

Additional laboratory tests include a lipid profile in patients at risk for metabolic or cardiovascular disease and urinalysis for infection and glucosuria.

Rating Scales

Self-reported scales, such as the Female Sexual Function Index (FSFI), while not sufficient for diagnosing FOD, can be helpful in monitoring the symptom presentation over time and response to treatment.^[25]

Treatment & Management

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