UCSF Center for Sexual Health

The UCSF Center for Sexual Health in San Francisco, CA operates as a specialized clinical program within the University of California San Francisco health system, focusing exclusively on women's sexual health concerns across the lifespan. Under the medical direction of Tami Rowen, MD, MS, an obstetrician-gynecologist with fellowship training in female pelvic medicine and reconstructive surgery, the center addresses sexual dysfunction through evidence-based medical interventions, hormonal therapies, and comprehensive diagnostic evaluation. Dr. Rowen holds dual appointments as Associate Professor in the Department of Obstetrics, Gynecology and Reproductive Sciences and the Department of Urology at UCSF, bringing academic rigor and research-informed protocols to clinical practice. The center treats conditions including hypoactive sexual desire disorder, arousal difficulties, orgasmic dysfunction, dyspareunia, vulvodynia, and sexual health concerns related to cancer treatment, pelvic surgery, or chronic medical conditions.

Treatment protocols at the center integrate hormonal optimization for sexual function, including localized estrogen therapy for genitourinary syndrome of menopause, testosterone therapy for hypoactive sexual desire disorder in appropriate candidates, and DHEA formulations for vulvovaginal atrophy. The clinical team evaluates patients for underlying medical contributors to sexual dysfunction including cardiovascular disease, diabetes, neurological conditions, and medication side effects that impair arousal or orgasmic response. For women experiencing sexual pain disorders, the center offers pelvic floor physical therapy referrals, nerve block procedures for provoked vestibulodynia, and multimodal pain management strategies. Menopause management extends beyond symptom relief to address the physiological changes affecting sexual response, including decreased genital blood flow, reduced vaginal elasticity, and altered hormone receptor sensitivity that impact desire and arousal.

Dr. Rowen's clinical approach incorporates validated assessment tools including the Female Sexual Function Index and the Female Sexual Distress Scale to quantify symptoms and track treatment response over time. Initial consultations involve detailed sexual health histories, medication reviews to identify agents that impair sexual function such as SSRIs or antihypertensives, and physical examination of pelvic floor muscle tone, vulvar tissue health, and signs of hormonal deficiency. The center collaborates with UCSF mental health providers when psychological factors including depression, anxiety, relationship conflict, or trauma history contribute to sexual dysfunction, recognizing that effective treatment often requires addressing both physiological and psychosocial components. For patients with complex presentations involving chronic pain conditions, autoimmune disease, or prior pelvic radiation, the team develops individualized treatment plans that may combine hormonal therapy, topical medications, dilator therapy, and referrals to specialized physical therapy.

Patients accessing care at the UCSF Center for Sexual Health can expect appointments that typically extend 60 minutes for initial consultations, allowing comprehensive evaluation of medical history, relationship factors, and specific sexual concerns without time constraints common in general gynecology practice. The center serves as a referral destination for complex cases that have not responded to first-line treatments in community settings, including women with lichen sclerosus affecting sexual function, persistent genital arousal disorder, or sexual dysfunction following gender-affirming surgery. Follow-up protocols involve reassessment at 8-12 week intervals to evaluate treatment efficacy, adjust hormonal dosing based on symptom response and laboratory values, and modify therapeutic approaches when initial interventions prove insufficient. The clinical team provides education on anatomy, sexual response physiology, and the neurobiological basis of desire and arousal to help patients understand their conditions and participate actively in treatment decisions.

The center's location within the UCSF Medical Center at Mount Zion in San Francisco provides access to the full spectrum of university hospital resources including advanced imaging, specialized laboratory testing, and multidisciplinary consultation when sexual dysfunction stems from or coexists with complex medical conditions. Dr. Rowen's research portfolio includes published studies on sexual function after pelvic organ prolapse surgery, the impact of mesh complications on sexual health, and hormonal interventions for postmenopausal sexual dysfunction, ensuring that clinical protocols reflect current evidence rather than outdated practice patterns. The center accepts referrals from primary care physicians, gynecologists, and urologists throughout the San Francisco Bay Area, and participates in training programs that educate the next generation of physicians in sexual medicine—a subspecialty that remains underrepresented in standard obstetrics and gynecology residency curricula.