Sex therapy for female sexual dysfunction

Valeska Martinho Pereira, Oscar Arias-Carrión, Sergio Machado, Antonio Egidio Nardi, Adriana Cardoso Silva, Valeska Martinho Pereira, Oscar Arias-Carrión, Sergio Machado, Antonio Egidio Nardi, Adriana Cardoso Silva

Abstract

Introduction: About 45% of women suffer from some form of sexual dysfunction. Despite its high prevalence, there are few studies that have systematically evaluated sex therapy in comparison with other interventions.

Objective: Review randomized clinical trials that present psychotherapeutic interventions for female sexual dysfunctions.

Method: Through a search in three databases (Medline, Web of Science and PsycInfo), 1419 references were found. After an analysis of the abstracts, twenty-seven articles met the inclusion criteria and composed this review.

Results: Sex therapy, as proposed by Masters and Johnson and Heiman and LoPiccolo, is still the most commonly used form of therapy for sexual dysfunctions; although it has shown results, the results do not consistently support that this is the best alternative in the treatment of sexual dysfunctions.

Conclusion: There is a lack of systematic study of many female sexual dysfunctions. Orgasmic disorder and sexual pain (vaginismus and dyspaurenia) are the most extensively studied disorders and those in which sex therapy seems to have better outcomes.

Figures

Figure 1
Figure 1
Flow diagram of selected studies.

References

    1. Lewis RW, Fugl-Meyer KS, Corona G, Hayes RD, Laumann EO, Moreira ED. et al.Definitions/epidemiology/risk factors for sexual dysfunction. J Sex Med. 2010;7(4 Pt 2):1598–1607.
    1. Hayes RD, Bennett CM, Fairley CK, Dennerstein L. What can prevalence studies tell us about female sexual difficulty and dysfunction? J Sex Med. 2006;3(4):589–595. doi: 10.1111/j.1743-6109.2006.00241.x.
    1. Masters WH, Johnson VE. Human sexual response. Oxford, England: Little, Brown; 1966.
    1. Kaplan HS. Disorders of Sexual Desire and Other New Concepts and Techniques in Sex Therapy. New York, NY: Brunner/Hazel Publications; 1979.
    1. Masters WH, Johnson VE. Human Sexual inadequacy. Boston: Little, Brown; 1970.
    1. Heiman JR, LoPiccolo J, Palladini D. Becoming orgasmic: A sexual and personal growth program for women (rev. & exp. ed.) Paramus, NJ, US: Prentice Hall Press; 1988.
    1. Asirdas S, Beech HR. The behavioural treatment of sexual inadequacy. J Psychosom Res. 1975;19(5–6):345–353.
    1. Letourneau EJ, O’Donohue W. Classical conditioning of female sexual arousal. Arch Sex Behav. 1997;26(1):63–78. doi: 10.1023/A:1024573420228.
    1. Riley AJ, Riley EJ. A controlled study to evaluate directed masturbation in the management of primary orgasmic failure in women. Br J Psychiatry. 1978;133:404–409. doi: 10.1192/bjp.133.5.404.
    1. Reisinger JJ. Effects of erotic stimulation and masturbatory training upon situational orgasmic dysfunction. J Sex Marital Ther. 1978;4(3):177–185. doi: 10.1080/00926237808403016.
    1. Andersen BL. A comparison of systematic desensitization and directed masturbation in the treatment of primary orgasmic dysfunction in females. J Consult Clin Psychol. 1981;49(4):568–570.
    1. Everaerd W, Dekker J. Treatment of secondary orgasmic dysfunction: a comparison of systematic desensitization and sex therapy. Behav Res Ther. 1982;20(3):269–274. doi: 10.1016/0005-7967(82)90145-0.
    1. Crowe MJ, Gillan P, Golombok S. Form and content in the conjoint treatment of sexual dysfunction: a controlled study. Behav Res Ther. 1981;19(1):47–54. doi: 10.1016/0005-7967(81)90111-X.
    1. Everaerd W, Dekker J. A comparison of sex therapy and communication therapy: Couples complaining of orgasmic dysfunction. J Sex Marital Ther. 1981;7(4):278–289. doi: 10.1080/00926238108405429.
    1. Kilmann PR RM Jr, Boland JP, Mills KH, Caid C, Davidson E. et al.The treatment of secondary orgasmic dysfunction II. J Sex Marital Ther. 1987;13(2):93–105. doi: 10.1080/00926238708403882.
    1. Fichten CS, Libman E, Brender W. Methodological Issues In the Study of Sex Therapy - Effective Components In the Treatment of Secondary Orgasmic Dysfunction. J Sex Marital Ther. 1983;9(3):191–202. doi: 10.1080/00926238308405847.
    1. Libman E, Fichten CS, Brender W, Burstein R, Cohen J, Binik YM. A comparison of three therapeutic formats in the treatment of secondary orgasmic dysfunction. J Sex Marital Ther. 1984;10(3):147–159. doi: 10.1080/00926238408405940.
    1. Fichten CS, Libman E, Brender W. Measurement of therapy outcome and maintenance of gains in the behavioral treatment of secondary orgasmic dysfunction. J Sex Marital Ther. 1986;12(1):22–34. doi: 10.1080/00926238608415391.
    1. Morokoff PJ, LoPiccolo J. A comparative evaluation of minimal therapist contact and 15-session treatment for female orgasmic dysfunction. J Consult Clin Psychol. 1986;54(3):294–300.
    1. Dodge LJ, Glasgow RE, O’Neill HK. Bibliotherapy in the treatment of female orgasmic dysfunction. J Consult Clin Psychol. 1982;50(3):442–443.
    1. Spence SH. Group versus individual treatment of primary and secondary female orgasmic dysfunction. Behav Res Ther. 1985;23(5):539–548. doi: 10.1016/0005-7967(85)90101-9.
    1. Trudel G, Saint-Laurent S. A comparison between the effects of Kegel’s exercises and a combination of sexual awareness relaxation and breathing on situational orgasmic dysfunction in women. J Sex Marital Ther. 1983;9(3):204–209. doi: 10.1080/00926238308405848.
    1. Chambless DL, Sultan FE, Stern TE, O’Neill C, Garrison S, Jackson A. Effect of pubococcygeal exercise on coital orgasm in women. J Consult Clin Psychol. 1984;52(1):114–118.
    1. Trudel G, Marchand A, Ravart M, Aubin S, Turgeon L, Fortier P. The effect of a cognitive-behavioral group treatment program on hypoactive sexual desire in women. Sex Relationship Ther. 2001;16(2):145–164. doi: 10.1080/14681990120040078.
    1. ter Kuile MM, de Groot E, Melles R, Neffs J, Zandbergen M. Cognitive-behavioral therapy for women with lifelong vaginismus: process and prognostic factors. Behav Res Ther. 2007;45(2):359–373. doi: 10.1016/j.brat.2006.03.013.
    1. Masheb RM, Kerns RD, Lozano C, Minkin MJ, Richman S. A randomized clinical trial for women with vulvodynia: Cognitive-behavioral therapy vs. supportive psychotherapy. Pain. 2009;141(1–2):31–40.
    1. Desrochers G, Bergeron S, Khalifé S, Dupuis MJ, Jodoin M. Provoked vestibulodynia: psychological predictors of topical and cognitive-behavioral treatment outcome. Behav Res Ther. 2010;48(2):106–115. doi: 10.1016/j.brat.2009.09.014.
    1. Van Lankeveld JJDM, Everaerd W, Grotjohann Y. Cognitive-behavioral bibliotherapy for sexual dysfunctions in heterosexual couples: A randomized waiting-list controlled clinical trial in the Netherlands. J Sex Res. 2001;38(1):51–67. doi: 10.1080/00224490109552070.
    1. Mathews A, Whitehead A, Kellett J. Psychological and hormonal factors in the treatment of female sexual dysfunction. Psychol Med. 1983;13(1):83–92. doi: 10.1017/S0033291700050091.
    1. Zimmer D. Does marital therapy enhance the effectiveness of treatment for sexual dysfunction? J Sex Marital Ther. 1987;13(3):193–209. doi: 10.1080/00926238708403892.
    1. Jones LM, McCabe MP. The effectiveness of an Internet-based psychological treatment program for female sexual dysfunction. J Sex Med. 2011;8(10):2781–2792. doi: 10.1111/j.1743-6109.2011.02381.x.
    1. Silverstein RG, Brown ACH, Roth HD, Britton WB. Effects of mindfulness training on body awareness to sexual stimuli: implications for female sexual dysfunction. Psychosom Med. 2011;73(9):817–825. doi: 10.1097/PSY.0b013e318234e628.
    1. Shifren JL, Monz BU, Russo PA, Segreti A, Johannes CB. Sexual problems and distress in United States women: prevalence and correlates. Obstet Gynecol. 2008;112(5):970–978. doi: 10.1097/AOG.0b013e3181898cdb.
    1. Basson R. Human sex-response cycles. J Sex Marital Ther. 2001;27(1):33–43. doi: 10.1080/00926230152035831.
    1. Basson R. The female sexual response: a different model. J Sex Marital Ther. 2000;26(1):51–65.
    1. Binik YM. The DSM, diagnostic criteria for dyspareunia. Arch Sex Behav. 2010;39(2):292–303. doi: 10.1007/s10508-009-9563-x.
    1. Graham CA. The DSM, diagnostic criteria for female orgasmic disorder. Arch Sex Behav. 2010;39(2):256–270. doi: 10.1007/s10508-009-9542-2.
    1. Graham CA. The DSM, diagnostic criteria for female sexual arousal disorder. Arch Sex Behav. 2010;39(2):240–255. doi: 10.1007/s10508-009-9535-1.
    1. Brotto LA. The DSM, diagnostic criteria for hypoactive sexual desire disorder in women. Arch Sex Behav. 2010;39(2):221–239. doi: 10.1007/s10508-009-9543-1.
    1. Binik YM. The DSM, diagnostic criteria for vaginismus. Arch Sex Behav. 2010;39(2):278–291. doi: 10.1007/s10508-009-9560-0.
    1. Hoyer J, Uhmann S, Rambow J, Jacobi F. Reduction of sexual dysfunction: by-product of cognitive-behavioural therapy for psychological disorders? Sex Relationship Ther. 2009;24(1):64–73. doi: 10.1080/14681990802649938.

Source: PubMed

3
Sottoscrivi