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New Concepts in the Understanding of Female Sexual Dysfunction

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Management of Sexual Dysfunction in Men and Women

Abstract

This chapter considers the factors that relate to the development of female sexual dysfunction (FSD), as well as new treatment approaches to these problems. The role of biological, psychological, and relationship factors is examined. Treatment approaches to FSD are also evaluated. New approaches to the treatment of FSD are considered, in particular mindful-based therapy as well as Internet therapies. Although there are limited data on the effectiveness of medical approaches to FSD, it is argued that combined medical and psychological interventions need to be the focus of future research in this field.

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References

  1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: APA; 2013.

    Google Scholar 

  2. Kontula O, Haavio-Mannila E. The impact of aging on human sexual activity and sexual desire. J Sex Res. 2009;46:46–56.

    Article  PubMed  Google Scholar 

  3. Kennedy SH, Eisfeld BS, Dickens SE, Bacchiochi JR, Bagby RM. Antidepressant induced sexual dysfunction during treatment with moclobemide, paroxetine, sertraline, and venlafaxine. J Clin Psychiatry. 2000;61:276–81.

    Article  CAS  PubMed  Google Scholar 

  4. Wincze JP, Carey MP. Sexual dysfunction: a guide for assessment and treatment. 2nd ed. New York: Guildford Press; 2001.

    Google Scholar 

  5. McVary KT, Carrier S, Wessells H. Smoking and erectile dysfunction: evidence based analysis. J Urol. 2001;166:1624–32.

    Article  CAS  PubMed  Google Scholar 

  6. Miri SM, Meyer RE, Mendelson JH, Ellingboe J. Opiate use and sexual function. Am J Psychiatry. 1980;137:909–15.

    Article  Google Scholar 

  7. McCabe MP. Sexual and relationship problems. In: Rieger E, editor. Abnormal psychology: leading researcher perspectives. 2nd ed. Melbourne: McGraw-Hill; 2011. p. 312–54.

    Google Scholar 

  8. McCabe MP. The development and maintenance of sexual dysfunction: an explanation based on cognitive theory. Sex Marital Ther. 1991;6:245–60.

    Article  Google Scholar 

  9. Nobre PJ. Determinants of sexual desire problems in women: testing a cognitive-emotional model. J Sex Marital Ther. 2009;35:360–77.

    Article  PubMed  Google Scholar 

  10. Hayes RD, Dennerstein L, Bennett CM, Fairley CK. What is the “true” prevalence of female sexual dysfunctions and does the way we assess these conditions have an impact? J Sex Med. 2008;5:777–87.

    Article  PubMed  Google Scholar 

  11. King M, Holt V, Nazareth I. Women’s views of their sexual difficulties: agreement and disagreement with clinical diagnoses. Arch Sex Behav. 2007;36:281–8.

    Article  PubMed  Google Scholar 

  12. 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 Relat Ther. 2001;16:145–64.

    Article  Google Scholar 

  13. Peplau LA. Human sexuality: how do men and women differ? Curr Dir Psychol Sci. 2003;12:37–40.

    Article  Google Scholar 

  14. Baumeister RF, Vohs KD. Sexual economics: sex as female resource for social exchange in heterosexual interactions. Pers Soc Psychol Rev. 2004;8:339–63.

    Article  PubMed  Google Scholar 

  15. Althof SE, Dean J, Derogatis LR, Rosen RC, Sisson M. Current perspectives on the clinical assessment and diagnosis of female sexual dysfunction and clinical studies of potential therapies: a statement of concern. J Sex Med. 2005;2:146–53.

    Article  PubMed  Google Scholar 

  16. Stuart FM, Hammond DC, Pett MA. Inhibited sexual desire in women. Arch Sex Behav. 1987;16:91–106.

    Article  CAS  PubMed  Google Scholar 

  17. Metz ME, Epstein N. Assessing the role of relationship conflict in sexual dysfunction. J Sex Marital Ther. 2002;28:139–64.

    Article  PubMed  Google Scholar 

  18. McCarthy BW, Thestrup M. Integrating sex therapy interventions with couple therapy. J Contemp Psychother. 2008;38:139–49.

    Article  Google Scholar 

  19. Costa RM, Brod S. Women’s relationship quality is associated with specifically penile-vaginal intercourse orgasm and frequency. J Sex Marital Ther. 2007;33:319–27.

    Article  PubMed  Google Scholar 

  20. Haning RV, O’Keefe SL, Randall EJ, Kommor MJ, Baker E, Wilson R. Intimacy, orgasm likelihood, and conflict predict sexual satisfaction in heterosexual male and female respondents. J Sex Marital Ther. 2007;33:93–113.

    Article  PubMed  Google Scholar 

  21. Talmadge LD, Talmadge WC. Relational sexuality: an understanding of low sexual desire. In: The Hatherleigh guide to marriage and family therapy. New York: Hatherleigh Press; 1996. p. 191–218.

    Google Scholar 

  22. Balon R, Segraves RT. Handbook of sexual dysfunction. Boca Raton: Taylor and Francis; 2005.

    Google Scholar 

  23. Goldberg DC, Pervin LA. Progress in the treatment of sexual desire disorders. PsycCRITIQUES. 2006;35:786–7.

    Google Scholar 

  24. Basson R, Berman J, Burnett A, Deogatis L, Ferguson D, Fourcroy J, et al. Report of the international consensus development conference on female sexual dysfunction: definitions and classification. J Urol. 2000;163:888–93.

    Article  CAS  PubMed  Google Scholar 

  25. Segraves RT, Balon R. Introduction: treatment of sexual disorders in the 21st century. In: Balon R, Segraves RT, editors. Handbook of sexual dysfunction. Boca Raton: Taylor and Francis; 2005. p. 1–11.

    Google Scholar 

  26. Everaerd W, Both S, Laan E. The experience of sexual emotions. Annu Rev Sex Res. 2006;17:183–99.

    Google Scholar 

  27. Althof SE. What’s new in sex therapy (CME). J Sex Med. 2010;7:5–13.

    Article  PubMed  Google Scholar 

  28. Brotto LA, Basson R, Luria M. A mindfulness-based group psychoeducational intervention targeting sexual arousal disorder in women. J Sex Med. 2008;5:1646–59.

    Article  PubMed  Google Scholar 

  29. Brotto LA, Heiman J, Goff B, Greer B, Lentz GM, Swisher E, et al. A psychoeducation intervention for sexual dysfunction in women with gynecologic cancer. Arch Sex Behav. 2008;37:317–29.

    Article  PubMed  Google Scholar 

  30. Brotto LA, Erskine Y, Carey M, Ehlen T, Fionalyson S, Heywood M, et al. A brief mindfulness-based cognitive behavioral intervention improves sexual functioning versus wait-list control in women treated for gynecologic cancer. Gynecol Oncol. 2012;125:320–5.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Brotto LA, Seal BN, Rellini A. Pilot study of a brief cognitive behavioral versus mindfulness-based intervention for women with sexual distress and a history of childhood sexual abuse. J Sex Marital Ther. 2012;38:1–27.

    Article  PubMed  Google Scholar 

  32. Haln TN. The miracle of mindfulness: a manual on meditation. Boston, MA: Beacon; 1975.

    Google Scholar 

  33. Brotto LA, Heiman JR. Mindfulness in sex therapy: applications for women with sexual difficulties following gynecologic cancer. Sex Relat Ther. 2007;22:3–11.

    Article  Google Scholar 

  34. Brotto LA, Krychman M, Jocabson P. Eastern approaches for enhancing women’ sexuality: mindfulness, acupuncture, and yoga. J Sex Med. 2008;6:2741–8.

    Article  Google Scholar 

  35. Basson R. The recurrent pain and sexual sequelae of provoked vestibulodynia: a perpetuating cycle. J Sex Med. 2012;9:2077–92.

    Article  PubMed  Google Scholar 

  36. Brotto LA, Basson R, Carlson M, Zhu C. Impact of an integrated mindfulness and cognitive behavioural treatment for provoked vestibulodynia (IMPROVED): a qualitative study. Sex Relat Ther. 2013;28(1):3–19.

    Article  Google Scholar 

  37. Hucker A, McCabe MP. Incorporating mindfulness and chat groups in online cognitive-behavioral therapy for mixed female sexual problems. J Sex Res. 2015; 52(6) 627–639.

    Google Scholar 

  38. Jones L, McCabe MP. The effectiveness of an internet-based psychological treatment program for female sexual dysfunction. J Sex Med. 2011;8:2781–92.

    Article  PubMed  Google Scholar 

  39. Kleinplatz PJ. What’s new in sex therapy? From stagnation to fragmentation. Sex Relat Ther. 2003;18:95–106.

    Article  Google Scholar 

  40. McCarthy BW. An integrative cognitive-behavioral approach to understanding, assessing and treating female sexual dysfunctions. J Fam Psychother. 2004;15:19–35.

    Article  Google Scholar 

  41. Tiefer L. Beyond the medical model of women’s sexual problems: a campaign to resist the promotion of ‘female sexual dysfunction’. Sex Relat Ther. 2002;17:127–35.

    Article  Google Scholar 

  42. Stinson RD. The behavioral and cognitive-behavioral treatment of female sexual dysfunction: how far we have come and the path left to go. Sex Relat Ther. 2009;24:271–85.

    Article  Google Scholar 

  43. Segraves RT. Female sexual disorders: psychiatric aspects. Can J Psychiatry. 2006;47:419–25.

    Google Scholar 

  44. Basson R, Brotto LA. Sexual psychophysiology and effects of sildenafil citrate in oestrogenised women with acquired genital arousal disorder and impaired orgasm: a randomized controlled trial. Int J Obstet Gynaecol. 2003;110:1014–24.

    Article  CAS  Google Scholar 

  45. Heiman JR. Sexual dysfunction: overview of prevalence, etiological factors, and treatments. J Sex Res. 2002;39:73–8.

    Article  PubMed  Google Scholar 

  46. Basson R. The female sexual response: a different model. J Sex Marital Ther. 2000;26:51–65.

    Article  CAS  PubMed  Google Scholar 

  47. Caruso S, Intelisano G, Lup L, Agnello C. Premenopausal women affected by sexual arousal disorder treated with sildenafil: a double-blind, cross-over, placebo-controlled study. Br J Obstet Gynecol. 2001;108:623–8.

    CAS  Google Scholar 

  48. Chives ML, Rosen RC. Phosphodiesterase type 5 inhibitors and female sexual response: faculty protocols or paradigms? J Sex Med. 2010;7:858–72.

    Article  Google Scholar 

  49. Davis SR, Braunstein GD. Efficacy and safety of testosterone in the management of hypoactive sexual desire disorder in postmenopausal women. J Sex Med. 2012;9:1134–48.

    Article  CAS  PubMed  Google Scholar 

  50. Panay N, Al-Azzawai F, Bouchard C, Davis SR, Eden J, Lodhi I, et al. Testosterone treatment of HSDD in natural menopausal women: the ADORE study. Climacteric. 2010;13:121–31.

    Article  CAS  PubMed  Google Scholar 

  51. Shifren JL, Braunstein GD, Simon JA, Casson PR, Buster JE, Redmond GP, et al. Transdermal testosterone treatment in women with impaired sexual function after oophorectomy. N Engl Med. 2000;343:682–8.

    Article  CAS  Google Scholar 

  52. Goldfischer ER, Breaux J, Katz M, Kaufman J, Smith WB, Kimura T, et al. Continued efficacy and safety of flibanserin in premenopausal women with hypoactive sexual desire disorder (HSDD): results from a randomized withdrawal trial. J Sex Med. 2011;8:3160–72.

    Article  CAS  PubMed  Google Scholar 

  53. Derogatis LR, Komer L, Moreau M, Kimura T, Garcia Jr M, Wunderlich G, Pyke R, VIOLET Trial Investigators. Treatment of hypoactive sexual desire disorders in premenopausal women: efficacy of flibanserin in the VIOLET study. J Sex Med. 2012;9:1074–85.

    Article  CAS  PubMed  Google Scholar 

  54. Thorp J, Simon J, Dattani D, Taylor L, Kimura T, Garcia Jr M, et al. Treatment of hypoactive sexual desire disorder in premenopausal women: efficacy of flibanserin in the DAISY study. J Sex Med. 2012;9:793–804.

    Article  CAS  PubMed  Google Scholar 

  55. Jayne C, Simon JA, Taylor LV, Kimura T, Lesko LM, SUNFLOWER study investigators. Open-label extension study of flibanserin in women with hypoactive sexual desire disorder. J Sex Med. 2012;9:3180–8.

    Article  CAS  PubMed  Google Scholar 

  56. Fabre LF, Brown CS, Smith LC, Derogatis LR. Gepirone-ER treatment of hypoactive sexual desire disorder (HSDD) associated with depression in women. J Sex Med. 2011;8:1411–19.

    Article  CAS  PubMed  Google Scholar 

  57. Moll JL, Brown CS. The use of monoamine pharmacological agents in the treatment of sexual dysfunction: evidence in the literature. J Sex Med. 2011;8:956–70.

    Article  CAS  PubMed  Google Scholar 

  58. Al-Azzawi F, Bitzer J, Brandernbury U, et al. Therapeutic options for postmenopausal female sexual dysfunction. Clumacteric. 2010;13:103–20.

    Article  CAS  Google Scholar 

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Correspondence to Marita P. McCabe Ph.D. .

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McCabe, M.P. (2016). New Concepts in the Understanding of Female Sexual Dysfunction. In: Lipshultz, L., Pastuszak, A., Goldstein, A., Giraldi, A., Perelman, M. (eds) Management of Sexual Dysfunction in Men and Women. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-3100-2_26

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  • DOI: https://doi.org/10.1007/978-1-4939-3100-2_26

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-3099-9

  • Online ISBN: 978-1-4939-3100-2

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