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11 - Sexual Dysfunctions

Published online by Cambridge University Press:  10 January 2025

Stephen Hupp
Affiliation:
Southern Illinois University, Edwardsville
David F. Tolin
Affiliation:
Institute of Living
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Summary

Sexual dysfunctions are diagnosed differently in women and men. Diagnoses for women include female sexual interest/arousal disorder, female orgasmic disorder, and genito-pelvic pain/penetration disorder. Diagnoses for men include hypoactive sexual desire disorder, erectile disorder, delayed ejaculation, and premature ejaculation. Research on treatments is limited. Common components of psychological treatments include psychoeducation, cognitive restructuring/emotional regulation, stimulus control/desensitization, contextual modifications, mindfulness, and relationship skill building. A sidebar describes comprehensive sex education for youth.

Type
Chapter
Information
Science-Based Therapy
Raising the Bar for Empirically Supported Treatments
, pp. 175 - 192
Publisher: Cambridge University Press
Print publication year: 2025

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References

Useful Resources

Brotto, L. A., & Nagoski, E. (2018). Better sex through mindfulness: How women can cultivate desire. Greystone Books.

Goldstein, A., Pukall, C. F., & Goldstein, I. (2020). Female sexual pain disorders evaluation and management (2nd ed.). Wiley-Blackwell.

Hall, K. S. K., & Binik, Y. M. (2020). Principles and practice of sex therapy (6th ed.). Guilford Press.

McCarthy, B. W., & McCarthy, E. J. (2021). Contemporary male sexuality: Confronting myths and promoting change. Routledge.

Meana, M. (2012). Sexual dysfunction in women. Hogrefe Publishing.

Perel, E. (2007). Mating in captivity: Unlocking erotic intelligence). Harper.

Rowland, D. (2012). Sexual dysfunction in men. Hogrefe Publishing.

References

Adam, F., De Sutter, P., Day, J., & Grimm, E. (2020). A randomized study comparing video-based mindfulness-based cognitive therapy with video-based traditional cognitive behavioral therapy in a sample of women struggling to achieve orgasm. Journal of Sexual Medicine, 17(2), 312324.CrossRefGoogle Scholar
Althof, S. (2020). Treatment of premature ejaculation: Psychotherapy, pharmacotherapy, and combined therapy. In: Hall, K. S. K. & Binik, Y. M. (Eds.), Principles and practice of sex therapy (6th ed.) (pp. 134155). Guilford Press.Google Scholar
American Psychiatric Association (2022). Diagnostic and statistical manual of mental disorders (5th ed., text revision). American Psychiatric Association.Google Scholar
Avery-Clark, C., Weiner, L. & Adams-Clark, A. A. (2019). Sensate focus for sexual concerns: An updated, critical literature review. Current Sexual Health Reports, 11, 8494.CrossRefGoogle Scholar
Bancroft, J. (2009). Human sexuality and its problems (3rd ed.). Elsevier.Google Scholar
Barlow, D. H. (1986). Causes of sexual dysfunction: The role of anxiety and cognitive interference. Journal of Consulting and Clinical Psychology, 54, 140148.CrossRefGoogle ScholarPubMed
Basson, R. (2000). The female sexual response: A different model. Journal of Sex & Marital Therapy, 26(1), 5165.CrossRefGoogle ScholarPubMed
Bergeron, S., Paquet, M., Steben, M., & Rosen, N. O. (2021). Perceived partner responsiveness is associated with sexual well-being in couples with genito-pelvic pain. Journal of Family Psychology, 35, 628638.CrossRefGoogle ScholarPubMed
Bergeron, S., Rosen, N. O., Pukall, C. F., & Corsini-Munt, S. (2020). Genital pain in women and men. In Hall, K. S. K. & Binik, Y. M. (Eds.), Principles and practice of sex therapy (6th ed.) (pp. 180201). The Guilford Press.Google Scholar
Binik, Y. M., & Meana, M. (2009). The future of sex therapy: Specialization or marginalization? Archives of Sexual Behavior, 38(6), 10161027.CrossRefGoogle ScholarPubMed
Boddi, V., Castellini, G., Casale, H., et al. (2015). An integrated approach with vardenafil orodispersible tablet and cognitive-behavioral sex therapy for treatment of erectile dysfunction: A randomized controlled pilot study. Andrology, 3(5), 909918.CrossRefGoogle ScholarPubMed
Brotto, L. A. (2018). Better sex through mindfulness. Greystone.Google Scholar
Brotto, L. A., Attallah, S., Johnson-Agbakwu, C., et al. (2016). Psychological and interpersonal dimensions of sexual function and dysfunction. Journal of Sexual Medicine, 13, 538571.CrossRefGoogle Scholar
Brotto, L. A., Bergeron, S., Zdaniuk, B., et al. (2019). A comparison of mindfulness-based cognitive therapy vs cognitive behavioral therapy for the treatment of provoked vestibulodynia in a hospital setting. Journal of Sexual Medicine, 16(6), 909923.CrossRefGoogle Scholar
Brotto, L. A., & Heiman, J. R. (2007). Mindfulness in sex therapy: Applications for women with sexual difficulties following gynecologic cancer. Sexual and Relationship Therapy, 22, 311.CrossRefGoogle Scholar
Brotto, L. A., Zdaniuk, B., Chivers, M. L., et al. (2021). A randomized control trial comparing group mindfulness-based cognitive therapy with group supportive sex education and therapy for the treatment of female sexual interest/arousal disorder. Journal of Consulting and Clinical Psychology, 89(7), 626639.CrossRefGoogle Scholar
Carvalheira, A., & Leal, I. (2013). Masturbation among women: Associated factors and sexual response in a Portuguese community. Journal of Sex and Marital Therapy, 39(4), 347367.CrossRefGoogle Scholar
Chambless, D. L., Baker, M. J., Baucom, D. H., et al. (1998). Update on empirically validated therapies. II. The Clinical Psychologist, 51(1), 316.Google Scholar
Chin, H. B., Sipe, T. A., Elder, R., et al. (2012). The effectiveness of group-based comprehensive risk-reduction and abstinence education interventions to prevent or reduce the risk of adolescent pregnancy, human immunodeficiency virus, and sexually transmitted infections: Two systematic reviews for the Guide to Community Preventative Services. American Journal of Preventative Medicine, 42, 272294.CrossRefGoogle ScholarPubMed
Christensen, B. S., Gronbaek, M., Osler, M., et al. (2011). Sexual dysfunctions and difficulties in Demark: Prevalence and associated sociodemographic factors. Archives of Sexual Behavior, 40, 121132.CrossRefGoogle Scholar
Corona, G., Rastrelli, G., Ricca, V., et al. (2013). Risk factors associated with primary and secondary reduced libido in male patients with sexual dysfunction. Journal of Sexual Medicine, 10, 10741089.CrossRefGoogle ScholarPubMed
Fruhauf, S., Gerger, H., Maren Schmidt, H., Munder, T., & Barth, J. (2013). Efficacy of psychological interventions for sexual dysfunction: A systematic review and meta-analysis. Archives of Sexual Behavior, 42, 915933.CrossRefGoogle ScholarPubMed
Goldfarb, E. S., & Lieberman, L. D. (2021). Three decades of research: The case for comprehensive sex education. Journal of Adolescent Health, 2021, 1327.CrossRefGoogle Scholar
Hall, K. S. K., & Graham, C. A. (2020). The privileging of pleasure: Sex therapy in global cultural context. In Hall, K. S. K. & Binik, Y. M. (Eds.), Principles and practice of sex therapy (6th ed.) (pp. 180201). The Guilford Press.Google Scholar
Hall, S. K., Males, J. M., Komro, K. A., & Santelli, J. (2016). The state of sex education in the United States. Journal of Adolescent Health, 58, 595597.CrossRefGoogle ScholarPubMed
Harte, C. B., & Meston, C. M. (2013). Association between cigarette smoking and erectile tumescence: The mediating role of heart rate variability. International Journal of Impotence Research, 25(4), 155159.CrossRefGoogle ScholarPubMed
Henrich, J., Heine, S. J., & Norenzayan, A. (2010). The weirdest people in the world? Behavioral and Brain Sciences, 32(2/3), 175.Google Scholar
Herbenick, D., Mullinax, M., & Mark, K. (2014). Sexual desire discrepancy as a feature, not a bug, of long-term relationships: Women’s self-reported strategies for modulating sexual desire. Journal of Sexual Medicine, 11(9), 21962206.CrossRefGoogle Scholar
Kalogeropoulos, D., & Larouche, J., (2020). An integrative biopsychosocial approach to the conceptualization and treatment of erectile disorder. In: Hall, K. S. K. & Binik, Y. M. (Eds.), Principles and practice of sex therapy (6th ed.) (pp. 87108). The Guilford Press.Google Scholar
Kaplan, H. S. (1979). Disorders of sexual desire and other new concepts and techniques in sex therapy. Brunner/Mazel.Google Scholar
Kohler, P. K., Manhart, L. E., & Lafferty, W. E. (2008). Abstinence-only and comprehensive sex education and the initiation of sexual activity and teen pregnancy. Journal of Adolescent Health, 42, 344351.CrossRefGoogle ScholarPubMed
Laan, E., Rellini, A. H., & Barnes, T. (2013). Standard operating procedures for female orgasmic disorder: Consensus of the International Society for Sexual Medicine. Journal of Sexual Medicine, 10, 7482.CrossRefGoogle ScholarPubMed
Lahaie, M. A., Amsel, R., Khalife, S., et al. (2015). Can fear, pain, and muscle tension discriminate vaginismus from dyspareunia/ provoked vestibulodynia? Implications for the new DSM-5 diagnosis of genito-pelvic pain/penetration disorder. Archives of Sexual Behavior, 44, 15371550.CrossRefGoogle ScholarPubMed
Landry, T., Bergeron, S., Dupuis, M.-J., & Desrochers, G. (2008). The treatment of provoked vestibulodynia: A critical review. Clinical Journal of Pain, 24, 155171.CrossRefGoogle ScholarPubMed
Laurent, S. E., & Simons, A. D. (2009). Sexual dysfunction in depression and anxiety: Conceptualizing sexual dysfunction as part of an internalizing dimension. Clinical Psychology Review, 29, 573585.CrossRefGoogle ScholarPubMed
Lewis, R. W., Fugl-Meyer, K. S., Corona, G., et al. (2010). Definitions/epidemiology/risk factors for sexual dysfunction. Journal of Sexual Medicine, 7(4), 15981607.CrossRefGoogle Scholar
Linschoten, M., Weiner, L., & Avery-Clark, C. (2016). Sensate focus: A critical literature review. Sexual and Relationship Therapy, 31, 230247.CrossRefGoogle Scholar
Masters, W. H., & Johnson, V. E. (1966). Human sexual response. Little, BrownGoogle Scholar
Masters, W. H., & Johnson, V. E. (1970). Human sexual inadequacy. Little, Brown.Google Scholar
McCabe, M. (2005). The role of performance anxiety in the development and maintenance of sexual dysfunction in men and women. International Journal of Stress Management, 12, 379388.CrossRefGoogle Scholar
McCabe, M. P., & Cobain, M. J. (1998). The impact of individual and relationship factors on sexual dysfunction among males and females. Sexual and Marital Therapy, 13, 131143.CrossRefGoogle Scholar
Meana, M. (2012). Sexual dysfunction in women. Hogrefe Press.Google Scholar
Meana, M., & Binik, Y. M. (2022). The biopsychosocial puzzle of painful sex. Annual Review of Clinical Psychology, 18, 471495.CrossRefGoogle ScholarPubMed
Meana, M., & Hall, K. (2023). Sexual dysfunctions. In Leong, T. L., Callahan, J., Eubanks, C., & Constantino, M. (Eds.), APA handbook of psychotherapy. American Psychological Association.Google Scholar
Meana, M., Hall, K., & Binik, Y. M. (2020). Conclusion: Where is sex therapy going? In Hall, K. S. K. & Binik, Y. M. (Eds.), Principles and practice of sex therapy (6th ed.) (pp. 505522). The Guilford Press.Google Scholar
Meana, M., Nobre, P., & Tavares, I. (2023). Sexual dysfunctions. In Tasman, A. et al. (Eds.) Tasmin’s Psychiatry (5th ed.). Springer.Google Scholar
Metz, M. E., & Epstein, N. (2002). Assessing the role of relationship conflict in sexual dysfunction. Journal of Sex & Marital Therapy, 28, 139164.CrossRefGoogle ScholarPubMed
Mintz, L. (2017). Becoming cliterate: Why orgasm equality matters – A guide for survivors of sexual abuse. Avon.Google Scholar
Mitchell, K. R., Mercer, C. H., Ploubidis, G. B., et al. (2013). Sexual function in Britain: Findings from the Third National Survey of Sexual Attitudes and Lifestyles (NATSAL-3). Lancet, 382, 18171829.CrossRefGoogle ScholarPubMed
Mitchell, K. R., Jones, K.G., Wellings, K., et al. (2016). Estimating the prevalence of sexual function problems: The impact of morbidity criteria. Journal of Sex Research, 53(8), 955967.CrossRefGoogle ScholarPubMed
Morin, M., Carroll, M.-S., & Bergeron, S. (2017). Systematic review of the effectiveness of physical therapy modalities in women with provoked vestibulodynia. Sexual Medicine Reviews, 5(3), 295322.CrossRefGoogle ScholarPubMed
Nobre, P. G., & Pinto-Gouveia, J. (2008). Differences in automatic thoughts presented during sexual activity between sexually functional and dysfunctional men and women. Cognitive Therapy and Research, 32, 3749.CrossRefGoogle Scholar
Nobre, P. J., Pinto-Gouveia, J., & Gomes, F. A. (2006). Prevalence and comorbidity of sexual dysfunctions in a Portuguese clinical sample. Journal of Sex & Marital Therapy, 32(2), 173182.CrossRefGoogle Scholar
Perelman, M. A. (2004). Regarded ejaculation. In Mulhull, J. (Ed.), Current sexual health reports (pp. 95101). Current Science.Google Scholar
Perelman, M. A., & Rowland, D. L. (2006). Retarded ejaculation. World Journal of Urology, 24(6), 645652.CrossRefGoogle ScholarPubMed
Polland, A., Davis, M., Zeymo, A., & Venkatesen, K. (2018). Comparison of correlated comorbidities in male and female sexual dysfunction: Findings from the Third National Survey of Sexual Attitudes and Lifestyles (NATSAL-3). Journal of Sexual Medicine, 15(5), 678686.CrossRefGoogle ScholarPubMed
Pukall, C. F. (2023). Sexual issues. In Hupp, S. & Santa Maria, C. L. (Eds.), Pseudoscience in therapy: A skeptical field guide (pp. 162178). Cambridge University Press.CrossRefGoogle Scholar
Pukall, C. F., Goldstein, A. T., Bergeron, S., et al. (2016). Vulvodynia: Definition, prevalence, impact, and pathophysiological factors. Journal of Sexual Medicine, 13(3), 291304.CrossRefGoogle ScholarPubMed
Reissing, E. D., Binik, Y. M., Khalife, S., Cohen, D., & Amsel, R. (2004). Vaginal spasm, pain, and behavior: An empirical investigation of the diagnosis of vaginismus. Archives of Sexual Behavior, 33, 517.CrossRefGoogle ScholarPubMed
Rosen, N. O., & Bergeron, S. (2019). Genito-pelvic pain through a dyadic lens: Moving toward an interpersonal emotional regulation model of women’s sexual dysfunction. The Journal of Sex Research, 56(4), 440461.CrossRefGoogle ScholarPubMed
Rosen, R. C., & Bachman, G. A. (2008). Sexual well-being, happiness, and satisfaction in women. The case for a new conceptual paradigm. Journal of Sex and Marital Therapy, 34, 291297.CrossRefGoogle ScholarPubMed
Rosen, R. C., Brown, C., Heiman, J., et al. (2000). The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function. Journal of Sex and Marital Therapy, 26(2), 191208.CrossRefGoogle ScholarPubMed
Rosen, R. C., Riley, A., Wagner, G., et al. (1997). The International Index of Erectile Function (IIEF): A multidimensional scale for assessment of erectile dysfunction. Urology, 49, 822830.CrossRefGoogle ScholarPubMed
Rowland, D. L. (2012). Sexual dysfunction in men. Hogrefe Press.Google Scholar
Rowland, D. L., & Cooper, S. E. (2017). Treating men’s orgasmic difficulties. In Peterson, Z. D. (Ed.), The Wiley handbook of sex therapy (pp. 7297). Wiley-Blackwell.CrossRefGoogle Scholar
SIECUS (2018). Position statements. Sexuality Information and Education Council of the United States. https://siecus.org/wp-content/uploads/2018/07/Position-Statements-2018.pdf (accessed March 29, 2023).Google Scholar
Silva, A. B., Sousa, N., Azevedo, L. F., & Martins, C. (2017). Physical activity and exercise for erectile dysfunction: Systematic review and meta-analysis. British Journal of Sports Medicine, 51, 14191424.CrossRefGoogle ScholarPubMed
Stanger-Hall, K. F., & Hall, D. W. (2011). Abstinence-only education and teen pregnancy rates: Why we need comprehensive sex education in the US. PLoS One, e24658.CrossRefGoogle Scholar
ter Kuile, M. M., Both, S., & van Lankveld, J. J. (2010). Cognitive-behavioral therapy for sexual dysfunctions in women. Psychiatric Clinics of North America, 33, 595610.CrossRefGoogle ScholarPubMed
ter Kuile, M. M., Melles, R., de Groot, H. E., Tuijnman-Raasveld, C. C., & van Lankveld, J. J. (2013). Therapist-aided exposure for women with lifelong vaginismus: A randomized waiting-list controlled trial of efficacy. Journal of Consulting and Clinical Psychology, 81, 11271136.CrossRefGoogle ScholarPubMed
ter Kuile, M. M., & Reissing, E. D. (2020). Lifelong inability to experience intercourse (vaginismus). In Hall, K. S. K. & Binik, Y. M. (Eds.), Principles and practice of sex therapy (6th ed.) (pp. 202223). Guilford Press.Google Scholar
Tolin, D. F., McKay, D., Forman, E. M., Klonsky, E. D., & Thombs, B. D. (2015). Empirically supported treatment: Recommendations for a new model. Clinical Psychology: Science and Practice, 22, 317338.Google Scholar
van Lankveld, J. D. M., & Grotjohann, Y. (2000). Psychiatric comorbidity in heterosexual couples with sexual dysfunction assessed with the Composite International Diagnostic Interview. Archives of Sexual Behavior, 29, 479498.CrossRefGoogle ScholarPubMed
Velten, J., & Margraf, J. (2017). Satisfaction guaranteed? How individual, partner, and Relationship factors impact sexual satisfaction within partnerships. PLoS One, e0172855.CrossRefGoogle Scholar

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