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Sexuality and Sexual Dysfunction
Published in Jane M. Ussher, Joan C. Chrisler, Janette Perz, Routledge International Handbook of Women’s Sexual and Reproductive Health, 2019
Most psychological treatments of female sexual dysfunction include couples counseling, behavioral sensate-focus exercises, mindfulness meditation, or a combination of these interventions. Although randomized controlled trials are still scarce, research suggests that psychological therapies—especially cognitive-behavioral and/or mindfulness-based interventions—are effective in treating female sexual dysfunctions (Frühauf, Gerger, Schmidt, Munder, & Barth, 2013). More studies are, however, needed to distinguish which aspects of the commonly used treatment programs are the effective components (Ahn & Wampold, 2001) and whether combinations of psychological and pharmacological treatments improve therapy outcomes (Brotto, 2015).
Dyspareunia and other psychosexual problems
Published in David M. Luesley, Mark D. Kilby, Obstetrics & Gynaecology, 2016
This is now often referred to as hypoactive sexual desire disorder (HSDD). This usually presents as loss of libido (loss of interest in sex). It should also be remembered that there is huge variability between individuals and within the normal range. Interest in sex declines in both sexes with increasing age, but this change is more pronounced in women. The prevalence of ‘low sexual desire’ is about 30 percent but the personal distress is about 20 percent from this problem and is highest in middle-aged women. Sometimes it is the disparity between partners that leads a woman or couple to seek help. Risk factors for female sexual dysfunction may be non-hormonal (e.g. conflict between partners, insomnia, inadequate stimulation, life stress, depression and other medical disorders such as hypothyroidism/diabetes) or hormonal (oestrogen and androgen deficiency). Testosterone deficiency can be considered among the underlying causes of desire disorders in post-menopausal women but no level of a single androgen is predictive of low sexual function in women. However, post-menopausal oestrogen deficiency does cause atrophic changes and lead to painful sex, which can in itself lead to a decrease in desire as well as any direct effect of oestrogen within the brain. Testosterone should only be replaced together with oestrogens.
Genitals
Published in Lisa Jean Moore, Monica J. Casper, The Body, 2014
Lisa Jean Moore, Monica J. Casper
Female sexual dysfunction is a term used to describe recurrent or persistent problems with sexual response or sexual desire in women. Obviously, the term raises the political, ethical question: for whom is women’s sexual response perceived to be a problem? Sociologist and bioethicist Jennifer Fishman (2004), among other critics, has suggested that female sexual dysfunction was manufactured by the pharmaceutical industry intent on seeking new markets for drugs.
An online sensate focus application to treat sexual desire discrepancy in intimate relationships: contrasting case studies
Published in Sexual and Relationship Therapy, 2023
A small number of studies exist that have examined the efficacy of online treatments for sexual dysfunctions. These treatments have shown promise for both male and female sexual dysfunctions. For example, Jones and McCabe (2011; McCabe & Jones, 2013) created two online intervention programs, Revive and Pursuing Pleasure, to treat female sexual dysfunction using cognitive behavioral therapy tools, mindfulness, and chat rooms (the latter two were only present in Pursuing Pleasure). Both programs showed a significant decrease in frequency of sexual difficulties and associated distress (Jones & McCabe, 2011; McCabe & Jones, 2013). Recently, Zippan et al. (2020) developed eSense, which is also a computer-assisted online intervention for female sexual dysfunctions. An initial feasibility study of eSense showed that participants were satisfied with the program and experienced higher levels of sexual desire, arousal, and satisfaction after a week (Zippan et al., 2020). Together these initial studies show that female sexual dysfunction can successfully be treated using online interventions. These programs are designed for women to complete by themselves without their partner. While these interventions have shown promise, it may be more beneficial to address sexual desire in a relationship context.
Postmenopausal sexual function and steroid hormone levels: a hospital-based cross-sectional study
Published in Climacteric, 2023
E. Nunes, E. Gallardo, S. Morgado-Nunes, J. Fonseca-Moutinho
With the increase in average life expectancy, nearly half of a woman’s life will be spent in the postmenopausal period. Although the frequency of sexual activity declines with age [1,2], older women engage in frequent and satisfying sexual activity [3]. Women want to talk more often about sexuality-related problems with their doctors and there is growing awareness in the medical community regarding this issue. Often seen as a minor problem in relation to all of the problems that exist at this stage of life, studies carried out in recent decades have shown that this issue is important for the maintenance of quality of life [4]. In a large study from the USA investigating the sexual experiences of 31,000 women aged 18–102 years, the prevalence of sexual problems increased with age: 27.2% for age 18–44 years, 44.6% for age 45–64 years and 80.1% for age 65 years and older [5]. However, a few studies mention that distress related to sexual problems changes little with age [6] or even declines [5] and the worldwide prevalence of sexual dysfunction among women 40–80 years old is estimated to be 43% [7]. The etiology of female sexual dysfunction includes biological, psychological, interpersonal and sociocultural risk factors [8]. In addition to lower self-esteem, relationship issues, mental health problems with higher prevalence of depression and chronic diseases such as diabetes, postmenopausal hormonal changes play an important role [9].
Effects of the Better Model Based Counseling on Sexuality of Women with Breast Cancer
Published in International Journal of Sexual Health, 2022
Zeynep Ozkan Olcer, Umran Oskay
Nurses spend most of their working time with patients. They play important roles in evaluating sexual life in breast cancer, detecting potential sexual issues, promoting sexual health, coping with sexual problems, referring these individuals to relevant departments when necessary and enhancing the overall quality of life. Women with breast cancer experience less sexual problems after nursing interventions (Boquiren et al., 2016, p. 66–67; Demirci et al., 2011, p. 1283; Kedde et al., 2013, p. 1993–1994; Krebber et al., 2014, p. 121–122; Pinto, 2013). Interventions applied for female sexual dysfunction range from lifestyle changes, education, sexual counseling, sex aids (lidocaine preparations, lubricants etc.), and dietary supplements to non-hormonal medications. All of these approaches are useful (Awan & Esfahani, 2018, p. 285–286). However, it is often difficult to talk about sexuality, thus leading nurses not to address this issue (Almeida et al., 2019, p. 1109–1110). Sexual problems are not routinely asked and even little counseling is provided for these problems (Katz, 2005, p. 238–239). In Turkey, likewise, women with breast cancer are not asked about their sexual problems so nurses do not provide the related counseling. However, professional nursing care for patients with breast cancer should include counseling on psychosocial and sexual issues (Johnson et al., 2018).