Female Sexual Dysfunction Treatment

Although the way in which female sexual arousal disorder and female orgasmic disorder are expressed shows a wide degree of variation, there is no evidence to suggest either that different factors contribute to the two disorders or that different treatment strategies should be used. In fact, the same treatment strategies are generally applied for both disorders. These strategies may need to be supplemented with additional techniques to resolve specific problems for individual women, but they are generally good starting points for resolving the issues that contribute to the development and maintenance of the sexual problem. Because the relationship between the woman and her partner has been shown to play a significant role in both the development and the maintenance of sexual problems, most programs are designed to be implemented by the couple, although there may also be additional strategies that focus on the individual.

If the woman is in a relationship, it is important that both partners be involved in the treatment process. Even if difficulties in the relationship were not initially responsible for the development of the orgasmic or arousal problems, once the sexual problem has developed, the relationship between the partners is influenced by the sexual disorder. Furthermore, once the woman begins to address (within the treatment process) issues related to her sexual dysfunction, changes occur in the sexual aspects of the relationship, and this, in turn, influences other areas of the relationship. Unless the partner is involved in this process of change, he (or she, for homosexual relationships) may act in ways that impede the therapeutic process. Strategies for treating orgasmic or arousal problems in women who are not involved in relationships are covered later in this chapter.

Sensate Focus
The first comprehensive treatment program for sexual dysfunction was developed by Masters and Johnson (1970). This program was implemented on a residential basis for men and women who were experiencing problems in their sexual functioning. To be eligible for treatment, people needed to be in a relationship, and both partners were required to attend the treatment program. The same treatment strategies were used for all female sexual disorders.

The essential ingredient of the Masters and Johnson program was sensate focus. Sensate focus is a useful strategy for overcoming the anxiety associated with the need to perform well. Women often feel under pressure to become aroused and to have an orgasm during intercourse as a means of proving their sexual adequacy. Sensate focus is designed to help the woman learn a wide range of touching and sexual skills that are enjoyable in themselves and thus remove the feeling of being under pressure to prove herself in intercourse. Sensate focus also helps in building communication between partners so that they can give each other clear directions (both verbally and nonverbally) with regard to methods of touching, so as to enhance the arousal of both partners. Finally, sensate focus may allow the woman to become more open and creative about exploring her sexual self and offer an opportunity to challenge some of her attitudes about sex that have come from her upbringing or previous experience.