New management approaches for female sexual dysfunction.
Journal
Current opinion in obstetrics & gynecology
ISSN: 1473-656X
Titre abrégé: Curr Opin Obstet Gynecol
Pays: England
ID NLM: 9007264
Informations de publication
Date de publication:
01 Aug 2024
01 Aug 2024
Historique:
medline:
7
8
2024
pubmed:
7
8
2024
entrez:
7
8
2024
Statut:
aheadofprint
Résumé
The goal of this paper is to review the most recent studies evaluating treatments for female sexual dysfunction (FSD), including distressing symptoms of desire, arousal, and orgasm disorder. We divide the sections into psychological and pharmacological. There is excellent evidence in favour of mindfulness, cognitive behavioural therapy, and psychoeducation for improving low sexual desire in women, and less evidence in support of these approaches to address other sexual dysfunctions in women. There are two US Food and Drug Administration (FDA) approved pharmacological treatments for low desire in premenopausal women that have modest benefits above placebo, and a significant proportion of users will experience side effects. Evidence also supports the use of transdermal testosterone for low desire in postmenopausal women. Sexual dysfunction in women is common and distressing, and there are a variety of psychological and pharmacological treatments. More research is needed to better understand the predictors of a positive treatment response in order to deliver more personalized care.
Identifiants
pubmed: 39109594
doi: 10.1097/GCO.0000000000000984
pii: 00001703-990000000-00148
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Références
Brotto LA, Basson R, Luria M. A mindfulness-based group psychoeducational intervention targeting sexual arousal disorder in women. J Sex Med 2008; 5:1646–1659.
Zarski AC, Velten J, Knauer J, et al. Internet- and mobile-based psychological interventions for sexual dysfunctions: a systematic review and meta-analysis. NPJ Digit Med 2022; 5:139.
Mirzaee F, Ahmadi A, Zangiabadi Z, et al. The effectiveness of psycho-educational and cognitive-behavioral counseling on female sexual dysfunction. Rev Bras Ginecol Obstet 2020; 42:333–339.
Rashedi S, Maasoumi R, Vosoughi N, et al. The effect of mindfulness-based cognitive-behavioral sex therapy on improving sexual desire disorder, sexual distress, sexual self-disclosure and sexual function in women: a randomized controlled clinical trial. J Sex Marital Ther 2021; 48:475–488.
Mohammadi M, Khani MB. Comparing the effect of face-to-face education and using educational films on couples’ sexual dysfunction during pregnancy. J Educ Health Promot 2021; 10:335.
Bolsoy N, Sen S, Sezer G, et al. The effect of training on women with postpartum sexual dysfunction: a randomized controlled trial. Niger J Clin Pract 2023; 26:949–956.
Nazarpour S, Simbar M, Ramezani Tehrani F, et al. Effects of sex education and Kegel exercises on the sexual function of postmenopausal women: a randomized clinical trial. J Sex Med 2017; 14:959–967.
Vakili Z, Noroozi M, Ehsanpoor S. Comparing the effects of two methods of group education and peer education on sexual dysfunction of menopausal women: a randomized controlled trial. Iran J Nurs Midwifery Res 2019; 24:187–192.
Alavipour N, Masoumi SZ, Kazemi F, et al. Randomized controlled trial protocol for evaluating the effect of group education on postmenopausal sexual dysfunction. J Menopausal Med 2020; 26:112–120.
Sasanpour M, Azh N, Alipour M. The effect of a midwife-based group discussion education on sexual dysfunction beliefs in rural postmenopausal women. Int J Womens Health 2020; 12:393–397.
Brotto LA, Zdaniuk B, Chivers ML, et al. A randomized trial comparing group mindfulness-based cognitive therapy with group supportive sex education and therapy for the treatment of female sexual interest/arousal disorder. J Consult Clin Psychol 2021; 89:626–639.
Zippan N, Stephenson KR, Brotto LA. Feasibility of a brief online psychoeducational intervention for women with sexual interest/arousal disorder. J Sex Med 2020; 17:2208–2219.
Masters WH, Johnson VE. Human sexual inadequacy. NYC:Bantam Books; 1970.
Seal BN, Meston CM. The impact of body awareness on sexual arousal in women with sexual dysfunction. J Sex Med 2007; 4:990–1000.
Avery-Clark C, Weiner L, Adams-Clark AA. Sensate focus for sexual concerns: an updated, critical literature review. Curr Sex Health Rep 2019; 11:84–94.
Weiner L, Avery-Clark C. Sensate focus in sex therapy: the illustrated manual. Abingdon, Oxfordshire:Taylor & Francis; 2017.
Alarcão V, Ribeiro S, Almeida J, Giami A. Clinical practice in Portuguese sexology. J Sex Marital Ther 2017; 43:760–773.
Tajik M, Shahali S, Shadjoo K. The co-effect of sensate focus technique and sexual position changing on sexual function of women who use medical treatment for endometriosis. J Obstet Gynaecol 2022; 42:3706–3711.
Fraser EE, Downing MG, Haines K, et al. Experience of adapted cognitive behaviour therapy to address sexuality problems after traumatic brain injury: a qualitative study. Neuropsychol Rehabil 2023; 34:572–599.
Hummel SB, van Lankveld JJDM, Oldenburg HSA, et al. Internet-based cognitive behavioral therapy realizes long-term improvement in the sexual functioning and body image of breast cancer survivors. J Sex Marital Ther 2018; 44:485–496.
Sheikh Miri A, Iravani M, Boostani H, et al. The effect of cognitive behavioral therapy on sexual function in reproductive aged women with hypothyroidism: a randomized controlled clinical trial. BMC Psychiatry 2023; 23:357.
Nobre PJ, Barlow DH. Barlow's cognitive-affective model of sexual dysfunction. In: Encyclopedia of sexuality and gender. 2023; Cham, Switzerland:Springer International Publishing, 1–9.
Nobre PJ. Nobre's cognitive-emotional model of sexual dysfunction. In: Encyclopedia of sexuality and gender. Springer International Publishing; 2023:1--9.
Pascoal PM, Rosa PJ, da Silva EP, et al. Sexual beliefs and sexual functioning: the mediating role of cognitive distraction. Int J Sexual Health 2018; 30:60–71.
Mahar EA, Mintz LB, Akers BM. Correction to: orgasm equality: scientific findings and societal implications. Curr Sex Health Rep 2020; 12:33.
Moura CV, Tavares IM, Nobre PJ. Cognitive-affective factors and female orgasm: a comparative study on women with and without orgasm difficulties. J Sex Med 2020; 17:2220–2228.
Tavares IM, Laan ETM, Nobre PJ. Cognitive-affective dimensions of female orgasm: the role of automatic thoughts and affect during sexual activity. J Sex Med 2017; 14:818–828.
Marchand E. Psychological and behavioral treatment of female orgasmic disorder. Sex Med Rev 2021; 9:194–211.
Chizary M, Aghdam NS, Ranjbaran M, et al. The effect of assertiveness-focused cognitive-behavioral group therapy on women's orgasm: a randomized clinical trial. Int J Women Health Reprod Sci 2023; 11:82–88.
Brotto LA. Evidence-based treatments for low sexual desire in women. Front Neuroendocrinol 2017; 45:11–17.
Lerner T, Bagnoli VR, de Pereyra EAG, et al. Cognitive-behavioral group therapy for women with hypoactive sexual desire: a pilot randomized study. Clinics 2022; 77:100054.
Stephenson KR, Zippan N, Brotto LA. Feasibility of a cognitive behavioral online intervention for women with sexual interest/arousal disorder. J Clin Psychol 2021; 77:1877–1893.
Bishop SR, Lau M, Shapiro S, et al. Mindfulness: a proposed operational definition. Clin Psycho Sci Pract 2004; 11:230–241.
Fox KCR, Nijeboer S, Dixon ML, et al. Is meditation associated with altered brain structure? A systematic review and meta-analysis of morphometric neuroimaging in meditation practitioners. Neurosci Biobehav Rev 2014; 43:48–73.
Brotto LA, Stephenson KR, Zippan N. Feasibility of an online mindfulness-based intervention for women with sexual interest/arousal disorder. Mindfulness (N Y) 2022; 13:647–659.
Toates F. An integrative theoretical framework for understanding sexual motivation, arousal, and behavior. J Sex Res 2009; 46:168–193.
Nobre P, Pinto-Gouveia J. Dysfunctional sexual beliefs as vulnerability factors for sexual dysfunction. J Sex Res 2006; 43:68–75.
Laan E, Both S. What makes women experience desire? Fem Psychol 2008; 18:505–514.
Jąderek I, Obarska K, Lew-Starowicz M. Assessment of the effect of mindfulness monotherapy on sexual dysfunction symptoms and sex-related quality of life in women. Sex Med 2023; 11:qfad022.
Johnson SM. The practice of emotionally focused couple therapy: creating connection. 3rd ed. NYC:Routledge/Taylor & Francis Group; 2019.
Christensen A, Doss B, Jacobson NS. Integrative behavioral couple therapy: a therapist's guide to creating acceptance and change. 2nd ed. NYC:Norton; 2020.
Wiebe SA, Elliott C, Johnson SM, et al. Attachment change in emotionally focused couple therapy and sexual satisfaction outcomes in a two-year follow-up study. J Couple Relat Ther 2019; 18:1–21.
Rothman K, Cicila LN, McGinn M, et al. Trajectories of sexual satisfaction and frequency during and After couple therapy for relationship distress. J Sex Marital Ther 2021; 47:209–223.
Johnson SM, Simakhodskaya Z, Moran M. Addressing issues of sexuality in couples therapy: emotionally focused therapy meets sex therapy. Curr Sex Health Rep 2018; 10:65–71.
Rosenthal MN, Dehle C. Coming together: synthesizing sex therapy with integrative behavioral couple therapy. J Sex Marital Ther 2023; 49:700–713.
Pfaus JG. Pathways of sexual desire. J Sex Med 2009; 6:1506–1533.
Simon JA, Thorp J, Millheiser L. Flibanserin for premenopausal hypoactive sexual desire disorder: pooled analysis of clinical trials. J Womens Health 2019; 28:769–777.
Simon JA, Kingsberg SA, Shumel B, et al. Efficacy and safety of flibanserin in postmenopausal women with hypoactive sexual desire disorder: results of the SNOWDROP trial. Menopause 2014; 21:633–640.
Simon JA, Clayton AH, Parish SJ, et al. Effects of alcohol administered with flibanserin in healthy premenopausal women: a randomized, double-blind, single-dose crossover study. J Sex Med 2020; 17:83–93.
Kingsberg SA, Clayton AH, Portman D, et al. Bremelanotide for the treatment of hypoactive sexual desire disorder: two randomized Phase 3 trials. Obstet Gynecol 2019; 134:899–908.
Mayer D, Lynch SE. Bremelanotide: new drug approved for treating hypoactive sexual desire disorder. Ann Pharmacother 2020; 54:684–690.
Davis SR, Baber R, Panay N, et al. Global consensus position statement on the use of testosterone therapy for women. J Clin Endocrinol Metab 2019; 104:4660–4666.
Parish SJ, Simon JA, Davis SR, et al. International society for the study of women's sexual health clinical practice guideline for the use of systemic testosterone for hypoactive sexual desire disorder in women. J Sex Med 2021; 18:849–867.