SEXUAL DYSFUNCTION

Sexual Dysfunction

Sexual Dysfunction

Introduction

The specific weaknesses in sexual dysfunction research fall into predictable areas. One problem is that treatment manuals are rather uncommon for the treatment of sexual problems, at least in the form we have come to know them. A second reason for the lack of empirically validated treatment is the lack of control groups. Clinical researchers have, for ethical reasons, preferred waiting-list controls over placebos, and reasonably efficacious alternative treatments have not been available for most of the dysfunctions. A third issue is the overwhelming and widespread impact of the Masters and Johnson text. Never, before or since, has such a large number of individuals (N - 792) with sexual problems been treated with such clearly described treatment techniques, and with a high success rate (overall 15% failure rate), including a 5-year follow-up.

Though methodological problems are clearly present in Masters and Johnson's work, particularly the fact that there was only one therapist-generated nonstandardized item that measured outcome, its impact truly brought sexual dysfunction research into the forefront so that increasingly systematic research might eventually be designed. In fact, more controlled research was delayed by the fact that there were no readily comparable and relatively successful treatments that seemed legitimate to offer as serious alternatives to Masters and Johnson's approach.

EMPIRICALLY VALIDATED TREATMENT FOR SEXUAL DYSFUNCTION Sexual Dysfunctions in Women

Orgasmic Dysfunctions

As is evident from the NHSLS, orgasmic disorders are common conditions among women and remain fairly constant across each five-year-age group between 18 and 59 (with a range from 19% at ages 45 to 49 to 28% at ages 30 to 34). By contrast, data from the same national sample showed that 29% of women reported always being orgasmic with their partner, 41% reported being extremely physically satisfied with their partner, and 39% reported being extremely emotionally satisfied with their partner (Laumann et al., 1994). Although previous researchers have not consistently shown socioeconomic status to be related to women's orgasmic experiences, the NHSLS found that low income women were somewhat more likely to report inability to experience orgasm than those classified as high income (27% vs. 21%), and women with less than a high school education reported greater orgasmic incapacity than those who had finished college (30% vs. 19%). Master's level and advanced degree women reported a comparably low orgasmic inability of 13%. One must be cautious about interpreting these results as indicative of only primary orgasmic dysfunction. The question posed was whether or not, in the past 12 months, there was ever a period of several months or more when the inability to have an orgasm was a problem. Because some of the women concerned may have had orgasm prior to the 12-month point, it is likely that this category includes women with both primary and secondary anorgasmia (Rosen & Leiblum, 1995).

Several other sources corroborate the finding that primary and secondary orgasmic disorders are common among women. Here we shall use primary anorgasmia to refer to lifelong and global anorgasmia and secondary anorgasmia to refer ...