[Contribution of psychosexual approach to assessment and treatment of sexual dysfunction: a working model]

Abstract

Introduction: Increasing awareness and medical studies of sexual dysfunction (SD) unveil the multi-dimensional nature of SD and the need for a multidisciplinary treatment approach.

Purpose: To describe the psychosexual contribution to the multidisciplinary model for the assessment and treatment of SD.

Methods: The psychosexual contribution will be demonstrated by 4 case reports and data of subjects applying for sex therapy during 2004-8.

Outcomes: A total of 822 women (age 35 +/- 12.0 years) and 813 men (age 38 +/- 13.2 years) applied for sex therapy; 44% were referred by a physician, 37% found information on the internet or in other media resources. The most frequent SDs in women were: hypoactive sexual desire disorder (HSDD] (29.7%), sexual pain (28.5%) and anorgasmia (20.9%); and in men: erectile dysfunction (44.2%), premature ejaculation (24.5%) and HSDD (17.5%). Co-morbid relationship distress was found in 217 of the cases (26.5%).

Conclusions: Subjects, referred by a physician or on their own initiation, present a variety of SDs, stemming from a combination of physical, psychological and interpersonal contributing factors. The presenting sexual problem is frequently the tip of the iceberg of hidden psychological problems, relationship distress or partner's SD. The overall goal of treatment is increased pleasure and satisfaction, rather than achieving a perfect genital response. Therefore, successful treatment outcome depends on multi-professional assessment and successful resolution of the issues that accompany the sexual complaint, sharing the process with patients and their partners.