Sexual well-being is an important element of sexual health in women. Sexual health is defined as safe sexual experiences free from oppression, discrimination and violence, with a state of physical, emotional, mental and social well-being.
In underdeveloped societies, sexual development is either suppressed or experienced negatively due to social pressure. The mainstay of sexual health includes fertility management, prevention of sexual violence, prevention of sexually transmitted infections, and sexual function, desire and arousal.
Female sexual dysfunctions are defined as when an individual experiences a clinically significant impairment in the physiological ability to respond or enjoy sexually in the presence of favorable conditions that also provide adequate and effective stimulation. Sexual sensitivity is influenced by personal, interpersonal and sociocultural factors. Therefore, a separate assessment should be made for each individual.
Female sexual dysfunction; includes female orgasmic disorder, female sexual interest/arousal disorder, and genito-pelvic pain/penetration disorder.
Obstacles to orgasm are not due to a lack of clitoral stimulation during vaginal penetration, a mental disorder, a drug/substance, a history of abuse, or interpersonal or sociocultural factors. Consider whether you have ever had an orgasm under any circumstances. Diagnosis is based on women's subjective, self-reported reports. Non-sexual mental disorders, substance/drug use, other medical conditions, interpersonal factors, other sexual dysfunctions.
The other problem is female sexual interest/arousal disorder. Another accused condition is genitopelvic pain/penetration disorder. The topic of genitopelvic pain is a very long and comprehensive one.
The treatment approach in orgasmic disorders is to encourage changes in attitudes and thoughts, to reduce anxiety, to increase orgasmic ability and sexual satisfaction.
Treatment of sexual interest/arousal disorder is a reward that approaches other aspects of a woman's sexual function; for example, arousal response and lubrication, orgasmic ability, reduction of pain, enhancement of erotic stimulation skills and improvement of couples' relationships
The treatment for genitopelvic pain is to reduce the fear of serious pain by focusing on pain and sexuality. This includes restoring satisfying sexuality, pelvic floor exercises. Using lubricant during sexual intercourse will support pain relief.
Sex education, cognitive restructuring, communication education, Kegel exercises, directed masturbation, tools from sensate focus therapy or sex therapy, communication exercises, emotional communication skills training, sexual fantasy training, orgasm consistency training is among the treatment modalities in orgasm and arousal disorder.
In genitopelvic pain disorder, muscle relaxation, abdominal breathing, kegel exercises, vaginal dilation, distraction techniques including focusing on sexuality, communication skills training and cognitive restructuring are among the treatment modalities.
- Mindfulness-based interventions: Mindfulness-based interventions have gained popularity in recent years as a way to reduce stress and improve well-being. These interventions involve focusing on the present moment and non-judgmentally observing one's thoughts and feelings. Mindfulness-based interventions have been found to be effective in treating sexual difficulties in women, particularly in cases of low desire and sexual pain.
- Sensate Focus Therapy: This therapy aims to enhance sexual arousal and intimacy through non-sexual and sensual touch. It involves a series of exercises where partners explore and focus on pleasurable sensations without the pressure of sexual performance. Sensate focus can help reduce anxiety and increase body awareness and intimacy. Sensate focus therapy has been found to be effective in treating sexual difficulties in women, particularly in cases of low desire and difficulty achieving orgasm.
- Behavioral Experiments: Behavioral experiments involve the systematic testing of new behaviors or thoughts related to sexual experiences. By challenging and modifying unhelpful patterns or assumptions, individuals can gain new insights and develop more adaptive sexual responses.
- Cognitive-behavioral therapy: CBT is a well-established therapeutic approach used in the treatment of various psychological conditions. It focuses on identifying and modifying negative thoughts, beliefs, and behaviors that may contribute to sexual difficulties. CBT techniques may include cognitive restructuring, psychoeducation, and the development of coping strategies. CBT has been found to be effective in treating sexual difficulties in women, particularly in cases of low desire and sexual pain.
- Communication and Relationship Enhancement (CARE): Open and effective communication is vital in addressing sexual difficulties within a relationship. Therapists may help couples improve communication skills, express desires and concerns, and foster emotional intimacy.
- Directed Masturbation Training: This technique involves self-exploration to enhance sexual pleasure and arousal. Through guidance and self-observation, individuals can better understand their sexual responses and preferences.
- Teletherapy: Teletherapy, or therapy conducted via phone or video chat, has become more widely available and accepted in recent years. Teletherapy can be a convenient and cost-effective way for women to access behavioral treatments for FSDs, particularly for those who live in rural areas or have difficulty traveling to in-person appointments. Teletherapy has been found to be effective in treating sexual difficulties in women, particularly in cases of low desire and sexual pain.
- Systematic Desensitization: This method aims to reduce anxiety or aversion related to sexual stimuli by gradually exposing individuals to their feared or avoided situations. It involves creating a hierarchy of anxiety-provoking situations and systematically working through them in a controlled and supportive environment.
It is crucial to note that the choice of behavioral treatment may vary depending on the specific type of female sexual dysfunction (e.g., hypoactive sexual desire disorder, arousal disorder, orgasmic disorder) and the individual's unique circumstances. Treatment plans are often tailored to address the specific needs and goals of each person.
Behavioral treatments have long been recognized as an effective way to treat FSDs, and recent innovations have expanded the potential of these treatments to help women with sexual difficulties. Mindfulness-based interventions, sensate focus therapy, cognitive-behavioral therapy, and teletherapy are all promising avenues for treatment, and further research is needed to determine their long-term effectiveness and optimal implementation. With continued innovation and research, behavioral treatments have the potential to significantly improve the sexual health and well-being of women with FSDs.