Volume 13, Issue 7 (9-2015)                   IJRM 2015, 13(7): 403-412 | Back to browse issues page

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Salmani Z, Zargham Boroujeni A, Salehi M, K.Killeen T, Merghati-Khoei E. The existing therapeutic interventions for orgasmic disorders: recommendations for culturally competent services, narrative review. IJRM. 2015; 13 (7) :403-412
URL: http://ijrm.ssu.ac.ir/article-1-669-en.html
1- Student Research Center, School Mursing and Midwifery, Isfahan University of Medical Science, Isfahan Iran
2- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan Iran
3- Psychosomatic research center, Isfahan University of Medical Sciences, Isfahan Iran
4- Addiction Science Division, Medical University of South Carolina, Charleston, South Carolina, USA
5- Sexual and Family Health Division in Brain and Spinal Injury Research Center (BASIR), Tehran University of Medical Sciences, Tehran, Iran , Effat_mer@yahoo.com
Abstract:   (1847 Views)
Background: In recent years, a growing number of interventions for treatment of female orgasmic problems (FODs) have emerged. Whereas orgasm is a extra biologically and learnable experience, there is a need for practitioners that to be able to select which therapy is the most appropriate to their context.
Objective: In this critical literature review, we aimed to assess areas of controversy in the existing therapeutic interventions in FOD with taking into accounted the Iranian cultural models.
Materials and Methods: For the present study, we conducted an extensive search of electronic databases using a comprehensive search strategy from 1970 till 2014. This strategy was using Google Scholar search, “pearl-growing” techniques and by hand-searching key guidelines, to identify distinct interventions to women's orgasmic problem therapy. We utilized various key combinations of words such as:" orgasm" OR "orgasmic "," female orgasmic dysfunction" OR Female anorgasmia OR Female Orgasmic Disorder ", orgasmic dysfunction AND treatment, “orgasm AND intervention”. Selection criteria in order to be included in this review, studies were required to: 1 employ clinical-based interventions, 2 focus on FOD.
Results: The majority of interventions (90%) related to non-pharmacological and other were about pharmacological interventions. Self-direct masturbation is suggested as the most privilege treatment in FOD. Reviewing all therapies indicates couple therapy, sexual skill training and sex therapy seem to be more appropriate to be applied in Iranian clinical settings.
Conclusion: Since many therapeutic interventions are introduced to inform sexually-related practices, it is important to select an intervention that will be culturally appropriate and sensitive to norms and values. Professionals working in the fields of health and sexuality need to be sensitive and apply culturally appropriate therapies for Iranian population. We further suggest community well defined protocols to screen, assessment and management of women’ sexual problems such as FOD in the Iranian settings.
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References
1. Polaschek N. Cultural safety: A new concept in nursing people of different ethnicities. Journal of Advanced Nursing-Institutional Subscription 1998;27:452-457. [DOI:10.1046/j.1365-2648.1998.00547.x]
2. Betancourt JR, Green AR, Carrillo JE, Ananeh-Firempong O. Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care. Public Health Reports 2003; 118: 293. [DOI:10.1016/S0033-3549(04)50253-4]
3. Merghati-Khoei E, Richters J. Concepts of sexuality and health among Iranian women in Australia. Aust Fam Physician 2008; 37: 190-192.
4. IsHak WW, Bokarius A, Jeffrey JK, Davis MC, Bakhta Y. Disorders of orgasm in women: A literature review of etiology and current treatments. The Journal of Sexual Medicine 2010; 7: 3254-3268. [DOI:10.1111/j.1743-6109.2010.01928.x]
5. Opperman E, Braun V, Clarke V, Rogers C. "It Feels So Good It Almost Hurts": Young Adults' Experiences of Orgasm and Sexual Pleasure. Journal of Sex Research 2013; 1-13.
6. Frühauf S, Gerger H, Schmidt HM, Munder T, Barth J. Efficacy of psychological interventions for sexual dysfunction: a systematic review and meta-analysis. Archives of Sexual Behavior 2013; 42: 915-933. [DOI:10.1007/s10508-012-0062-0]
7. Meston CM, Bradford A. Sexual dysfunctions in women. Annu Rev Clin Psychol 2007; 3: 233-256. [DOI:10.1146/annurev.clinpsy.3.022806.091507]
8. Graham CA. The DSM diagnostic criteria for female orgasmic disorder. Archives of Sexual Behavior 2010; 39: 256-270. [DOI:10.1007/s10508-009-9542-2]
9. Fabes RA, Martin CL. Gender and age stereotypes of emotionality. Personality and Social Psychology Bulletin 1991; 17: 532-540. [DOI:10.1177/0146167291175008]
10. Shirpak KR, Ardebili HE, Mohammad K, Maticka‐Tyndale E, Chinichian M, Ramenzankhani A, et al. Developing and testing a sex education program for the female clients of health centers in Iran. Sex Education 2007; 7: 333-349. [DOI:10.1080/14681810701636044]
11. Lavie-Ajayi M, Joffe H. Social representations of female orgasm. Journal of Health Psychology 2009; 14: 98-107. [DOI:10.1177/1359105308097950]
12. Redelman M. A general look at female orgasm and anorgasmia. Sexual Health 2006; 3: 143-153. [DOI:10.1071/SH06005]
13. Harris JM, Cherkas LF, Kato BS, Heiman JR, Spector TD. Normal Variations in Personality are Associated with Coital Orgasmic Infrequency in Heterosexual Women: A Population‐Based Study. J Sex Med 2008; 5: 1177-1183. [DOI:10.1111/j.1743-6109.2008.00800.x]
14. Widiger TA, Simonsen E. Introduction to the special section: The American Psychiatric Association's research agenda for the DSM–V. Journal of Personality Disorders 2005; 19: 103-109. [DOI:10.1521/pedi.19.2.103.62626]
15. Hayes RD, Bennett CM, Fairley CK, Dennerstein L. ORIGINAL RESEARCHEPIDEMIOLOGY: What can Prevalence Studies Tell Us about Female Sexual Difficulty and Dysfunction? J Sex Med 2006; 3: 589-595. [DOI:10.1111/j.1743-6109.2006.00241.x]
16. Bancroft J, Loftus J, Long JS. Distress about sex: A national survey of women in heterosexual relationships. Arch Sex Behav 2003; 32: 193-208. [DOI:10.1023/A:1023420431760]
17. Laumann E, Glasser D, Neves R, Moreira E. A population-based survey of sexual activity, sexual problems and associated help-seeking behavior patterns in mature adults in the United States of America. International Journal of Impotence Research 2009; 21: 171-178. [DOI:10.1038/ijir.2009.7]
18. Richters J, Grulich AE, Visser RO, Smith A, Rissel CE. Sex in Australia: Sexual difficulties in a representative sample of adults. Australian and New Zealand Journal of Public Health 2003; 27: 164-170. [DOI:10.1111/j.1467-842X.2003.tb00804.x]
19. Laumann EO, Nicolosi A, Glasser DB, Paik A, Gingell C, Moreira E, et al. Sexual problems among women and men aged 40–80 y: prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors. International J Impot Res 2005; 17: 39-57. [DOI:10.1038/sj.ijir.3901250]
20. Safarinejad M. Female sexual dysfunction in a population-based study in Iran: prevalence and associated risk factors. Int J Impot Res 2006; 18: 382-395. [DOI:10.1038/sj.ijir.3901440]
21. Goshtasbi A, Vahdaninia M, Rahimi Foroushani A, Mohammadi A. Reproductive correlates of female sexual dysfunctions in Kohgilouyeh-Boyerahmad Province: a population-based study. Payesh 2008; 1: 67-73.
22. Philpott A, Knerr W, Boydell V. Pleasure and prevention: when good sex is safer sex. Reprod Health Matters 2006; 14: 23-31. [DOI:10.1016/S0968-8080(06)28254-5]
23. Dunn KM, Cherkas LF, Spector TD. Genetic influences on variation in female orgasmic function: A twin study. Biol Lett 2005; 1: 260-263. [DOI:10.1098/rsbl.2005.0308]
24. Gagnon JH. The explicit and implicit use of the scripting perspective in sex research. Annual Review of Sex Research 1990; 1: 1-43.
25. Parker R. Sexuality, culture and society: shifting paradigms in sexuality research. Cult Health Sex 2009; 11: 251-266. [DOI:10.1080/13691050701606941]
26. Mah K, Binik YM. Are orgasms in the mind or the body? Psychosocial versus physiological correlates of orgasmic pleasure and satisfaction. J Sex Marital Ther 2005; 31: 187-200. [DOI:10.1080/00926230590513401]
27. Rodríguez MMD, Baumann AA, Schwartz AL. Cultural adaptation of an evidence based intervention: From theory to practice in a Latino/a community context. Am J Community Psychol 2011; 47: 170-186. [DOI:10.1007/s10464-010-9371-4]
28. Montorsi F, Basson R, Adaikan P, Becher E, Clayton A, Giuliano F, et al. Sexual medicine: Sexual dysfunction in Men and woman.Paris: Health Publications Ltd 2010;10-11.
29. Shokrollahi P, Mirmohamadi M, Mehrabi F, Babaei G. Prevalence of sexual dysfunction in women seeking services at family planning centers in Tehran. J Sex Marital Ther 1999; 25: 211-215. [DOI:10.1080/00926239908403995]
30. Shirpak KR, Chinichian M, Maticka-Tyndale E, Ardebili HE, Pourreza A, Ramenzankhani A. A qualitative assessment of the sex education needs of married Iranian women. Sexuality & Culture 2008;12:133-150. [DOI:10.1007/s12119-008-9023-0]
31. Farnam F, Janghorbani M, Raisi F, Merghati‐Khoei E. Compare the Effectiveness of PLISSIT and Sexual Health Models on Women's Sexual Problems in Tehran, Iran: A Randomized Controlled Trial. J Sex Med 2014; 11: 2679-2689. [DOI:10.1111/jsm.12659]
32. Rostamkhani F, Ozgoli G, Khoei EM, Jafari F, Majd HA. Effectiveness of the PLISSIT-based Counseling on sexual function of women. Journal of Shahid Beheshti School of Nursing & Midwifery 2012;22:1-9.
33. Gudarzi S. Female Orgasmic Disorder Treatment Using Cognitive-behavioral Approach. Advances in Life Sciences 2014; 4: 196-199.
34. Almas E, Landmark B. Non-pharmacological treatment of sexual problems–A review of research literature 1970–2008. Sexologies 2010; 19: 202-211. [DOI:10.1016/j.sexol.2010.09.011]
35. Meston CM, Hull E, Levin RJ, Sipski M. Disorders of orgasm in women. J Sex Med 2004; 1: 66-68. [DOI:10.1111/j.1743-6109.2004.10110.x]
36. Pereira VM, Arias-Carrión O, Machado S, Nardi AE, Silva AC. Sex therapy for female sexual dysfunction. Int Arch Med 2013; 6: 37. [DOI:10.1186/1755-7682-6-37]
37. Bitzer J, Brandenburg U. Psychotherapeutic interventions for female sexual dysfunction. Maturitas 2009; 63: 160-163. [DOI:10.1016/j.maturitas.2009.02.012]
38. Heiman JR. Sexual dysfunction: Overview of prevalence, etiological factors, and treatments. J Sex Res 2002; 39: 73-78. [DOI:10.1080/00224490209552124]
39. Cooper AJ. Frigidity, treatment and short-term prognosis. J Psychosom Res 1970; 14: 133-147. [DOI:10.1016/0022-3999(70)90023-1]
40. LoPiccolo J, Stock WE. Treatment of sexual dysfunction. J Consult Clin Psychol 1986; 54: 158-167. [DOI:10.1037/0022-006X.54.2.158]
41. Fichten CS, Libman E, Brender W. Methodological issues in the study of sex therapy: effective components in the treatment of secondary orgasmic dysfunction. J Sex Marital Ther 1983; 9: 191-202. [DOI:10.1080/00926238308405847]
42. Van Lankveld JJ. Bibliotherapy in the treatment of sexual dysfunctions: A meta-analysis. J Consult Clin Psychol 1998; 66: 702-708. [DOI:10.1037/0022-006X.66.4.702]
43. De Amicis LA, Goldberg DC, LoPiccolo J, Friedman J, Davies L. Clinical follow-up of couples treated for sexual dysfunction. Arch Sex Behav 1985; 14: 467-489. [DOI:10.1007/BF01541749]
44. Heiman JR, LoPiccolo J. Clinical outcome of sex therapy: effects of daily v weekly treatment. Arch Gen Psychiatry 1983; 40: 443-449. [DOI:10.1001/archpsyc.1983.01790040097013]
45. Kilmann PR. The treatment of primary and secondary orgasmic dysfunction: A methodological review of the literature since 1970. J Sex Marital Ther 1978; 4: 155-176. [DOI:10.1080/00926237808403015]
46. Smith WJ, Beadle K, Shuster EJ. The impact of a group psychoeducational appointment on women with sexual dysfunction. Am J Obstet Gynecol 2008; 198: 697. e1- e7.
47. Lewis RW, Fugl‐Meyer KS, Bosch R, Fugl‐Meyer AR, Laumann EO, Lizza E, et al. Epidemiology/risk factors of sexual dysfunction. J Sex Med 2004; 1: 35-39. [DOI:10.1111/j.1743-6109.2004.10106.x]
48. Kuriansky JB, Sharpe L, O'Connor D. The treatment of anorgasmia: Long-term effectiveness of a short-term behavioral group therapy. J Sex Marital Ther 1982; 8: 29-43. [DOI:10.1080/00926238208405810]
49. Hurlbert DF, Apt C. The coital alignment technique and directed masturbation: A comparative study on female orgasm. J Sex Marital Ther 1995; 21: 21-29. [DOI:10.1080/00926239508405968]
50. McCabe MP. Evaluation of a cognitive behavior therapy program for people with sexual dysfunction. J Sex Marital Ther 2001; 27: 259-271. [DOI:10.1080/009262301750257119]
51. Sarwer DB, Durlak JA. A field trial of the effectiveness of behavioral treatment for sexual dysfunctions. J Sex Marital Ther 1997; 23: 87-97. [DOI:10.1080/00926239708405309]
52. Billups KL, Berman L, Berman J, Metz ME, Glennon ME, Goldstein I. A new non-pharmacological vacuum therapy for female sexual dysfunction. J Sex Marital Ther 2001; 27: 435-441. [DOI:10.1080/713846826]
53. LoPiccolo J, Lobitz WC. The role of masturbation in the treatment of orgasmic dysfunction. Arch Sex Behav 1972; 2: 163-171. [DOI:10.1007/BF01541865]
54. Andersen BL. A comparison of systematic desensitization and directed masturbation in the treatment of primary orgasmic dysfunction in females. J Consult Clin Psychol 1981; 49: 568-570. [DOI:10.1037/0022-006X.49.4.568]
55. Anderson BL. Primary orgasmic dysfunction: Diagnostic considerations and review of treatment. Psychol Bull 1983; 93: 105-136. [DOI:10.1037/0033-2909.93.1.105]
56. Hurlbert DF, White LC, Powell RD, Apt C. Orgasm consistency training in the treatment of women reporting hypoactive sexual desire: An outcome comparison of women-only groups and couples-only groups. J Behav Ther Exp Psychiatry 1993; 24: 3-13. [DOI:10.1016/0005-7916(93)90003-F]
57. Munjack D, Cristol A, Goldstein A, Phillips D, Goldberg A, Whipple K, et al. Behavioural treatment of orgasmic dysfunction: a controlled study. Br J Psychiatry 1976; 129: 497-502. [DOI:10.1192/bjp.129.5.497]
58. Trudel G, Laurin F. The effects of bibliotherapy on orgasmic dysfunction and couple interactions: An experimental study. Sex Marital Ther 1988; 3: 223-228. [DOI:10.1080/02674658808407713]
59. Hoseini SS. Masturbation: Scientific Evidence and Islam's View. J Relig Health 2013: 1-6.
60. Auerbach R, Kilmann PR. The effects of group systematic desensitization on secondary erectile failure. Behav Ther 1977; 8: 330-339. [DOI:10.1016/S0005-7894(77)80065-8]
61. Everaerd W, Dekker J. Treatment of male sexual dysfunction: Sex therapy compared with systematic desensitization and rational emotive therapy. Behav Res Ther 1985; 23: 13-25. [DOI:10.1016/0005-7967(85)90138-X]
62. Kockott G, Dittmar F, Nusselt L. Systematic desensitization of erectile impotence: A controlled study. Arch Sex Behav 1975; 4: 493-500. [DOI:10.1007/BF01542127]
63. Mathews A, Bancroft J, Whitehead A, Hackmann A, Julier D, Bancroft J, et al. The behavioural treatment of sexual inadequacy: A comparative study. Behav Res Ther 1976; 14: 427-436. [DOI:10.1016/0005-7967(76)90089-9]
64. O'Gorman EC. The treatment of frigidity: a comparative study of group and individual desensitization. The Br J Psychiatry 1978; 132: 580-584. [DOI:10.1192/bjp.132.6.580]
65. Sotile WM, Kilmann PR. Treatments of psychogenic female sexual dysfunctions. Psychol Bull 1977; 84: 619-633. [DOI:10.1037/0033-2909.84.4.619]
66. Sotile WM, Kilmann PR. Effects of group systematic desensitization on female orgasmic dysfunction. Arch Sex Behav 1978; 7: 477-491. [DOI:10.1007/BF01542492]
67. Sotile WM, Kilmann P, Follingstad DR. A sexual-enhancement workshop: Beyond group systematic desensitization for women's sexual anxiety. J Sex Marital Ther 1977; 3: 249-255. [DOI:10.1080/00926237708402992]
68. Brown JM, Chaves JF. Hypnosis in the treatment of sexual dysfunction. J Sex Marital Ther 1980; 6: 63-74. [DOI:10.1080/00926238008404247]
69. Gilmore LG. Hypnotic metaphor and sexual dysfunction. J Sex Marital Ther 1987; 13: 45-57. [DOI:10.1080/00926238708403878]
70. Marrs RW. A meta-analysis of bibliotherapy studies. Am J Community Psychol 1995; 23: 843-870. [DOI:10.1007/BF02507018]
71. Barbach LG. Group treatment of preorgasmic women. J Sex Marital Ther 1974; 1: 139-145. [DOI:10.1080/00926237408405281]
72. Zeiss RA. Self-directed treatment for premature ejaculation. J Consult Clin Psychol 1978; 46: 1234. [DOI:10.1037/0022-006X.46.6.1234]
73. Glasgow RE, Rosen GM. Behavioral bibliotherapy: A review of self-help behavior therapy manuals. Psychol Bull 1978; 85: 1-23. [DOI:10.1037/0033-2909.85.1.1]
74. van Lankveld JJ, Everaerd W, Grotjohann Y. Cognitive‐behavioral bibliotherapy for sexual dysfunctions in heterosexual couples: A randomized waiting‐list controlled clinical trial in the Netherlands. J Sex Res 2001; 38: 51-67. [DOI:10.1080/00224490109552070]
75. Jack SJ, Ronan KR. Bibliotherapy practice and research. School Psychology International 2008;29:161-182. [DOI:10.1177/0143034308090058]
76. Leiblum SR. Becoming Orgasmic. By Julia R. Heiman and Joseph LoPiccolo. J Sex Educ Ther 1997; 22: 52-53. [DOI:10.1080/01614576.1997.11074197]
77. Hartman WE, Fithian MA. Treatment of sexual dysfunction. Am J Fam Ther 1974; 2: 68-80. [DOI:10.1080/01926187408250944]
78. Kilmann PR, Boland JP, Norton SP, Davidson E, Caid C. Perspectives of sex therapy outcome: a survey of AASECT providers. J Sex Marital Ther 1986; 12: 116-138. [DOI:10.1080/00926238608415400]
79. LoPiccolo J, Miller VH. Procedural outline: Sexual enrichment groups. Couns Psychol 1975. [DOI:10.1177/001100007500500111]
80. BeatriceBean'E R, Bockting WO, Rosser BS, Miner M, Coleman E. The sexual health model: application of a sexological approach to HIV prevention. Health Educ Res 2002; 17: 43-57. [DOI:10.1093/her/17.1.43]
81. Westheimer RK, Lopater S, Westheimer, Lopater. Human sexuality: A psychosocial perspective: Lippincott Williams & Wilkins; 2002:88.
82. Leiblum SR, Wiegel M. Psychotherapeutic interventions for treating female sexual dysfunction. World J Urol 2002; 20: 127-136. [DOI:10.1007/s00345-002-0266-3]
83. Leiblum SR. After sildenafil: bridging the gap between pharmacologic treatment and satisfying sexual relationships. J Clin Psychiatry 2002; 63: 17-22.
84. Sue S, Zane N, Hall GCN, Berger LK. The case for cultural competency in psychotherapeutic interventions. Annu Rev Psychol 2009; 60: 525-548. [DOI:10.1146/annurev.psych.60.110707.163651]
85. Hatfield E, Rapson RL. Passionate love/sexual desire: Can the same paradigm explain both? Arch Sex Behav 1987; 16: 259-278. [DOI:10.1007/BF01541613]
86. Baumeister RF, Twenge JM. Cultural suppression of female sexuality. Rev Gen Psychol 2002; 6: 166. [DOI:10.1037/1089-2680.6.2.166]
87. Laan E, Rellini AH. Can we treat anorgasmia in women? The challenge to experiencing pleasure. Sex Relation Ther 2011; 26: 329-341. [DOI:10.1080/14681994.2011.649691]
88. Sanchez DT, Kiefer AK, Ybarra O. Sexual submissiveness in women: Costs for sexual autonomy and arousal. Pers Soc Psychol Bull 2006; 32: 512-524. [DOI:10.1177/0146167205282154]
89. Ahmad-Nia S. Women's work and health in Iran: a comparison of working and non-working mothers. Soc Sci Med 2002; 54: 753-765. [DOI:10.1016/S0277-9536(01)00107-1]
90. Merghati-Khoei E, Whelan A, Cohen J. Sharing beliefs: what sexuality means to Muslim Iranian women living in Australia. Cult Health Sex 2008; 10: 237-248. [DOI:10.1080/13691050701740039]
91. Laumann EO, Paik A, Rosen RC. Sexual dysfunction in the United States. JAMA, 1999; 281: 537-544. [DOI:10.1001/jama.281.6.537]
92. Brody S, Costa RM. Sexual satisfaction and health are positively associated with penile-vaginal intercourse but not other sexual activities. Am J Public Health 2012; 102: 6-7. [DOI:10.2105/AJPH.2011.300428]
93. Brody S, Weiss P. Vaginal orgasm is associated with vaginal (not clitoral) sex education, focusing mental attention on vaginal sensations, intercourse duration, and a preference for a longer penis. J Sex Med 2010; 7: 2774-2781. [DOI:10.1111/j.1743-6109.2009.01469.x]
94. Leong FT. Cultural accommodation model of counseling. J Employ Couns 2011; 48: 150-152. [DOI:10.1002/j.2161-1920.2011.tb01099.x]
95. Tepper MS. Sexuality and disability: the missing discourse of pleasure. Sex Disabil 2000; 18: 283-290. [DOI:10.1023/A:1005698311392]
96. Tiefer L. Female sexual dysfunction: A case study of disease mongering and activist resistance. PLoS Med 2006; 3: e178. [DOI:10.1371/journal.pmed.0030178]
97. Merghati Khoei E, Whelan A, Cohen J. Sharing beliefs: What sexuality means to Muslim Iranian women living in Australia. Cult health sex 2008; 10: 237-248. [DOI:10.1080/13691050701740039]

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