Sexual dysfunctions in women

Sexual dysfunctions in women are classified into disorders of desire, arousal, orgasm, and pain (including dyspareunia and vaginismus). As the psychological treatment procedures differ between these sexual disorders the treatments for each disorder are reviewed separately. To state if a treatment is evidence based we follow the criteria of Chambless and Hollon (1998). In total, 23 controlled studies investigated the effect of a psychological treatment for women with a sexual dysfunction. Only directed masturbation for primary anorgasmia fulfilled the criteria of well established. Orgasm consistency training, coital alignment and cognitive behavior therapy, including sensate focus exercises, are promising approaches in the treatment of hypoactive sexual desire disorder. There are no evidence-based psychological treatments for arousal disorder, but directed masturbation or comparable approaches may be as effective for arousal disorder as they are for orgasm disorders although we await the evidence on this possibility. There are no well-established psychological treatments for dyspareunia and vaginismus; however, cognitive behavior therapy and electromyographic biofeedback training are promising treatment procedures for dyspareunia. Focusing explicitly and systematically on exposure to stimuli feared during penetration appears to be an effective treatment for women with vaginismus. It is concluded that only a few psychological treatments for women's sexual dysfunction are empirically supported and that little is known about which of the treatment components are most effective.