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Sexual Dysfunction

Correspondence: Address correspondence to Waguih William IsHak, M.D., Department of Psychiatry, UCLA School of Medicine, Los Angeles, California, 8730 Alden Drive, Thalians W-157, Los Angeles, CA 90048.

Sexual dysfunction encompasses disorders of the sexual response cycle or sex-related pain. Disorders of desire include hypoactive sexual desire disorder and sexual aversion disorder. Disorders of arousal include male erectile disorder and female arousal disorder. Disorders of orgasm include premature ejaculation, female orgasmic disorder, and male orgasmic disorder. Sexual pain disorders include vaginismus and dyspareunia. In recent years, the treatment of sexual dysfunction has shifted from mostly psychosocial interventions, such as sex therapy, to the use of recently developed biochemical interventions, such as the phosphodiesterase type 5 inhibitors. However, the increased focus on the medical treatment of erectile problems has been accompanied by a neglect of the biopsychosocial factors that affect the couple. This clinical synthesis provides up-to-date information on evaluating individuals and couples and on empirically based treatments. Each of the sexual disorders will be discussed from the phenomenological, etiological, and therapeutic angles.

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