Treatment of most sexual dysfunctions begins with a medical history and workup to identify any physiological causes. In addition to a medical history and exam, it is also important to evaluate any past sexual trauma or abuse that may cause or contribute to the dysfunction. After identifying causes for a sexual dysfunction, the next step is to determine a plan of treatment. Such treatment may be multimodal, involving more than one type of therapy. Different types of therapies have different success rates. The highest success rates for treatment of sexual dysfunctions range from about 60% in those with primary erectile disorder to 97% in premature ejaculation; rates of about 80% have been reported in treatment of orgasmic disorder in women.
Much of the current clinical research today focuses on developing new drugs to treat dysfunctions (even though a number of dysfunctions may be caused by or worsened by
other medications). As we discussed in Chapter 13, the Food and Drug Administration (FDA) plays a major role in the approval of all new drugs in the United States. Many drug therapies used today for sexual dysfunctions, such as Wellbutrin or Viagra, were originally approved by the FDA to treat other diseases. There is also a brisk business in health supplements to aid in sexual functioning, including aphrodisiacs (see Sex in Real Life, “What Is an Aphrodisiac?” on page 467).
I I 1-6 times per week ТП Once a day or more
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Figure 14.1
How frequently have you had sex in the last 12 months?
Data from The Global Study of Sexual Attitudes and Behaviors, funded by Pfizer, Inc. (© 2002 Pfizer, Inc.)
We will discuss illness and physical causes later in this chapter, but now let us turn to the symptoms and possible causes of various sexual dysfunctions and the current therapies used to treat them.