Efficacy of Psychosocial Interventions in Men and Women With Sexual Dysfunctions—A Systematic Review of Controlled Clinical Trials

Part 2—The Efficacy of Psychosocial Interventions for Female Sexual Dysfunction

Authors

  • Cindy Günzler PhD,

    Corresponding author
    1. University Medical Center Freiburg, Department of Psychiatry and Psychotherapy, Freiburg, Germany
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  • Michael M. Berner MD

    Corresponding author
    1. University Medical Center Freiburg, Department of Psychiatry and Psychotherapy, Freiburg, Germany
    2. Rhein-Jura-Clinic for Psychiatry, Psychosomatic Medicine and Psychotherapy, Bad Säckingen, Germany
    3. Section for Sexual Medicine, German Society for Psychiatry and Psychotherapy (DGPPN), Berlin, Germany
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Cindy Günzler, PhD, University Medical Center Freiburg, Department of Psychiatry and Psychotherapy, Hauptstraße 5, D-79104 Freiburg, Germany. Tel: +49 761 270 69700; Fax: +49 761 270 6966; E-mail: cindy.guenzler@uniklinik-freiburg.de; and Michael M. Berner, MD, Rhein-Jura-Clinic for Psychiatry, Psychosomatic Medicine and Psychotherapy, Schneckenhalde 13, D-79713 Bad Säckingen, Germany. Tel: +49 7761 56000; Fax: +49 7761 5600165; E-mail: dr.m.berner@rhein-jura-klinik.de

ABSTRACT

Introduction.  As yet, a summary of the research evidence concerning the efficacy of psychological treatment in female sexual dysfunction is lacking. Previous reviews were often nonsystematic or explored one specific sexual dysfunction.

Aim.  Our systematic review provides an overview of the efficacy of psychosocial interventions in all female sexual dysfunction.

Main Outcome Measures.  Main outcome measures included for example psychometrically validated scales, diary notes, interviews, and vulvar algesiometer. The efficacy of psychosocial interventions was measured for example by the frequency of and satisfaction with sexual activity and sexual functioning. Safety and acceptance were evaluated on the basis of adverse events and dropout rates.

Methods.  The systematic literature search included electronic database search, handsearch, contact with experts, and an ancestry approach. Studies were included if the woman was given a formal diagnosis of a sexual dysfunction (International Statistical Classification of Diseases and Related Health Problems—ICD10/-9; Diagnostic and Statistical Manual of Mental Disorders-IV/-III-R) and when the intervention was psychosocial or psychotherapeutic. The control group included either another treatment or a waiting-list control group. The report of relevant outcomes was necessary for inclusion as well as the design of the study (randomized, controlled trials [RCTs] and controlled clinical trials). The assessment of methodological quality comprised aspects of randomization, blinding, incomplete outcome data, selective reporting, and allegiance.

Results.  We identified 15 RCTs that investigated efficacy in female sexual dysfunction and two further studies that examined male and female sexual dysfunction together. Most trials explored sexual pain disorders. About half of all studies in women used either a concept derived from Masters and Johnson or a cognitive-behavioral treatment program. Both approaches showed significant improvements compared with a control group. Benefit was not always maintained over the (variable) follow-up period.

Conclusions.  Traditional sexual therapeutic concepts proved to be efficacious in the treatment of female sexual dysfunction. A shortcoming was the rather low methodological quality of included studies. Günzler C, and Berner MM. Efficacy of psychosocial interventions in men and women with sexual dysfunctions—A systematic review of controlled clinical trials. J Sex Med 2012;9:3108–3125.

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