Skip to main content

Application of the Sexual Health Model in the Long-Term Treatment of Hypoactive Sexual Desire and Female Orgasmic Disorder

Archives of Sexual Behavior volume 40, pages 469–478 (2011)Cite this article

Abstract

Using the Sexual Health Model as a framework, this case study illustrates the treatment of female orgasmic and low desire disorder in a long-term case with numerous complexities and other co-morbid mental health diagnoses. Derived from a sexological approach to education, the Sexual Health Model defines 10 key components posited to be essential aspects of healthy human sexuality: talking about sex, culture and sexual identity, sexual anatomy and functioning, sexual health care and safer sex, challenges to sexual health, body image, masturbation and fantasy, positive sexuality, intimacy and relationships, and spirituality. The client was selected because of the commonality of her initial presenting concerns and the etiological and treatment complexity of the case, which necessitated the use of all the sexual health treatment modalities provided at our center—individual, couple, and group therapy, sexual medicine, and psychiatric care. Her case is distinct in that her sexual dysfunctions and negative cognitions, while common, occurred in the context of serious relational, family sexual abuse, depression, and life-threatening medical problems, which necessitated long-term treatment. This case illustrates the multifactoral etiology of complex sexual dysfunctions requiring treatment that deals with varied psychosocial and biological factors.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  • Adams, C. (1981). Sexuality and the older adult. Unpublished doctoral dissertation, University of Massachusetts, Amherst.

  • Althof, S. E., Leiblum, S. L., Chevret-Measson, M., Hartmann, U., Levine, S. B., McCabe, M., …Wylie, K. (2005). Psychological and interpersonal dimensions of sexual function and dysfunction. Journal of Sexual Medicine, 2, 793–800.

    PubMed  Article  Google Scholar 

  • American Association of Sex Educators, Counselors, and Therapists Board of Directors (AASECT). (1994). New standards for sexual attitude reassessment (SAR) materials. Mount Vernon, IA: Author.

  • Anastasiadis, A. G., Davis, A. R., Salomon, L., Burchardt, M., & Shabsigh, R. (2002). Hormonal factors in female sexual dysfunction. Current Opinion in Urology, 12, 503–507.

    PubMed  Article  Google Scholar 

  • Billups, K. L., Berman, L., Berman, J., Metz, M. E., Glennon, M. E., & Goldstein, I. (2001). A new non-pharmacological vacuum therapy for female sexual dysfunction. Journal of Sex and Marital Therapy, 27, 435–441.

    PubMed  Article  Google Scholar 

  • Bockting, W. O., Robinson, B. E., Forberg, J., & Scheltema, K. (2005). Evaluation of a sexual health approach to reducing HIV/STD risk in the transgender community. AIDS Care, 17, 289–303.

    PubMed  Article  Google Scholar 

  • Cass, V. (2007). The elusive orgasm: A woman’s guide to why she can’t and how she can orgasm. New York: Marlowe & Co.

    Google Scholar 

  • Coleman, E. (1997) Promoting sexual health: The challenges of the present and future. In J. J. Borras-Valls & M. Perez-Conchillo (Eds.), Sexuality and human rights: Proceedings of the XIIIth World Congress of Sexology (pp. 25–29). Valencia: Scientific Committee: Instituto de Sexologia y Psicoterapia Espill.

  • Das, A. (2007). Masturbation in the United States. Journal of Sex and Marital Therapy, 33, 301–317.

    PubMed  Article  Google Scholar 

  • Hayes, R. C., Dennerstein, L., Bennett, C. M., & Fairley, C. K. (2008). What is the “True” prevalence of female sexual dysfunctions and does the way we assess these conditions have an impact? Journal of Sexual Medicine, 5, 777–787.

    PubMed  Article  Google Scholar 

  • Heiman, J. R. (2002). Sexual dysfunction: Overview of prevalence, etiological factors, and treatments. Journal of Sex Research, 39, 73–78.

    PubMed  Article  Google Scholar 

  • Koert, E., & Daniluk, J. C. (2010). Sexual transitions in the lives of adult women. In T. W. Miller (Ed.), Handbook of stressful transitions across the lifespan (pp. 235–252). New York: Springer.

    Chapter  Google Scholar 

  • Leitenberg, H., Detzer, M. J., & Srebnik, D. (1993). Gender differences in masturbation and the relation of masturbation experience in preadolescence and/or early adolescence to sexual behavior and sexual adjustment in young adulthood. Archives of Sexual Behavior, 22, 87–98.

    PubMed  Article  Google Scholar 

  • Loulan, J. (1984). Lesbian sex. San Francisco, CA: Spinsters Book Company.

    Google Scholar 

  • McCabe, M. P. (2001). Evaluation of a cognitive behavior therapy program for people with sexual dysfunction. Journal of Sex and Marital Therapy, 27, 259–271.

    PubMed  Article  Google Scholar 

  • Meston, C. M., Hull, E., Levin, R. J., Sipski, M., & Heiman, J. R. (2004). Women’s orgasm. In T. F. Lue, R. Basson, R. Rosen, F. Guiliano, S. Khoury, & F. Montorsi (Eds.), Sexual medicine: Sexual dysfunctions in men and women (pp. 783–850). Paris: Health Publications.

    Google Scholar 

  • Nurnberg, H. G., Hensley, P. L., Heiman, J. R., Croft, H. A., Debattista, C., & Paine, S. (2008). Sildenafil treatment of women with antidepressant-associated sexual dysfunction: A randomized controlled trial. Journal of the American Medical Association, 300, 395–404.

    PubMed  Article  Google Scholar 

  • Reiss, I. L., & Reiss, H. M. (1997). Solving America’s sexual crises. Amherst, NY: Prometheus Books.

    Google Scholar 

  • Reitano, M. (1997). Counseling patients with genital warts. American Journal of Medicine, 102, 38–42.

    PubMed  Article  Google Scholar 

  • Robinson, B. E., & Bacon, J. G. (1996). The “If Only I Were Thin…”. Treatment Program: Decreasing the stigmatizing effects of fatness. Professional Psychology, Research, and Practice, 27, 175–183.

    Article  Google Scholar 

  • Robinson, B. E., Bockting, W. O., Rosser, B. R. S., Miner, M., & Coleman, E. (2002). The Sexual Health Model: Application of a sexological approach to HIV prevention. Health Education Research, 17, 43–57.

    PubMed  Article  Google Scholar 

  • Robinson, B. E., Feldman, J., Striepe, M., Raymond, N., & Mize, S. (2003). Women’s sexual health: An interdisciplinary approach to treating low sexual desire. Minnesota Medicine, 86, 34–41.

    PubMed  Google Scholar 

  • Robinson, B. E., Scheltema, K., & Cherry, T. (2005). Risky sexual behavior in low-income African American women. The impact of sexual health variables. Journal of Sex Research, 42, 224–237.

    PubMed  Article  Google Scholar 

  • Robinson, B. E., Uhl, G., Miner, M., Bockting, W. O., Scheltema, K., Rosser, B. R. S., & Westover, B. (2002). Evaluation of a sexual health approach to prevent HIV among low income, urban, primarily African-American women: Results of a randomized controlled trial. AIDS Education and Prevention, 14(Suppl. A), 81–96.

    PubMed  Article  Google Scholar 

  • Rosser, B. R., Bockting, W. O., Rugg, D. L., Robinson, B. E., Ross, M. W., Bauer, G. R., & Coleman, E. (2002). A randomized controlled intervention trial of a sexual health approach to long-term HIV risk reduction for men who have sex with men: Effects of the intervention on unsafe sexual behavior. AIDS Education and Prevention, 14, 59–71.

    PubMed  Article  Google Scholar 

  • Rosser, B. R. S., Dwyer, S. M., Coleman, E., Miner, M., Metz, M., Robinson, B. E., & Bockting, W. O. (1995). Using sexually explicit material in sex education: An eighteen year comparative analysis. Journal of Sex Education and Therapy, 21, 117–128.

    Google Scholar 

  • Shifren, J. L., Monz, B. U., Russo, P. A., Segreti, A., & Johannes, C. B. (2008). Sexual problems and distress in United States women. Obstetrics and Gynecology, 112, 970–978.

    PubMed  Article  Google Scholar 

  • Stinson, R. D. (2009). The behavioral and cognitive-behavioral treatment of female sexual dysfunction: How far we have come and the path left to go. Sexual and Relationship Therapy, 24, 271–285.

    Article  Google Scholar 

  • Trudel, G., Marchand, A., Ravart, M., Aubin, S., Turgeon, L., & Fortier, P. (2001). The effect of a cognitive-behavioral group treatment program on hypoactive sexual desire in women. Sexual and Relationship Therapy, 16, 145–164.

    Article  Google Scholar 

  • West, S. L., D’Aloisio, A. A., Agans, R. P., Kalsbeek, W. D., Borisov, N. N., & Thorp, J. M. (2008). Prevalence of low sexual desire and hypoactive sexual desire disorder in a nationally representative sample of US women. Archives of Internal Medicine, 168, 1441–1449.

    PubMed  Article  Google Scholar 

  • World Health Organization. (1975). Education and treatment in human sexuality: The training of health professionals (WHO Technical Report Series No. 572). Geneva: Author.

Download references

Acknowledgments

This work was supported by the Department of Family Medicine and Community Health, University of Minnesota Medical School. We thank Drs. Meg Striepe and Jamie Feldman for their clinical work with this patient and Dr. Eli Coleman, Director of the Center for Sexual Health, for providing the environment and freedom to design new and innovative treatment modalities and groups. We also thank Heidi Fall for helping with manuscript preparation and Ross Johnson for assisting with literature search and retrieval.

Author information

Affiliations

  1. Program in Human Sexuality, Department of Family Medicine and Community Health, University of Minnesota Medical School, 1300 South Second Street, Suite 180, Minneapolis, MN, 55454, USA

    Beatrice “Bean” E. Robinson, Rosemary A. Munns, Margaret A. Lowe & Nancy C. Raymond

  2. Department of Medicine, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN, 55414, USA

    Anne M. Weber-Main

  3. Department of Psychiatry, University of Minnesota Medical School, F288/2A West, 2450 Riverside, Minneapolis, MN, 55454, USA

    Nancy C. Raymond

Authors
  1. Beatrice “Bean” E. Robinson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rosemary A. Munns
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anne M. Weber-Main
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Margaret A. Lowe
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Nancy C. Raymond
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Beatrice “Bean” E. Robinson.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Robinson, B.“.E., Munns, R.A., Weber-Main, A.M. et al. Application of the Sexual Health Model in the Long-Term Treatment of Hypoactive Sexual Desire and Female Orgasmic Disorder. Arch Sex Behav 40, 469–478 (2011). https://doi.org/10.1007/s10508-010-9673-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10508-010-9673-5

Keywords

  • Orgasmic difficulties
  • Sexual desire
  • Sexual health
  • Sex therapy
  • Hypoactive sexual desire disorder
  • Female orgasmic disorder