Skip to main content
SpringerLink
Log in

Virtual Reality Therapy for Sexual Dysfunctions: a Scoping Review

  • Published:
Current Sexual Health Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Despite the growing body of research on virtual reality (VR) applications in psychology, there remains a scarcity of studies in sexology. This scoping review comprehensively assesses the size, nature, and scope of the literature on VR-based research on sexual dysfunctions and their related issues (e.g., sexual response, sexual satisfaction, and sexual skills) to identify promising VR applications in sex therapy. This review included empirical, theoretical, and review publications, as well as ongoing research. It systematically identified papers published between 1993 and 2023 using Scopus, PsycINFO, and PubMed. To ensure completeness, a secondary search on Google Scholar and an examination of references was also conducted in eligible papers. Forty-three papers were included in this review.

Recent Findings

Results reveal a consistent increase in the number of papers over the past decade, with four main domains investigated: sexual dysfunctions (n = 15), sexual responsiveness (n = 14), sexual victimization (n = 11), and sexual skills (n = 3).

Summary

Empirical reports reviewed suggest that VR represents a promising avenue to explore sexual arousal and improve sexual skills, as well as to alleviate symptoms of sexual dysfunctions and related factors, such as experiences of sexual assault. Yet, to move forward, several issues in prior research must be addressed, including the use of outdated technologies, the lack of operationalization of conceptual frameworks and targeted mechanisms in sexual dysfunctions, the predominance of proof-of-concept studies, as well as limited diversity in sample composition.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Rizzo A, Bouchard S, editors. Virtual reality for psychological and neurocognitive interventions. Berlin/Heidelberg: Springer; 2019.

    Google Scholar 

  2. Freeman D, Reeve S, Robinson A, Ehlers A, Clark D, Spanlang B, Slater M. Virtual reality in the assessment, understanding, and treatment of mental health disorders. Psychol Med. 2017;47(14):2393–400. https://doi.org/10.1017/S003329171700040X.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  3. Slater M. Immersion and the illusion of presence in virtual reality. Br J Psychol. 2018;109(3):431–3. https://doi.org/10.1111/bjop.12305.

    Article  PubMed  Google Scholar 

  4. Kardong-Edgren SS, Farra SL, Alinier G, Young HM. A call to unify definitions of virtual reality. Clin Simul Nurs. 2019;31:28–34. https://doi.org/10.1016/j.ecns.2019.02.006.

    Article  Google Scholar 

  5. Emmelkamp PM, Meyerbröker K. Virtual reality therapy in mental health. Annu Rev Clin Psychol. 2021;17:495–519. https://doi.org/10.1007/978-1-4939-9482-3.

    Article  PubMed  Google Scholar 

  6. Carl E, Stein AT, Levihn-Coon A, Pogue JR, Rothbaum B, Emmelkamp P, Asmundson GJ, Carlbring P, Powers MB. Virtual reality exposure therapy for anxiety and related disorders: a meta-analysis of randomized controlled trials. J Anxiety Disord. 2019;61:27–36. https://doi.org/10.1016/j‧janxdis.2018.08.003.

    Article  PubMed  Google Scholar 

  7. Fodor LA, Cotet CD, Cuijpers P, Szamoskozi Ş, David D, Cristea IA. The effectiveness of virtual reality based interventions for symptoms of anxiety and depression: a meta-analysis. Sci Rep. 2018;8(1):10323. https://doi.org/10.1038/s41598-018-28113-6.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  8. Opriş D, Pintea S, García-Palacios A, Botella C, Szamosközi Ş, David D. Virtual reality exposure therapy in anxiety disorders: a quantitative meta-analysis. Depress Anxiety. 2012;29(2):85–93. https://doi.org/10.1002/da.20910.

    Article  PubMed  Google Scholar 

  9. Low TL, Ho R, Ho C, Tam W. The efficacy of virtual reality in the treatment of binge-purging eating disorders: a meta-analysis. Eur Eat Disord Rev. 2021;29(1):52–9. https://doi.org/10.1002/erv.2804.

    Article  PubMed  Google Scholar 

  10. Baus O, Bouchard S. Moving from virtual reality exposure-based therapy to augmented reality exposure-based therapy: a review. Front Hum Neurosc. 2014;8:112. https://doi.org/10.3389/fnhum.2014.00112.

    Article  Google Scholar 

  11. Bell IH, Nicholas J, Alvarez-Jimenez M, Thompson A, Valmaggia L. Virtual reality as a clinical tool in mental health research and practice. Dialogues Clin Neurosci. 2020;22(2):169–77. https://doi.org/10.31887/DCNS.2020.22.2/lvalmaggia.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Hendrickx L, Gijs L, Enzlin P. Sexual difficulties and associated sexual distress in Flanders (Belgium): a representative population-based survey study. J Sex Med. 2016;13(4):650–68. https://doi.org/10.1016/j.jsxm.2016.01.014.

    Article  PubMed  Google Scholar 

  13. Mitchell KR, Mercer CH, Ploubidis GB, Jones KG, Datta J, Field N, et al. Sexual function in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Lancet. 2013;382(9907):1817–29. https://doi.org/10.1016/S0140-6736(13)62366-1.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Grant MJ, Booth A. A typology of reviews: an analysis of 14 review types and associated methodologies. Health Inf Libr J. 2009;26(2):91–108. https://doi.org/10.1111/j.1471-1842.2009.00848.x.

    Article  Google Scholar 

  15. Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19–32. https://doi.org/10.1080/1364557032000119616.

    Article  Google Scholar 

  16. Kelley EL, Gidycz CA. Posttraumatic stress and sexual functioning difficulties in college women with a history of sexual assault victimization. Psychol Violence. 2019;9(1):98–107. https://doi.org/10.1037/vio0000162.

    Article  Google Scholar 

  17. Leonard LM, Follette VM. Sexual functioning in women reporting a history of child sexual abuse: review of the empirical literature and clinical implications. Annu Rev Sex Res. 2002;13(1):346–88. https://doi.org/10.1080/10532528.2002.10559809.

    Article  PubMed  Google Scholar 

  18. Berthelot N, Godbout N, Hébert M, Goulet M, Bergeron S. Prevalence and correlates of childhood sexual abuse in adults consulting for sexual problems. J Sex Marital Ther. 2014;40(5):434–43. https://doi.org/10.1080/0092623X.2013.772548.

    Article  PubMed  Google Scholar 

  19. Sarwer DB, Durlak JA. Childhood sexual abuse as a predictor of adult female sexual dysfunction: a study of couples seeking sex therapy. Child Abuse & Negl. 1996;20(10):963–72. https://doi.org/10.1016/0145-2134(96)00085-3.

    Article  CAS  Google Scholar 

  20. Optale G, Munari A, Nasta A, Pianon C, Verde JB, Viggiano G. Multimedia and virtual reality techniques in the treatment of male erectile disorders. Int J Impot Res. 1997;9(4):197–203. https://doi.org/10.1038/sj.ijir.3900316.

    Article  PubMed  CAS  Google Scholar 

  21. Optale G, Munari A, Nasta A, Pianon C, Verde JB, Viggiano G. Virtual environments in the treatment of impotence and premature ejaculation. Cyberpsychology Behav Soc. 1998;1(3):213–6. https://doi.org/10.1089/cpb.1998.1.213.

    Article  Google Scholar 

  22. Optale G, Marin S, Pastore M, Nasta A, Pianon C. Male sexual dysfunctions and multimedia immersion therapy (follow-up). Cyberpsychology Behav Soc. 2003;6(3):289–94. https://doi.org/10.1089/109493103322011588.

    Article  Google Scholar 

  23. Optale G, Pastore M, Marin S, Bordin D, Nasta A, Pianon C. Male sexual dysfunctions: immersive virtual reality and multimedia therapy. Cybertherapy. 2004;99:165–78. https://doi.org/10.3233/978-1-60750-943-1-165.

    Article  Google Scholar 

  24. Spagnolli A, Gamberini L, Cottone P, Mantovani G. Ergonomics of virtual environments for clinical use. Cybertherapy. 2004;2004(99):217–30. https://doi.org/10.3233/978-1-60750-943-1-217.

    Article  Google Scholar 

  25. Lafortune D, Lapointe VA, Canivet C, Godbout N, Boislard MA. Validation of a virtual environment for sexual aversion. J Behav Cogn Ther. 2022;32(2):85–98. https://doi.org/10.1016/j‧jbct.2021.11.001. This study revealed that individuals with high sexual aversion symptoms experienced greater anxiety and disgust in response to virtual sexual stimuli, compared to individuals with low sexual aversion symptoms. Furthermore, emotional responses increased in intensity with the level of sexual stimuli, suggesting that the efficacy of this virtual environment as part of a VRET for sexual aversion disorder should be tested.

    Article  Google Scholar 

  26. Lafortune D, Dubé S, Lapointe V, Bonneau J, Champoux C, Sigouin N. Virtual reality as a potential diagnostic tool for sexual aversion. J Sex Res. 2023. https://doi.org/10.1080/00224499.2023.2241860. This research revealed that individuals with sexual aversion experienced greater disgust and anxiety in response to virtual sexual stimuli compared to healthy controls, and that higher levels of sexual avoidance were associated with a lower duration of genital touch. Those results highlight the promise of VR to elicit and measure sexual aversion clinical features.

    Article  PubMed  Google Scholar 

  27. Lafortune D, Lapointe VA, Dubé S, Godbout, N. How is disgust related to sexual functioning? Subjective responses to sexual stimuli in virtual reality. Unpublished manuscript; 2023b.

  28. Vila A, Riva G. SexTreatverse: avatar-based virtual reality for the treatment of female sexual disorders. Cyberpsychol Behav Soc Netw. 2022;25(6):404–5. https://doi.org/10.1089/cyber.2022.29249.ceu. This article describes the ongoing development of an VR-based treatment for sexual dysfunctions (SexTreatverse study) and its promising preliminary results for individuals living with female orgasm disorder.

    Article  PubMed  Google Scholar 

  29. Brown N, Brotto L. VIVID study. University of British Columbia; 2023. Available from: https://brottolab.med.ubc.ca/studies/vivid/. Accessed 1 Aug 2023

  30. Lafortune D, Lapointe VA, Dubé S, Bonneau J, Godbout N, Boislard MA. Development and validation of a virtual reality-assisted tool for the assessment and treatment of sexual aversion (EVAS study). University du Québec à Montréal; 2023c.

  31. Lafortune D, Dion L, Renaud P. Virtual reality and sex therapy: future directions for clinical research. J Sex Marital Ther. 2020;46(1):1–7. https://doi.org/10.1080/0092623X.2019.1623357.

    Article  PubMed  Google Scholar 

  32. Döring N, Krämer N, Mikhailova V, Brand M, Krüger TH, Vowe G. Sexual interaction in digital contexts and its implications for sexual health: a conceptual analysis. Front Psychol. 2021;12:769732. https://doi.org/10.3389/fpsyg.2021.769732.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Dubé S, Santaguida M, Anctil D. Erobots as research tools: overcoming the ethical and methodological challenges of sexology. J Future Robot Life. 2022;3(2):207–21. https://doi.org/10.3233/FRL-210017.

    Article  Google Scholar 

  34. Massa N, Bisconti P, Nardi D. The psychological implications of companion robots: a theoretical framework and an experimental setup. Int J Soc Robot;1–14. https://doi.org/10.1007/s12369-021-00846-x

  35. Dekker A, Wenzlaff F, Biedermann SV, Briken P, Fuss J. VR porn as “empathy machine”? Perception of self and others in virtual reality pornography. J Sex Res. 2021;58(3):273–8. https://doi.org/10.1080/00224499.2020.1856316. This study revealed that an erotic film presented in VR elicits heightened sexual arousal and greater perceived intimacy with the actress, compared to the flat-screen condition.

    Article  PubMed  Google Scholar 

  36. Elsey JW, van Andel K, Kater RB, Reints IM, Spiering M. The impact of virtual reality versus 2D pornography on sexual arousal and presence. Comput Hum Behav. 2019;97:35–43. https://doi.org/10.1016/j.chb.2019.02.031.

    Article  Google Scholar 

  37. Fromberger P, Meyer S, Kempf C, Jordan K, Müller JL. Virtual viewing time: the relationship between presence and sexual interest in androphilic and gynephilic men. PLoS ONE. 2015;10(5):e0127156. https://doi.org/10.1371/journal.pone.0127156.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  38. Milani S, Jabs F, Brown NB, Zdaniuk B, Kingstone A, Brotto LA. Virtual reality erotica: exploring general presence, sexual presence, sexual arousal, and sexual desire in women. Arch Sex Behav. 2022;51:565–76. https://doi.org/10.1007/s10508-021-02111-8. This paper provides evidence for the effectiveness of presenting erotic videos in VR to elicit sexual arousal, sexual presence, and general presence among women, as compared to 2D videos. The results also indicated that first-person perspectives may lead to higher levels of sexual arousal than third-person perspectives. These findings provide further support for the emerging use of VR in sex research.

    Article  PubMed  Google Scholar 

  39. Simon SC, Greitemeyer T. The impact of immersion on the perception of pornography: a virtual reality study. Comput Hum Behav. 2019;93:141–8. https://doi.org/10.1016/j.chb.2018.12.018.

    Article  Google Scholar 

  40. Renaud P, Rouleau JL, Granger L, Barsetti I, Bouchard S. Measuring sexual preferences in virtual reality: a pilot study. Cyberpsychol Behav Soc Netw. 2002;5(1):1–9. https://doi.org/10.1089/109493102753685836.

    Article  Google Scholar 

  41. Aleksandrovich A, Gomes LM. Shared multisensory sexual arousal in virtual reality (VR) environments. Paladyn. 2020;11(1):379–89. https://doi.org/10.1515/pjbr-2020-0018.

    Article  Google Scholar 

  42. Fusaro M, Lisi MP, Tieri G, Aglioti SM. Heterosexual, gay, and lesbian people’s reactivity to virtual caresses on their embodied avatars’ taboo zones. Sci Rep. 2021;11(1):2221. https://doi.org/10.1038/s41598-021-81168-w. This study uncovered that participants experienced more erogenous sensations when their avatar’s genitals were touched by avatars of the opposite sex (in a heterosexual sample). Also, participants reported that touches on their genitals were more erogenous than touches on other body parts. These results highlight the potential of first-person-based simulations to elicit more ecologically valid sexual responses.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  43. Marschall-Lévesque S, Rouleau JL, Renaud P. Increasing valid profiles in phallometric assessment of sex offenders with child victims: combining the strengths of audio stimuli and synthetic characters. Arch Sex Behav. 2018;47:417–28. https://doi.org/10.1007/s10508-017-1053-y.

    Article  PubMed  Google Scholar 

  44. Renaud P, Chartier S, Rouleau JL, Proulx J, Goyette M, Trottier D, Fedoroff P, Bradford JP, Dassylva B, Bouchard S. Using immersive virtual reality and ecological psychology to probe into child molesters’ phenomenology. J Sex Aggress. 2013;19(1):102–20. https://doi.org/10.1007/s10055-013-0235-8.

    Article  Google Scholar 

  45. Trottier D, Renaud P, Rouleau JL, Goyette M, Saumur C, Boukhalfi T, Bouchard S. Using immersive virtual reality and anatomically correct computer-generated characters in the forensic assessment of deviant sexual preferences. Virtual Real. 2014;18:37–47. https://doi.org/10.1007/s10055-013-0235-8.

    Article  Google Scholar 

  46. Binter J, Klapilová K, Zikánová T, Nilsson T, Bártová K, Krejčová L, Androvičová R, Lindová J, Průšová D, Wells T, Riha D. Exploring the pathways of adaptation: avatar 3D animation procedures and virtual reality arenas in research of human courtship behaviour and sexual reactivity in psychological research. In: Jerry P, Tavares-Jones N, editors. Virtual worlds: the virtual reality and augmented reality intersections. Leiden: Brill; 2016.

  47. Říha D, Bártová K, Binter J. Use of virtual reality and human-computer interface for diagnostic and treatment purposes in human sexuality research. In: Design, user experience, and usability: technological contexts: 5th International Conference [Internet]; Toronto, Canada; 2016. Available from: https://link.springer.com/chapter/10.1007/978-3-319-40406-6_28

  48. Schippers EE, Smid WJ, Hoogsteder LM. Excitation transfer between sexual arousal and other emotions: study protocol. Int J Psychiatr Res. 2023;6(1):1–7.

    Google Scholar 

  49. Loranger C, Bouchard S. Validating a virtual environment for sexual assault victims. J Trauma Stress. 2017;30(2):157–65. https://doi.org/10.1002/jts.22170.

    Article  PubMed  Google Scholar 

  50. Loucks L, Yasinski C, Norrholm SD, Maples-Keller J, Post L, Zwiebach L, Fiorillo D, Goodlin M, Jovanovic T, Rizzo AA, Rothbaum BO. You can do that?!: Feasibility of virtual reality exposure therapy in the treatment of PTSD due to military sexual trauma. J Anxiety Disord 2019;61:55–63. https://doi.org/10.1016/j‧janxdis.2018.06.004.

  51. van Meggelen M, Morina N, van der Heiden C, Brinkman WP, Yocarini IE, Tielman ML, Rodenburg J, van Ee E, van Schie K, Broekman ME, Franken IH. A randomized controlled trial to pilot the efficacy of a computer-based intervention with elements of virtual reality and limited therapist assistance for the treatment of post-traumatic stress disorder. Front Digit Health. 2022;4:974668. https://doi.org/10.3389/fdgth.2022.974668.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Jouriles EN, McDonald R, Kullowatz A, Rosenfield D, Gomez GS, Cuevas A. Can virtual reality increase the realism of role plays used to teach college women sexual coercion and rape-resistance skills? Behav Ther. 2009;40(4):337–45. https://doi.org/10.1016/j‧beth.2008.09.002.

    Article  PubMed  Google Scholar 

  53. Jouriles EN, Rowe LS, McDonald R, Platt CG, Gomez GS. Assessing women’s responses to sexual threat: validity of a virtual role-play procedure. Behav Ther. 2011;42(3):475–84. https://doi.org/10.1016/j‧beth.2010.11.005.

    Article  PubMed  Google Scholar 

  54. Platt CG. Women’s perception of risk in sexually coercive situations (Doctoral dissertation, Southern Methodist University); 2013. Available from: https://www.proquest.com/docview/1496775225?accountid=14719 [cited 2023 Aug 1st]

  55. Tavabi L, Poon A, Rizzo AS, Soleymani M. Computer-based PTSD assessment in VR exposure therapy. In: HCI International 2020–late breaking papers: virtual and augmented reality: 22nd HCI International Conference; Copenhagen, Denmark, 2020.

  56. Weniger G, Siemerkus J, Barke A, Lange C, Ruhleder M, Sachsse U, Schmidt-Samoa C, Dechent P, Irle E. Egocentric virtual maze learning in adult survivors of childhood abuse with dissociative disorders: evidence from functional magnetic resonance imaging. Psychiatry Res Neuroimaging. 2013;212(2):116–24. https://doi.org/10.1016/j‧pscychresns.2012.11.004.

    Article  Google Scholar 

  57. Rowe LS, Jouriles EN, McDonald R. Reducing sexual victimization among adolescent girls: a randomized controlled pilot trial of My Voice. My Choice Behav Ther. 2015;46(3):315–27. https://doi.org/10.1016/j‧beth.2014.11.003.

    Article  Google Scholar 

  58. Corno G, Bouchard S. An innovative positive psychology VR application for victims of sexual violence: a qualitative study. In: Cipresso P, Serino S, editors. In Virtual reality: technologies, medical applications and challenges. Hauppauge: Nova Science Publishers; 2015.

  59. Rizzo AS, Shilling R. Clinical virtual reality tools to advance the prevention, assessment, and treatment of PTSD. Eur J Psychotraumatol. 2017;8(5):1414560. https://doi.org/10.1080/20008198.2017.1414560.

    Article  PubMed  Google Scholar 

  60. Abbey A, Pegram SE, Woerner J, Wegner R. Men’s responses to women’s sexual refusals: development and construct validity of a virtual dating simulation of sexual aggression. Psychol Violence. 2018;8(1):87–99. https://doi.org/10.1037/vio0000078.

    Article  PubMed  Google Scholar 

  61. Pegram SE, Abbey A, Helmers BR, Benbouriche M, Jilani Z, Woerner J. Men who sexually assault drinking women: similarities and differences with men who sexually assault sober women and nonperpetrators. Violence Against Women. 2018;24(11):1327–48. https://doi.org/10.1177/1077801218787927.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Schmidt EK. Usability and feasibility of an enhanced sexual health education program for individuals with intellectual and developmental disabilities (Doctoral dissertation, Ohio State University); 2019. Available from: https://www.proquest.com/docview/2388000949?accountid=14719 [cited 2023 Aug 1st]

  63. Hall KS, Binik YM. Principles and practice of sex therapy (6th ed.). New York: Guilford Publications; 2020.

  64. Wincze JP, Weisberg RB. Sexual dysfunction: a guide for assessment and treatment (3rd edition). New York: Guilford Publications; 2015.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Sexology, Université du Québec À Montréal, Montréal, QC, Canada

    David Lafortune

  2. Department of Psychology, Université du Québec À Montréal, Montréal, QC, Canada

    Valerie A. Lapointe

  3. Kinsey Institute, Indiana University, Bloomington, IN, USA

    Simon Dubé

  4. Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada

    Lori A. Brotto

Authors
  1. David Lafortune
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Valerie A. Lapointe
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Simon Dubé
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lori A. Brotto
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

D.L. and V.A.L. wrote the main manuscript text (original draft, review, and editing), V.A.L. prepared table 1, and S.D. and L.B. reviewed the manuscript thoroughly.

Corresponding author

Correspondence to David Lafortune.

Ethics declarations

Conflict of Interest

The authors declare no competing interests.

Human and Animal Rights and Informed Consent

All reported studies/experiments with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lafortune, D., Lapointe, V.A., Dubé, S. et al. Virtual Reality Therapy for Sexual Dysfunctions: a Scoping Review. Curr Sex Health Rep 15, 261–279 (2023). https://doi.org/10.1007/s11930-023-00374-x

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11930-023-00374-x

Keywords

Search

Navigation