Psychological and hormonal factors in the treatment of female sexual dysfunction.

Forty-eight couples with a presenting problem of female sexual unresponsiveness were treated in a controlled study using a balanced factorial design. The factors varied in this design were medication (testosterone or placebo), treatment frequency (weekly or monthly sessions), and the number of therapists involved (one female or a male/female pair). All counselling was adapted from that described by Masters & Johnson (1970) and Heiman et al. (1976). Results were assessed before and after a 3-month treatment period, and again 6 months later. Contrary to expectations from earlier work, there was no benefit attributable to testosterone or to the use of two therapists; self-ratings favoured weekly sessions with one therapist. It was concluded that testosterone (at least in the dosage used) is unlikely to have a useful place in the treatment of sexually unresponsive women, but that weekly counselling sessions with a single therapist is a reasonably effective and economic form of sex therapy. Findings from this research suggest the need for a clearer understanding of aetiological and treatment mechanisms.