Using the “Good Enough Sex” Model to Treat Female Sexual Interest/Arousal Disorder
Sexual desire is important for healthy sexual relationships, but many women experience female sexual interest/arousal disorder (FSIAD). FSIAD is a condition characterized by a decrease or absence of sexual desire and arousal in women during sexual activities, often leading to distress and dissatisfaction. Factors contributing to FSIAD include biological, psychological, and contextual aspects.
This condition is the most common sexual complaint among women, affecting individuals of various age groups. Treatment typically involves therapy, as medications may have limited effectiveness and side effects. The “good enough sex” (GES) model prioritizes pleasure and intimacy over performance in addressing FSIAD.
A recent study study examined how counseling based on the GES model, especially with the involvement of partners, could impact women’s sexual health. The counseling sessions were conducted online due to the COVID-19 pandemic.
This randomized controlled trial was completed in Iran from January to December 2021, where women with FSIAD were recruited through social media advertisements and underwent screening by a clinician. Participants completed an online questionnaire anonymously.
Inclusion criteria included meeting DSM-5 criteria for FSIAD, being aged 18 to menopause, and having spouses willing to attend counseling. Once the participants completed a pretest on their symptoms, they were randomly assigned to either individual or couples’ counseling sessions focusing on the 12 dimensions of the GES model. Some examples of GES dimensions are: “Relaxation is the foundation for pleasure and function” and “Pleasure is as important as function.” The participants attended weekly online sessions, and a posttest was conducted three months after counseling.
Information was gathered using a demographic survey and six standard questionnaires aimed at evaluating different aspects of sexual well-being. These surveys covered areas such as sexual desire, satisfaction, function, distress, communication, and beliefs related to sexuality. Participants also reported on the frequency of sexual activity through a single question.
Ultimately, 36 women from group A (individual counseling sessions) and 33 from group B (couples’ counseling sessions) completed the trial. There were no significant differences in demographics or main variables between the groups, and the average age was 34.3 years, with an average marriage duration of 10.4 years.
Both groups experienced improvements in sexual function, satisfaction, communication, and reduced distress. The participants in group B, where spouses attended counseling, showed higher sexual communication quality and frequency of intercourse compared to those in group A. Overall, counseling based on the GES model positively impacted sexual health variables for women with FSIAD.
While both groups receiving counseling showed significant improvements in sexual desire, satisfaction, function, distress, communication, and frequency of intercourse, notably, the presence of spouses in counseling slightly enhanced outcomes. This held true particularly in frequency of intercourse measure.
Since the GES model prioritizes intimacy and realistic expectations, it fosters healthy sexual habits and motivation. The online counseling sessions proved effective, offering convenience, accessibility, and privacy. Although the presence of spouses in counseling sessions yielded favorable outcomes, significant improvements were observed even when women attended alone. This suggests promising results for treating FSIAD, particularly in societies where male participation in sexual therapy is uncommon.
For more information on this topic, please read these publications from the ISSM Journals: The Journal of Sexual Medicine, Sexual Medicine Reviews, and Sexual Medicine Open Access:
Female Sexual Arousal Disorders
References:
Farahi, Z., HashemZadeh, M., & Farnam, F. (2024). Sexual counseling for female sexual interest/arousal disorders: A randomized controlled trial based on the "good enough sex" model. The Journal of Sexual Medicine, 21(2), 153–162. https://doi.org/10.1093/jsxmed/qdad168
