(Sotile & Kilmann, 1977) the only real exception to Sotile & Kilmann's assessmernt of scientific innacuracy and ineficiency was the now famed Masters and Johnson research which cooencided with a very effective treatment modality in a large sample and with reported success over a relatively short period of time, using a combiantion systematic desensatization and retraining regimen. (1977, pp. 626-627)
McMulle & Rosen in Self-Administered Masturbation Training in the Treatment of Primary Orgasmic Dysfunction (1979) the authors assess the use of self-administered masturbation training in a comparative model between written instruction programs and video instruction programs. The researchers found that the method was as effective as other models for counseling intervention treatment (about 60% effective for inorgasmic women) it was cost effective in that it allowed a single treatment session to serve as a resolution, rather than an extensive counseling regimen. The written and video formats also had no significant difference. One of the focuses of the work was on the transition of orgasm to coital activity post treatment, as this was the mark of success for the participants. The assumption being that if the individual inorgasmic woman were simply taught how to have an orgasm that the orgasm would begin to occur with some regularity during intercourse alone as a result of her new ability to recognize the sensations and/or needs for achievement associated with the event. The researchers also point out that the goal of the treatment plan was ultimately coital female orgasm, and yet they also acknowledge that some treatment researchers are seeing any orgasmic achievement, no matter the mode as success. Additionally the researchers discuss partner knowledge and communication as a main reason for the inability of newly orgasmic women to transition to achieve orgasm with coital intercourse stimulation alone. The most important acknowledgement that may be seen to be particular for the feminization of this issue is that information was the key to success, rather than the traditional claims that video or visual aid was more effective as written instruction was equally effective for the treatment of primary orgasmic disorder in women. (McMulle & Rosen, 1979) This is reflective of the more modern therapeutic intervention, as much work has been done that supports coital stimulation may not be physiologically adequate for many women to achieve orgasm. This is also supported by the more modern take on the expansion of the idea of sexuality to include much more than the simple act of heterosexual penile penetrative intercourse. (Lavie-Ajayi, 2005)
Tripet Dodge, Glasgow & O'Neill in Bibliotherapy in the Treatment of Female Orgasmic Disorder (1982) consisted of a relatively small sample assize assessment (n 13) where a comparison was made between minimal therapy contact and no therapy contact programs where each individual was given a the same information regarding female sexual stimulation and achievement of orgasm and one group, serving as the control group was offered a post treatment follow up and the other group was offered 6 half hour sessions where the counselor met with the client to review success and address questions and/or concerns. Again like the above comparison study (McMulle & Rosen, 1979) the researchers found little differnce between the two groups and no statistical differnce in success for the achievement of orgasm, though for counseling purposes the study group regimen of periodic review was more effective for the treatment research and for the sake of the counselor. Again the researchers support th idea that information is the key and mode of infromation delivery is irrelivant. The work also supported treatmetn fo primary (unable to achieve in any form) and secondary (able to achieve most often with masterbation but rarely with intercourse) but did not compare the two groups as a result of the limited sample size. (Tripet Dodge, Glasgow, & O'Neill, 1982)
Andersen in Primary Orgasmic Dysfunction: Diagnostic Considerations and Review of Treatment (1983) points out a significant change in the development of treatment modalities for primary orgasmic dysfunction, and that is the addition of the disorder with emphasis on inorgasmia being included in the Diagnostic and Statistical Manual III, (DSM III) and how this has changed the diagnostic abilities of the therapist. (Andersen, 1983, p. 106) This is a significant change as it acknowledges that the disorder exists and affects the psychological health of the individual. The work then goes on to review, rather than compare and contrast the current treatment modalities available to women for primary orgasmic dysfunction; systematic desensitization, sensate focus, directed masturbation and hypnosis. Among the four treatment types reviewed Andersen points out the variances coming to the conclusion that more research needs to be done with regard to the contributions and needs of clients, therapists, researchers and others before any clear better or worse assessment can be made about any given treatment modality, but sex therapy including guided masturbation and systematic desensitization seem to be treatment modalities with the best reported outcomes. (Andersen, 1983)
At this point it must be noted that there seems to be a lack of chronological research for the 1990s. The reason for this is unknown but it may be associated with a lag in feminist research and a quiet internal review of efficacy and treatment for the definitions and standards of FOD. That being said Winton in Gender, Sexual Dysfunctions, and the Journal of Sex & Marital Therapy (2001) discusses the research trend of refocussing on male erectile dysfunction, as apposed to female sexual disorders, by reviewing journal article frequency. Which cooencides with pharmacological treatments that have recently been releised into the market to treat erectile dysfunction. Winton points out that the implications of this research refocus is that FOD and other female centered sexual disorders seem to have been set asside, either as a result of the fact that the disorders are considdered effectively treated with current treatment modalities or as a result of the trend to study altrnatives and drug therapy in combination with any given counseling therapy. This reviewer also points out that the sistribution of estimated frequency disorders does not warrant a reduction in discussion regarding FOD and other female sexual dysfunctions; "Epidemiological findings indicate that 18.8% of women have trouble becoming lubricated; 10.4% of men have trouble obtaining or maintaining an erection; 24.1% of women are unable to have an orgasm; and 28.5% of men reach orgasm too quickly (Laumann, Gagnon, Michael, & Michaels, 1994)." (Winton, 2001, pp. 333-334) Winton calls for refocus on the part of the major sexuality journal son multi-disciplinary focuses that are broader rather than dependant on the trends of medicalization. (Winton, 2001)
Meston in Validation of the Female Sexual Function Index (FSFI) in Women with Female Orgasmic Disorder and in Women with Hypoactive Sexual Desire Disorder (2003) strategically assess the diagnostic tool called the Female Sexual Function Index (FSFI) as both valid and effective for as a diagniostic tool associated witht the development of effective treatment planning for individuals women wuth FOD or hypoactive sexual desire disorder, where previous validity tests had only been done for women with female sexual arousal disorder a broader diagnostic disorder. The work establishes that the FSFI, a self report sexual function questionair translates to more defined diagnostic disorders, as well as for assessing treatment induced changes and will seriously aide in the crucial development of patient histories, with regard to sexual function and in measurement of post intervention change. The work marks a new and intense focus on universalization and the application of scientific method to these disorders, an essential step in treatment efficacy development. (Meston, 2003)
Lavie-Ajayi's "Because all real women do":the construction and deconstruction of "female orgasmic disorder" (2005) is probably the most inflamatory of all the research gathered for this review. The work specifically attacks the medical community for medicalizing female sexual dysfunction. The work stresses the many and frequent conflicts and inconsistancies asosciated with the various female sexual dysfunctions and asks that the research and practicum communites broaden the definitions and strict heterosexual/coital applications of "normal" female sexual activity and function. The work asserst that its; "findings challenge the idea that absence of orgasm is a medical condition, and argue that it is an embodiment experience that is socially constructed, both through media portrayals and throughmale expectations and "needs." (Lavie-Ajayi, 2005, p. 57) Fundamentally readressing this issue is essential to effective treatment but it is likely that many women who expeience inorgasmia would like the condition to be taken seriously, if not medically and addressed as such.
Kelly, Strassberg, & Turner in Behavioral Assessment of Couples' Communication in Female Orgasmic Disorder (2006) bring the discussion full circle with the development of the idea that treatment modalities are fruitless when the core issues of the psychology of sexual arousal are not addressed.
The results of this study demonstrate that there are behaviorally assessable differences in the communication…