Few empirically validated or anecdotal reports of psychological treatment interventions can be found for arousal disorders in women. (34) Spence^ has proposed that clinicians employ techniques to facilitate increased arousal, such as fantasy training, use of erotic materials, attention-focusing skills, Kegel exercises (voluntary relaxation and contraction of the pubococcygeus muscle), and enhancing the partner's sexual skills. Concomitantly, she suggests techniques to reduce factors that may inhibit sexual arousal, such as cognitive restructuring, relaxation training, systematic desensitization of anxiety-provoking situations, and addressing the relationship issues that generate negative affects. No treatment data is available on her strategy. The lack of reported treatment studies for this female disorder may reflect the paucity of patients presenting with an arousal disorder clearly attributable to a psychological cause; most arousal complaints appear to be the result of inadequate lubrication.
Thus most female arousal disorders are initially treated with topical lubricants. Chronic medical conditions and medications that may be responsible for decreasing arousal must be carefully evaluated.
The advances in elucidating the pathophysiology of erectile response in men has recently led to renewed efforts to investigate the physiology of female arousal. Several clinical studies are under way to determine whether oral agents may have a role in the treatment of this disorder.
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