Some people struggle to maintain a healthy sex life. This paper describes the effectiveness of sex therapy in treating patients facing troubles in maintaining a healthy sex life. It improves human sexuality study by defining obstacles individuals face in forming connections with intimate partners and ways to overcome them. Different obstacles affect sex life. Some experience trauma due to sexual harassment, especially in childhood. They feel guilty and ashamed, preventing them from opening up and being vulnerable with their partners (Kolacz et al., 2020). They do not experience true intimacy since they are preoccupied with negative thoughts about themselves and others. For instance, if a female has a trauma history with a man, she can resent and become bitter towards other men, leading to poor sex health even in marriage. Another obstacle is sickness. Some diseases require patients to spend more time in hospitals, while others affect physical and emotional wellness (Merghati-Khoei et al., 2018). The individuals lack the energy and time to spend with their romantic partners. Physical diseases also cause stress and anxiety due to financial strains. Medical bills are expensive and negatively affect families, including their capacity to maintain healthy sex lives. Others experience sexual-related illnesses. There is a stigma around sexual illnesses that leads to people not seeking help. Their sexual lives are affected due to discomfort, shame, and inability to open up and seek assistance. This paper will assess whether sex therapy helps such individuals.
The articles raise several themes. They describe the role of sex therapy in different ailments, arousal/desire discrepancies, and the effectiveness of cognitive behavioral therapy (CBT). They describe different ailments and how therapies empower patients to handle and regain sexual health. They also explore arousal and desire discrepancies, primarily in how people communicate their thoughts and feelings. They emphasize CBT’s role in enabling clients to understand and cope with their thoughts and behaviors, improving their sexual lives. This literature review investigates the role of therapy in maintaining a healthy sex life. The effects of physical and sexual illnesses are discussed. CBT’s role and how couples learn to express their feelings and build intimacy are described.
Literature Review
Ailments
Ailments and impacts on sexual partners are some of the themes in the articles. Vaishnav et al. (2020) describe the clinical guidelines of the Indian Journal of Psychiatry. A descriptive approach is used, elaborating on principles that care providers should follow when interacting with patients with sexual dysfunctions. Sex education is an effective measure. It helps clients know their experiences are typical, reducing anxiety (Vaishnav et al., 2020). Care providers should also describe myths and misconceptions that can interfere with recovery. The article lists hypoactive sexual desire and female sexual arousal, arousal, orgasmic, and sexual disorders as the most prevalent. Among the suggested treatment options include psychotherapy, behavior modification, and sexual devices. They also mention that CBT is effective in treating them but is implemented differently (Vaishnav et al., 2020). In treating HSDD, a sensate focus approach should be applied, while in female orgasmic disorder, behavioral exercises like directed masturbation and systemic desensitization should be preferred (Vaishnav et al., 2020).
Moreover, patients with physical illnesses affecting their sexual health need treatment and emotional support to recover fully. According to Fernandez et al. (2023), physical therapy does not effectively improve sexual health in patients with female dyspareunia. The study used systemic review and meta-analysis from Web of Science, Scopus, Medline, PubMed, and Cinahl publications. They found that electrotherapy and pelvic floor muscle training reduce pain in patients with female dyspareunia and improve their general life quality Fernandez et al., (2023). However, the intervention does not improve sexual functioning. Bronner and Korczyn (2018) believe that patients with Parkinson’s disease improve their sexual lives through therapy. The scholars combine their expertise in treating sexual clinical disorders and review the literature to define their findings and conclusions. They claimed that when clinicians start sex talk, clients express their concerns and access the needed help. The sex therapist explores the diverse factors that can affect the patient’s sexual health and address them. They found that some patients do not spend enough time with their partners, others cannot move well, and the rest cannot express their feelings. They conclude that sex therapy is a reliable tool, as care providers identify limiting factors and empower clients to resolve them. They add that patients with dementia and multiple system atrophy also benefit from sex therapy.
Merghati-Khoei et al. (2018) also assert that physical illnesses take a toll on sexual health. The study reviewed literature from diverse databases, and the time limit was not considered. They selected articles describing the relationship between chronic illnesses and sexual function. They found that illnesses stem from social, psychological, physical, and cultural factors (Merghati-Khoei et al., 2018). Common illnesses included cancer, diabetes, and cardiovascular-related. The study found that chronic illnesses cause depression and grief (Merghati-Khoei et al., 2018). The patients lose self-confidence, esteem, and self-concept (Merghati-Khoei et al., 2018). Elderly adults experience worse effects because age causes fear, more illnesses, and changes in physical appearance. They concluded that chronic illnesses alter sexual function and performance significantly among elderly adults.
Individuals with obsessive-compulsive disorder also experience sexual dysfunction. According to Dettore et al., 2021, sex therapy can help both males and females maintain a healthy sex life despite having OCD. They used the interview method involving seventy-two OCD patients. Most questions revolved around sexual excitation, inhibition, and attachment styles. They found that more women experienced SE and less SI because they faced more performance outcomes than men (Dettore et al., 2021). The study also found that avoidantly attached patients face discomfort building intimacy (Dettore et al., 2021). Those who are anxiously attached are also preoccupied with anxious thoughts, while the secure relate well. These findings show that attachment style determines how OCD patients navigate sexual encounters. Avoidants and anxiously attached would benefit more from sex therapy because they are empowered to cope so that limitations heightened by OCD are reduced.
Cognitive Behavioral Therapy
Another critical theme in the articles is cognitive behavioral therapy. Babakhani et al., 2018 assessed the impacts of CBT on Hamadan women seeking sexual health services. It was a randomized clinical trial involving one hundred ninety-eight women working in Hamadan facilities. They were divided into two groups: one team received CBT while the other did not. Four weeks later, significant changes were evident. The group that went through CBT had better sexual health and satisfaction than the control group. The study concluded that CBT consultation determines sexual function, as women with sexual dysfunctions cope effectively, aligning their thoughts and feelings. Almas and Benestad (2021) also insist that CBT effectively helps couples improve sexual health. Both scholars work in the Department of Health and Sports at Agder University, Norway. They base the article on their experiences and William Masters and Virginia Johnson’s concepts. They mention that CBT is effective, but therapists must assess if couples need couple or individual therapies. If one or both parties have a trauma history and harmful behaviors such as infidelity, it is better to start with individual therapy before couples. Therefore, the articles believe that CBT is an effective tool in treating couples with sexual challenges.
Intimacy
The studies also shed light on desire discrepancies. Intimacy can be lacking due to illnesses. Sheikh et al., 2023 assessed whether CBT is reliable in treating women with hypothyroidism, which affects their libido and attractiveness to their sexual partners. The study involved sixty-six randomly selected reproductive women with hypothyroidism in Iran. They found that CBT was effective, as the actual group expressed better sexual functions than the control group. However, the researchers suggest that more research involving larger sample sizes is done to confirm the effectiveness of the treatment method. Almas and Benestad (2021) add that some couples experience sexual challenges because of their past and poor communication. Couples with a trauma history might not express their feelings. To build intimacy, the study suggests that therapists create a good rapport, respect clients, show empathy, and create an open environment. When couples fix their issues and learn to communicate, better sexual health develops.
Discussion
Agreement and Disagreements
The studies agree on several themes and disagree on others. They agree that ailments impact sexual health, requiring couples to seek assistance (Vaishnav et al.,2020); (Fernandez et al.,2023); (Bronner & Korczyn, 2018); (Merghati-Khoei et al., 2018) and (Dettore et al., 2021). Illnesses such as hypoactive sexual desire and female sexual arousal, arousal, orgasmic, and sexual disorders are common. Physical and mental illnesses such as diabetes, Parkinson’s Disorder, OCD, cardiovascular-related conditions, and hypothyroidism significantly impact couples. They agree that those who seek sex therapy and physical interventions overcome the issues better, resuming their healthy lives faster. The studies put more concern on elderly adults since they experience more health issues and their bodies change. They are likelier to have less self-esteem due to body changes. Current literature insists that they should seek sex therapy for better lives.
The studies also agree that CBT is an effective tool in helping couples needing sexual health services (Babakhani et al., 2018); (Almas & Benestad, 2021). The patients feel shame and guilt due to trauma histories. Others cannot express their sexual needs to their partners. These issues relate to thoughts, feelings, and behaviors, which CBT addresses. Through CBT, clients learn to communicate, cope with illnesses and past conditions, and also express themselves. It leads to better sexual functions and satisfaction. They also agree that sex therapy involves intimacy, as the partner’s communication improves and closeness (Sheikh et al., 2023); (Almas & Benestad, 2021).
However, the studies disagree that CBT helps all individuals with sexual challenges. Fernandez et al. (2023) argue that CBT does not help patients with dyspareunia. When used with exercise interventions, it eliminates pain and improves patients’ general well-being. However, this does not translate to better sexual functioning. The disagreement insinuates a need for further research to determine when care providers should consider other interventions besides CBT.
Conclusions
Based on the literature above, several conclusions concerning the role of sex therapy in maintaining a healthy sex life are evident. One, ailments are a significant obstacle affecting sexual health. Physical, mental, and sexual disorders prevent couples from having healthy sexual lives (Vaishnav et al.,2020); (Fernandez et al.,2023); (Bronner & Korczyn, 2018); (Merghati-Khoei et al., 2018) and (Dettore et al., 2021). They separate them physically but also emotionally, as they alter arousal, desire, and capacity to engage sexually. Elderly adults are affected more because they are likelier to have chronic illnesses, and body changes cause fear and reduce self-esteem. This conclusion indicates that couples experiencing diseases should seek sex therapy to avoid unsatisfying sexual lives.
Another conclusion is that CBT is an effective intervention in helping couples overcome sexually related illnesses (Sheikh et al., 2023); (Almas & Benestad, 2021). They are empowered to understand their thoughts and feelings and improve communication and intimacy. Participants who went through CBT showed better sexual functions and satisfaction. CBT might not be effective in all illnesses, but it is reliable for the majority of illnesses that impact couples’ sexual health.
Gaps
The current literature does not touch on some key concepts that can contribute to sexual health. The studies do not explore the role of attachment, which is vital in determining and shaping sexual experience. Dettore et al. (2021) touch on avoidant, anxious, and secure attachments, but it is limited to OCD patients. It is necessary to determine its role in other illnesses and situations to help therapists offer more holistic services. Also, the studies do not assess whether other therapies can be used. They agree that CBT is effective, but Fernandez et al., 2023 argue that it does not help dyspareunia patients. There is a need to assess whether other therapies are applicable so that care providers have more comprehensive options when CBT does not meet the expected outcomes.
Moreover, the current literature does not explore women’s sexual desires. They need to assess the impacts of physical illnesses on women’s sexual desires and whether sex therapy fixes it. Separating women’s and men’s sexual desires will provide more precise details to guide sex therapists in dealing with couples. Current literature mentions that people with a trauma history do not connect with their partners. However, the differences between the genders are unknown. Also, the studies do not explore thyroid illnesses and their impacts on sex life. Finally, the current studies do not diversify the populations studied. Population-specified studies lack, yet they are essential since culture plays a role in sexuality.
Next Steps and Further Research Needed
Subsequent studies should prioritize the following. They should assess the connection between attachment style and the impact of sex therapy. It will define whether some attaches recover better than others. They should also test other therapies to give care providers a more comprehensive alternative. They should test cognitive, humanistic, and behavioral therapy because they are closely related to CBT. Diversifying the populations evaluated and methods used is also necessary. Data of specific races and different socioeconomic classes should be considered. Incoming studies should use more primary studies to provide more accurate and specific findings.
Conclusion
The paper focused on the role of sexual therapy in helping people struggling with sexual health. It is essential for human sexuality to determine the challenges people face regarding ailments, arousal, and intimacy and how therapy addresses them. Different obstacles affect sex life. Some couples are unwell, thus separating them from their loved ones, while others face sexual harassment, with the effects of trauma affecting sexual interactions. These obstacles deter them from having a healthy sex life. As the rest of the population, they deserve a healthy sex life, hence a need to determine ways to assist them.
Studies conclude that CBT helps patients cope, learn needs, and communicate them. Therapists help the patients learn their triggers and thoughts that push them to not wanting to connect with their partners. Learning the triggers empowers them to cope. Another finding is that ailments are a significant obstacle. Here, the studies claim that seeking sex therapy is the ideal solution. Moreover, the studies found that intimacy and desire are a concern. Patients with painful pasts, such as sexual harassment, require guidance. They should seek therapy to establish close connections with their partner.
More research is needed to gather more details on female sexual desires and expressions. Current studies insist that not enough information on female desires is known. Both genders play a role in a healthy sex life, so future studies should focus on it. Women’s expressions also need to be explored. Subsequent studies should assess how females express their sexual desires to help counselors learn how to guide them. They should also assess the connection between attachment style and the impact of sex therapy and diversify the populations concerning race and socioeconomic status.
References
Almås, E., & Benestad, E. E. P. (2021). Treatment of traumatised sexuality. Frontiers in Psychology, 12, 610619. https://doi.org/10.3389/fpsyg.2021.610619
Babakhani, N., Taravati, M., Masoumi, Z., Garousian, M., Faradmal, J., & Shayan, A. (2018). The effect of cognitive-behavioral consultation on sexual function among women: a randomized clinical trial. Journal of Caring Sciences, 7(2), 83. https://doi.org/10.15171%2Fjcs.2018.013
Bronner, G., & Korczyn, A. D. (2018). The role of sex therapy in the management of patients with Parkinson’s Disease. Movement Disorders Clinical Practice, 5(1), 6-13. https://doi.org/10.1002%2Fmdc3.12561
Dèttore, D., Angelo, N. L., Marazziti, D., Mucci, F., Prestia, D., & Pozza, A. (2021). A pilot study of gender differences in sexual arousal of patients with OCD: The moderator roles of attachment and contamination symptoms. Frontiers in Psychiatry, 11, 609989. https://doi.org/10.3389/fpsyt.2020.609989
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Merghati-Khoei, E., Pirak, A., Yazdkhasti, M., & Rezasoltani, P. (2016). Sexuality and elderly with chronic diseases: A review of the existing literature. Journal of Research in Medical Sciences: the official journal of Isfahan University of Medical Sciences, 21. https://doi.org/10.4103%2F1735-1995.196618
Sheikh Miri, A., Iravani, M., Boostani, H, & Latifi, M. (2023). The effect of cognitive behavioral therapy on sexual function in reproductive-aged women with hypothyroidism: A randomized controlled clinical trial. BMC Psychiatry 23, 357. https://doi.org/10.1186/s12888-023-04870-1
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