Chapter 1

Introduction
Chapter 2
Introduction
Sexual function
Sex
The best time to have sex
The Physical and mental condition of the partners
Preparing the woman before intercourse (foreplay)
Frequency of intercourse
Place of intercourse
Intercourse positions
Sexual activity
History and evolution of attitudes toward sexual behavior
The course of scientific developments
Cultural studies on human sexual behavior
Definition of sexual behavior from the perspective of physiology and psychology
Important concepts in sexual behavior
Theories of human sexuality
Social Constructionist Theory
Feminist theory or feminist sexology
Theory of evolutionary
Psychoanalytic theory
Social exchange theory
Kelly’s personal construct theory
social learning theory
Chapter 3
Opinions of renowned psychologists and psychiatrists about human sexuality and sexual behaviors
Freud’s view on human sexuality
Stages of psychosexual development
Jung’s view on sexuality
Adler’s view on sexuality
Love and sexual desire in the view of Frankl Logotherapy
Libido theory of Erich Fromm
Horney’s theory of sexuality
Maslow’s theory of sexual behavior
Perls’s theory of sexual behavior
Masters and Johnson’s two-factor model
Normal and abnormal sexual desires and behaviors
Chapter 4
Anatomy of the female reproductive system
External genitals
Internal genitals
Secondary sex organs
Breasts
Labia
The nature of the human sexual response
Chapter 5
The female sexual response cycle phases
Linear model
Circular model
Nonlinear model
Sexual response cycle phases based on the DSM-V
Desire (libido) phase
Arousal (excitement) phase
Orgasm phase
Female orgasm phases
Types of female orgasm
Resolution
New perspectives on the phases of the female sexual response cycle
Chapter 6
Understanding the concepts and classification of sexual disorders
Classification of sexual disorders
Sexual dysfunction
Desire/arousal disorder
DSM-V criteria for female desire/arousal disorder
Prevalence of female sexual desire/arousal disorder
Factors affecting female sexual desire/arousal disorder
Specific techniques for treating female arousal/arousal disorder
Sexual pain disorders: genito-pelvic pain/penetration disorder (GPPPD)
DSM-V criteria for GPPPD
Prevalence of GPPPD
Factors affecting GPPPD
Specific techniques for treating GPPPD
Orgasmic disorders
Definition of female orgasmic disorder (FOD)
Diagnostic criteria for FOD based on DSM-V
Subtypes of FOD
Characteristics and comorbid disorders
Evolution of orgasmic disorder
Prevalence of the orgasmic disorder
Factors affecting the occurrence of orgasmic disorder
Chapter 7
General treatments for sexual dysfunction
Hypnotherapy
Analytically oriented sex therapy
Group Therapy
Pharmacological Therapy
Hormone Therapy
Mechanical aids
Behavioral Therapy
Biofeedback
Masters and Johnson Couple Therapy
Cognitive Behavioral Sex Therapy (CBST)
A general approach to sex therapy
Specific techniques for treating FOD
Appendices
References
Persian references
Non-Persian references

Chapter 1
Introduction
And of His signs is that He created for you from yourselves mates that you may find tranquility in them, and He placed between you affection and mercy. Indeed, in that are signs for people who give thought.
“Surah Ar-Rum, verse 21”

Most societies have tabooed sexual issues. However, this is an instinct that must be satisfied like any other instinct, because the formation of society will have problems and difficulties as a result of suppressing this instinct, being silent against it, building a wall of ambiguity around it, and especially the lack of proper education and understanding of it.
Sexual function is a part of human life and behavior and is so intertwined with a person’s personality that it seems impossible to speak of it as an independent phenomenon. Sexuality has always been the center of human attention, interest, and curiosity and has an undeniable effect on the quality of life of a person and his/her sexual partner. This has led to the classification of sexual dysfunction as a disorder in the field of psychiatric disorders and considering it on a diagnostic axis.
Given the many factors that affect female sexual function, it is not surprising that this process is impaired and causes problems in the phases of the sexual response cycle such as desire, arousal, and orgasm.
The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V) defines female sexual dysfunction as follows: “Disorders in the four phases of sexual activity, which are considered normal phases of sexual intercourse, or pain that occurs during intercourse.” All four phases of sexual processes have different mechanisms, so sexual dysfunction can occur in any of these mechanisms or a combination of them.
When a sexual problem occurs during the orgasm phase of the sexual response cycle, it leads to an orgasmic disorder in the person. By definition, a woman’s persistent or recurrent inability to achieve orgasm is manifested by the recurring absence or delay of orgasm following the natural sexual arousal phase, and the arousal is sufficient in terms of concentration, intensity, and duration, according to the clinician.
Female orgasmic disorder (FOD) is a common phenomenon in which a woman may not complain, but pelvic pain, vaginal itching and discharge, irritability, and fatigue are common complaints.
Statistics show that FOD is the second most common female sexual disorder in the world. According to studies, a quarter of women have not experienced orgasm during their first year of marriage.
Some of the most common psychological factors in female sexual dysfunction, especially orgasm, are inadequate education about sexual activity, insufficient sexual information, lack of foreplay, communication incompatibility, incorrect sexual beliefs and attitudes, unpleasant premarital sexual experiences, feelings of guilt about having sex and its conflict with religion, anxiety, and depression.
Previously, it was mainly tried to treat a couple’s sexual disorder by resorting to one of the types of psychotherapy (such as psychoanalysis, hypnotherapy, behavioral therapy, etc.).
Behavioral therapy is one of the most effective therapies today, but in this therapeutic approach, a person’s attitudes, sexual thoughts, and beliefs about sex are not explored much. So far, many studies have been conducted on the prevalence and etiology of FOD in general, but the study of its treatment methods has not received much attention in Iran. It should be noted that sexual attitudes and thoughts affect a person to reach orgasm, so this book is an attempt to explore this area.
Couples’ sexual problems are those that can be considered silent but ignited. Many couples end their marriage due to a lack of awareness or misunderstanding of the nature of sexual disorders.
Orgasm is an emotional and physical experience that occurs during the sexual response cycle. According to studies, reaching orgasm and sexual arousal is normal in women and all women should be able to reach orgasm. Orgasmic disorder is a type of sexual-psychosocial disorder that is a repetitive and persistent inhibition of orgasm and manifests with a delay or lack of orgasm after the arousal phase.
Despite the existence of non-behavioral therapies for the treatment of female sexual dysfunction, the most common therapies for its treatment are currently based on the Masters and Johnson approach and are mainly behavioral therapies.
It is now believed that failure to reduce maladaptive cognitions and cognitive skills deficits associated with sexual disorders such as concentration/attention skills (focusing) limit the long-term effectiveness of treatment. It is unlikely that a person’s overtly sexual behavior will change and thus disrupt behavioral therapy if such maladaptive cognitions are not properly addressed. These issues have led to cognitive approaches are also taken into consideration.
It seems that many Iranian couples suffer from sexual dissatisfaction but feel ashamed and guilty about talking about it and are unaware of its negative effects on marital dissatisfaction and, as a result, dissatisfaction with their lives.
Sexual dissatisfaction can cause deep problems in the couple’s relationship and hatred of the spouse, resentment, jealousy, competition, revenge, feelings of humiliation, lack of self-confidence, and the like. These issues are reinforced or manifested by tensions and conflicts, and gradually widen the gap between spouses.
Despite the high prevalence of sexual dysfunction in women, little attention has been paid to it and few women seek treatment.
Social, cultural, and economic factors affect the referral of these individuals for treatment. Many studies indicate that couples have hidden sexual conflicts but consider them a secret and avoid revealing them.
Patients with sexual disorders usually hide it or try to solve the problem at home. Some patients are also referred to as a gynecologist or urologist for medical treatment. These disorders require psychological therapies because psychological factors are their main causes. Therefore, their lack of proper treatment causes chronic symptoms and psychological disorders, and ultimately, deprives the couples of peace and comfort.
Considering the studies inside and outside the country and the undeniable effect of sexual dysfunction on marital conflicts on the one hand and the place of psychological therapies, especially cognitive-behavioral therapies in the treatment of sexual dysfunction, on the other hand, this book seeks to explain the effect of disorders and the place of cognitive-behavioral therapies for the audience.