Women's Sexual Function and Dysfunction. Irwin Goldstein MD


Women’s Sexual Function and Dysfunction: Study, Diagnosis, and Treatment is the first comprehensive, multidisciplinary textbook to integrate both psychologic and biologic aspects of women’s sexual health. The goal of this textbook is to disseminate, for the first time, state-of-the-art, scientific, evidence-based information on the study, diagnosis, and treatment of women’s sexual health concerns. It is the long-range intention that this textbook be revised regularly to continue to make available to the reader the inevitable advances in the field.

The target audience for this textbook is broad, including: (1) all health-care professionals who treat women for general health issues and specifically for sexual health concerns; (2) all health-care professionals who treat men for sexual health issues and who may wish to expand their horizons and engage in treatment of the couple; (3) all basic science investigators who research the epidemiology, physiology, and pathophysiology of women’s sexual function and dysfunction; (4) women’s health educators, specifically women’s sexual health educators and those interested in the history of women’s sexual health research and the International Society for the Study of Women’s Sexual Health (ISSWSH); and (5) affected women and their families and friends, although this textbook is not tailored for the lay audience.

All women have the right to optimize their health, including sexual health. Health-care providers for woman’s health issues need access to evidence-based knowledge concerning women’s sexual health issues. To this end, the ISSWSH was established (see Chapter 1.2) by researchers and practitioners in various disciplines in a common cause. As the first multidisciplinary organization devoted solely to women’s sexual function and dysfunction from a biopsychosocial model, the ISSWSH provides the opportunity for researchers and clinicians from around the world to bring their various perspectives and share experience and knowledge in the field of women’s sexual health. The society mirrors the goals and intention of the textbook; therefore, the editors decided to donate 100% of the profits from this and future textbooks directly to ISSWSH. The editors concluded that what was of benefit for the textbook, was of benefit for the field and for the ISSWSH. Not surprisingly, all contributors agreed to participate under these circumstances. This textbook is the magnanimous expression of an idyllic spirit that permeates researchers and health-care professionals in the field of women’s sexual health.

The process of planning the textbook required development of a table of contents fluid enough to incorporate new chapters as editors realized there were areas not originally included. The editors engaged and motivated numerous experts from multiple disciplines to contribute to this textbook. These contributors are specialists of both genders and provide psychologic and biologic input from broad, international and multicultural backgrounds. We have thus drawn on the intellectual resources for this textbook from many members of the ISSWSH. Consequently, this textbook has 128 contributors from five continents. Most of the editors, associate editors, and authors are members of ISSWSH, including many of the past and present officers of the society.

Women’s Sexual Function and Dysfunction: Study, Diagnosis, and Treatment is divided into four sections. Each section presents the overall theme of the essential integration of psychologic and biologic components of women’s sexual health. The first section covers the history of sexual dysfunction research from Kinsey to the present and the history of the ISSWSH. The second section engages the multitude of psychologic and biologic etiologic factors involved in women’s sexual function and dysfunction, including many special issues concerning female sexual dysfunction syndromes as well as psychologic and biologic factors affecting the couple. The third section addresses the myriad of issues and factors involved in psychologic and biologic diagnosis and treatment of women with sexual health concerns, including management of special issues, difficult cases, and strategies to integrate medical and psychologic management. The fourth and final section relates to education and outreach for female sexual dysfunction, including educational strategies to expand women’s sexual health awareness in medical school and in the lay audience.

A critical goal was to provide basic and practical information to health-care practitioners to enable them to provide sensible and realistic care for affected women.

While the mental health community has long recognized women’s sexual dysfunction, the medical and scientific communities only recently acknowledged the biologic contributions. Building on the early physiologic studies of scientists such as Roy J Levin and Gorm Wagner, contemporary basic science researchers in women’s sexual health are continuing and broadening the investigation of the physiologic contribution to women’s sexual function. Women’s Sexual Function and Dysfunction: Study, Diagnosis, and Treatment repeatedly cultivates and promotes the concept that correct management of a woman with sexual health concerns includes both psychologic and biologic components.

We are aware that there are several areas of repetition in this book. For example, material on how to perform a sexual history and genital physical examination in a woman with sexual dysfunction is replicated several times throughout the text. This reflects the multidisciplinary nature of this book and the varying perspectives in the study, diagnosis, and treatment of women’s sexual health disorders. In addition, not all chapter requests were fulfilled. Specifically, chapters on psychologic etiology, cultural factors, and feminist approaches to sexuality education were not completed and therefore have not been included in this first printing. As we are made aware of the shortcomings of this textbook, we intend that revisions will address inadvertently deficient areas.

Because the intended readers of this book are from many different disciplines sharing the common purpose of studying, diagnosing, and treating women with sexual health concerns, it became apparent to us that there was a need for a common language. As experts in their unique niche areas of sexual medicine, authors often were highly specialized and used abbreviations known within their area of expertise. We have tried to eliminate such abbreviations whenever possible so that all readers can understand all chapters. It is our hope that this textbook successfully enables the dissemination of scientific and practical information concerning state-of-the-art management of women’s sexual health. The information contained within these covers is state of the art at the time of publication. For timely updates on new research, we recommend that readers join the ISSWSH.

We, the editors, sincerely hope you will find reading Women’s Sexual Function and Dysfunction: Study, Diagnosis, and Treatment to be as rewarding as we have found writing and editing this first textbook.


The editors wish to acknowledge the dedication and commitment of many colleagues without whom this project would not have been completed. We are indebted to the associate editors of the book: Lori A Brotto, PhD; Annamaria Giraldi, MD; Sue W Goldstein, AB; André Guay, MD; Emmanuele A Jannini, MD; Noel N Kim, PhD; Rossella E Nappi, MD, PhD; Sharon Parish, MD; Kwangsung Park, MD, PhD; and Alessandra H Rellini, MA. We take this opportunity to thank all the authors who took valuable time from their already busy lives to write chapters for this book. In particular, we would like to thank those who authored more than one chapter, as this demonstrated dedication and commitment to the field that will be appreciated by all who read this work.

In addition, we would like to thank Nick Dunton and Oliver Walter of Taylor and Francis; Nick for having the insight to want this book to be published, and Oliver for having the patience to work with us constantly. We especially would like to thank Sue W Goldstein, who, in addition to acting as an associate editor, took responsibility for keeping everyone informed and on time; without her efforts, this project would not have come to fruition.

We also wish to acknowledge those authors who lost loved ones during this time, yet persevered through their personal pain to help bring you, the reader, this timely body of - knowledge.