Treatment for FSD Related to Unresolved Childhood Sexual Abuse
423
were excluded from the study. All patients met with a trained sex therapist
who completed a psychosexual history which addressed the history of the
presenting problem, basic sexual history, relationship status and history, and
earlier sexual development. This evaluation was also used to confirm that all
patients exhibited symptoms of sexual arousal disorder with or without other
sexual function complaints, were comfortable with self-stimulation, and were
satisfied with their or their partner’s ability to stimulate them sexually.
Of the sample, 7 (23%) women had a history of unresolved CSA . Unre-
solved CSA status was determined through an initial questionnaire and de-
tails were addressed as part of the psychosexual history. Although they were
initially prescribed psychotherapy, all patients with unresolved CSA insisted
on trying sildenafil first, and pursuing therapy if sildenafil was not effective
as a first-line therapy.
Following the medical evaluation, all women were treated with 100 mg
of sildenafil to be used over a 6-week period at home. Once they had com-
pleted the home doses, patients filled out a brief 5-item questionnaire, the
Female Intervention Efficacy Index (FIEI), asking about their sexual experi-
ence following the use of sildenafil. Parameters addressed in the question-
naire included vaginal lubrication, amount and quality of sensation, satisfac-
tion with intercourse, and ability to reach orgasm. Validity of the FIEI has
been established and reliability was assessed by calculating a Cronbach a
coefficient (.81). Trends for women with and without unresolved CSA were
calculated and compared.
RESULTS
Study findings are outlined in Table 2. The parameters of sexual arousal
considered on the FIEI included vaginal lubrication, presence of genital sen-
sation, quality of genital sensation, satisfaction with intercourse and/or fore-
play, and ability to achieve orgasm. Increased vaginal lubrication with the
use of sildenafil was reported by 51% of study participants. However, the
majority of that group (60%) had no history of CSA and only 29% had unre-
solved CSA history. The results, with regard to sensation, are similar. Of the
total population, 77% reported greater sensation and 61% reported that the
sensation was pleasant or satisfying. Of these, the majority were women
without an abuse history (91% and 70%, respectively) as compared with
women with unresolved CSA history (29% for both quantity and quality of
sensation). Intercourse was reported to be more pleasant and satisfying than
before by 58% of the total sample. Of women with no CSA history, 70%
reported that intercourse was more satisfactory and satisfying and 20% re-
ported that it was pleasant, but not as pleasant as prior to female sexual
dysfunction (FSD). Of CSA survivors, only 14% reported intercourse was
more pleasant and satisfying and 14% stated that it was pleasant but not like
it was prior to their experience with FSD. Further, 14% of CSA survivors
Cason
