LE DESIR FEMININ HYPOACTIF
PANORAMA DE LA CLINIQUE SEXOLOGIQUE ACTUELLE
ANALYSE ET PROPOSITIONS DE COUNSELLING

Annexe 1

Newly published revised, expanded definitions of women’s sexual dysfunctions attempt to acknowledge the highly contextual nature of women’s sexuality. To aid clinical
management of these dysfunctions, these definitions now emphasize assessment of the context of women’s problematic sexual experiences.

Seven key questions for the couple

1. Ask the couple to explain their sexual problem(s) in their own words. Clarify details with direct questions, giving options rather than leading questions.
2. Establish the duration of their problems; whether they are generalized or situational; and which one(s) have priority.
3. Determine the context of the sexual problems. How is their emotional intimacy? How useful are the sexual stimuli?
4. How erotic is the context? Are attempts restricted to bedtime, when 1 or both partners need to sleep? What frequency of sex is expected or attempted? Are there concerns about birth control, safety from STDs or privacy ? Are the sexual skills of the partners adequate? Is their mutual communication about their sexual needs problematic?
5. Determine the rest of the sexual response for each partner. (For example, she presents with dyspareunia but currently rarely becomes aroused or attains any sexual desire during the experience, and is progressively losing her motivation to be receptive to sex.) If these problems have developed during the current relationship, check each partner’s earlier response(s) when together.
6. Enquire how each partner has reacted to the problem(s).
7. Note any previous treatment(s), their compliance and benefit. Clarify why the couple is seeking help now, and assess their motivation to
make changes.

Interview each partner alone

• Clarify this partner’s view of the problem(s) and how this partner thinks they are coping.
• Review this partner’s sexual response to self-stimulation.

- Ask about the interviewee’s past partnered sexual experiences and their positive and negative aspects.
- Determine a developmental history: relationships with parents or caregivers, any losses or traumas, and how he or she coped.
- Inquire if the partner ever experienced sexual, emotional or physical abuse, whether as a child or as an adult.

*Questions marked with open bullets (-) may be omitted in some cases, e.g., for a recently developed problem after decades of healthy sexual function.

BASSON Rosemary . Women’s sexual dysfunction: revised and expanded definitions CMAJ • MAY 10, 2005; 172 (10)