Biopsychosocial Approach to Therapy

There is a general expectation that modulation of the neurotransmitters involved in sexual arousability and desire from hormonal and nonhormonal therapy, will become available. As there are psychological and interpersonal sequelae of medical disruption of the sexual response, benefit beyond placebo may only be seen if a holistic biopsychosexual treatment approach is used. For instance, loss of arousability and desire in breast cancer survivors is strongly linked to ovarian failure induced by chemotherapy (103). These women report that their former means of sexual stimulation to arousal are no longer effective. Couples describe how local (vaginal) nonsystemic estrogen can allow painless but rather perfunctory intercourse. Most need encouragement to bring back their former sexual contexts and stimuli that were discarded once they no longer worked. Usually, the partner needs to be heard regarding his/her feelings of rejection. Both partners need information on the role of ovarian hormones. Partial replacement of the woman's lost ovarian androgens, rarely helps on its own.

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