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Diagnosis and Treatment |

Marital Sexual Dysfunction: Introductory Concepts

STEPHEN B. LEVINE, M.D.
[+] Article and Author Information

Grant support: by a grant from the Robert Wood Johnson Foundation, Princeton, New Jersey. The opinions, conclusions, and proposals in this paper are those of the author and do not necessarily represent the views of the Robert Wood Johnson Foundation, in whose program Dr. Levine is a Clinical Scholar specializing in sexual problems.

▸Requests for reprints should be addressed to Stephen B. Levine, M.D., 2040 Abington Rd., Cleveland, OH 44106.


Cleveland, Ohio


Ann Intern Med. 1976;84(4):448-453. doi:10.7326/0003-4819-84-4-448
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The concepts presented in this overview of marital sexual dysfunction are derived from increasing clinical experience with couples who seek help for their sexual problems. These couples, in marked contrast to couples with good sexual functioning, usually report a steady state of emotional dissatisfaction and minimal physical pleasure from sex. The effectual and behavioral consequences of persistent dysfunction are reviewed. Sexual therapy is discussed in terms of its two elements, sensate focus and psychotherapy. The various tasks which the sexual therapist may have to accomplish with individual couples are described. Consideration is given to the specific hypotheses usually offered as explanation for sexual dysfunction—i.e., organic factors, varying degrees of relationship failure, poor communication, sexual ignorance, performance anxiety, and intrapsychic residua of past experience. A protocol for the screening physician to use in the formulation of a reasonable clinical plan for dysfunctional couples is included.

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