Patients report anxiety, fear, or disgust in sexual situations. Even after the dyspareunia disappeared, painful memories may persist. Situational sexual aversion may occur in persons who attempt to or are expected to have sexual relations incongruent with their sexual orientation. Treatment Treatment is aimed at removing the underlying cause when possible. The choice of behavioral or psychodynamic psychotherapy depends on the diagnostic understanding.
Marital therapy is indicated if the cause is interpersonal.
Panic states can be treated with tricyclic antidepressants, selective serotonin reuptake inhibitors, monoamine oxidase inhibitors, or benzodiazepines. For example, diabetes mellitus may cause erectile dysfunction without psychologic contributions, but psychologic factors often also contribute. It is diagnosed when evidence from a patient's history, physical examination, or laboratory assessment can explain the dysfunction physiologically and when mental disorders that may better explain it can be ruled out. Resolution of the underlying physical disorders often results in resolution or amelioration of the sexual dysfunction. When the cause of sexual dysfunction is a combination of psychologic and physical factors, the appropriate diagnosis is sexual dysfunction due to combined factors.