The existing therapeutic interventions for orgasmic disorders: recommendations for culturally competent services, narrative review.
BACKGROUND
In recent years, a growing number of interventions for treatment of female orgasmic problems (FODs) have emerged. Whereas orgasm is a extra biologically and learnable experience, there is a need for practitioners that to be able to select which therapy is the most appropriate to their context.


OBJECTIVE
In this critical literature review, we aimed to assess areas of controversy in the existing therapeutic interventions in FOD with taking into accounted the Iranian cultural models.


METHODS
For the present study, we conducted an extensive search of electronic databases using a comprehensive search strategy from 1970 till 2014. This strategy was using Google Scholar search, "pearl-growing" techniques and by hand-searching key guidelines, to identify distinct interventions to women's orgasmic problem therapy. We utilized various key combinations of words such as:" orgasm" OR "orgasmic "," female orgasmic dysfunction" OR Female anorgasmia OR Female Orgasmic Disorder ", orgasmic dysfunction AND treatment, "orgasm AND intervention". Selection criteria in order to be included in this review, studies were required to: 1 employ clinical-based interventions, 2 focus on FOD.


RESULTS
The majority of interventions (90%) related to non-pharmacological and other were about pharmacological interventions. Self-direct masturbation is suggested as the most privilege treatment in FOD. Reviewing all therapies indicates couple therapy, sexual skill training and sex therapy seem to be more appropriate to be applied in Iranian clinical settings.


CONCLUSIONS
Since many therapeutic interventions are introduced to inform sexually-related practices, it is important to select an intervention that will be culturally appropriate and sensitive to norms and values. Professionals working in the fields of health and sexuality need to be sensitive and apply culturally appropriate therapies for Iranian population. We further suggest community well defined protocols to screen, assessment and management of women' sexual problems such as FOD in the Iranian settings.
Student Research Center, School Mursing and Midwifery, Isfahan University of Medical Science, Isfahan Iran.
Zahra
Z
Salmani
Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan Iran.
Ali
A
Zargham-Boroujeni
Psychosomatic research center, Isfahan University of Medical Sciences, Isfahan Iran.
Mehrdad
M
Salehi
Addiction Science Division, Medical University of South Carolina, Charleston, South Carolina, USA.
Therese
T
K Killeen
Sexual and Family Health Division in Brain and Spinal Injury Research Center (BASIR), Tehran University of Medical Sciences, Tehran, Iran.
Effat
E
Merghati-Khoei
Iranian women; Orgasm; Reproductive health; Sexual dysfunction