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Abstract
Sildenafil reinvigorated sex therapy, expanding the number and range of individuals restored to sexual health. Sildenafil used adjunctively with sex therapy accelerated therapy and improved outcome in treating erectile dysfunction (ED). For women, sildenafil initially was used "off label" as a primary treatment for female sexual dysfunction (FSD). However, sildenafil could also be used in conjunction with sex therapy for dysfunctional male partners of women with FSD, so that his ED does not sabotage her treatment. This article describes an integrated treatment, where adjunctive sildenafil use was an important strategic component in the sex therapy of a couple's unconsummated marriage in which the wife's vaginismus, dyspareunia, and anorgasmia was complicated by her husband's ED and retarded ejaculation (RE).