Objective: The author reviews the historical paradigms that have influenced the treatment of sexual problems, changes in the diagnostic nomenclature, and recent innovations in sex therapy. Methods: The author reviews the literature and provides expert opinion. Results: The author gives a historical overview of how theoretical models of understanding human sexuality have influenced treatment, describes the changes in sexual dysfunction nomenclature, and focuses on the combined medical and psychological treatment of sexual dysfunction. Conclusion: Sex therapy continues to evolve with new paradigms and definitions for understanding and diagnosing sexual problems and innovative methods of treating sexual problems.