All About Female Sexual Arousal Disorder

Female sexual interest/arousal disorder (FSIAD) is the recurring inability to experience physical arousal, sexual desire, or both.

Wondering why you haven’t heard much about it? It is a newly recognized condition.

Before the release of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), experts recognized two conditions: hypoactive sexual desire disorder (HSDD) and female sexual arousal disorder (FSAD).

HSDD was considered to be a lack of sexual desire and sexual fantasies. In comparison, FSAD was characterized by an inability to maintain lubrication.

However, experts explain that because a low level of lubrication doesn’t necessarily point to a lack of arousal, it made sense to combine the two conditions. Lack of lubrication also doesn’t stop or prevent sex since there are workarounds, like lubricated condoms or lubricants.

The new diagnostic requirements for FSIAD suggest a close link between your sexual desire and how your body responds to arousal.

Prevalence

No one knows the exact number of people with FSIAD, but sexual disorders are fairly common — and nothing to be ashamed of.

Estimates suggest that between 41% and 46% of females experience sexual disorders.

No two people with FSIAD will experience the same symptoms.

You may experience:

• a lack of both physical arousal and sexual desire
• a lack of physical arousal
• a lack of sexual desire

According to the DSM-5’s diagnostic criteria, to have FSIAD, you must experience three or more of the following:

• no or limited initiation of sexual activity with partner
• no interest or reduced interest in sex
• decreased pleasure or sexual arousal during sexual activities
• limited or no thoughts about sex
• limited or no sensation in the genitals
• reduced or no arousal in response to verbal, written, or visual cues

For a doctor to diagnose you with FSIAD, your symptoms must impact your life and affect you emotionally. Some people may not feel bothered by these symptoms.

Many people consider their sexuality an important part of their life.

If you’re living with FSIAD, it can take a toll on your emotional and mental well-being.

You may feel:

• anxious
• stressed
• a low sense of self or self-worth
• like you are not pleasing your partner
• embarrassment

With treatment, you might find that your symptoms improve.

As your symptoms improve, you may have a better quality of life. Treatment may also help you feel less anxious and more satisfied with yourself and your partner.

Sexual arousal and feelings of desire are complex.

Many things can influence what you like, how often you want to take part in sexual activities, and how your body responds.

The DSM-5 lists a range of factors that can influence FSIAD, such as:

• emotional or sexual abuse
• body dysmorphic disorder
• depression or anxiety
• stress
• being dissatisfied in a relationship
• experiencing other sexual issues such as dryness, pain during sex, problems reaching orgasm, or generalized pain in the pelvic area
• menopause
• cultural, personal, or religious beliefs about sex
• lack of sexual education
• hormone imbalance
• use of certain medications, such as birth control or antidepressants

Everyone goes through periods of reduced sexual drive or physical arousal from time to time. But if you’re concerned about a consistent low sex drive, you may want to consider talking with a doctor.

If you think you may have FSIAD, you may find it helpful to perform a self-check based on the DSM-5’s criteria.

Not only do you have to experience three or more of the symptoms listed above, but the DSM-5 also says you must experience:

• significant distress regarding your symptoms
• symptoms for 6 months or more

If you meet the criteria and your doctor can’t find an underlying cause for your low sex drive, your doctor may diagnose FSIAD.

You don’t have to live with FSIAD symptoms. Treatment options are available if you decide you want to pursue them.

Some possible options to explore include:

• relationship or couples counseling
• sexual counseling
• medications to alter arousal
• hormone therapy (if you’re going through menopause)
• making changes to medications that can affect arousal, like antidepressants and birth control
• treatment for any underlying condition such as depression

It’s up to you to decide on a therapy you’re comfortable with, and that best fits your needs.

Remember, it’s a good idea to talk to a doctor before stopping or changing any medication. They can help you make the adjustment safely.

Sexual health is often a difficult topic of conversation. Talking about it may help you regain some of the pleasure FSIAD prevents.

When you’re ready, one of the first steps you can take is to contact a doctor who specializes in sexual health-related issues. Even if they can’t help you directly, they should be able to point you toward someone who can.

If you experience physical pain in your genital area, consider telling your doctor. You may have a treatable underlying condition. Treating discomfort or pain may help you feel desire and arousal.

If you’re taking medications for anxiety or depression, consider talking to your doctor about how they may be affecting your sexual health. Your prescribing doctor can adjust or change your medications to help reduce sexual side effects.

Finally, if you are in a partnered relationship and are feeling emotionally distressed, consider talking with your partner about couples counseling. Talking things out in therapy may help resolve interpersonal issues contributing to your lack of desire.