159 Female Sexual Arousal Disorder (302.72)

DSM-IV-TR criteria

• A. Persistent or recurrent inability to attain, or to maintain until completion of the sexual activity, an adequate lubrication- swelling response of sexual excitement.
• B. The disturbance causes marked distress or interpersonal difficulty.
• C. The sexual dysfunction is not better accounted for by another Axis I disorder (except another Sexual Dysfunction) and is not due exclusively to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.
• Specify type:
  • Lifelong Type
  • Acquired Type
• Specify Type:
  • Generalized Type
  • Situational Type
• Specify:
  • Due to Psychological Factors
  • Due to Combined Factors
• Limited evidence suggests that Female Sexual Arousal Disorder is often accompanied by Sexual Desire Disorders and Female Orgasmic Disorder. The individual with Female Sexual Arousal Disorder may have little or no subjective sense of sexual arousal. The disorder may result in painful intercourse, sexual avoidance, and the disturbance of marital or sexual relationships.

Associated Features

• Personal relationship problems
• Inability to attain or maintain adequate physical response to sexual excitement. It is considered a disorder when it causes distress or interpersonal conflict

Child vs. adult presentation

Gender and cultural differences in presentation

Epidemiology

Inhibited female orgasm ranged from 18% to 76% in clinics, but only 5% to 20% in community samples. Similarly up to 62% of females seeking sex therapy experience arousal disorder, while community estimates are closer to 11%.

Etiology

May be associated with specific settings, situations and relationships or generally present in all sexual settings. It may be due to psychological factors or a combination of psychological and physical factors.

Empirically supported treatments

• Relaxation techniques and various creams and jellys are suitable lubricants and may help to alleviate the discomfort
• There is a clitoral device called Eros that was approved y the Food ad Drug Administration in 2000 and is available by prescription. The clitoris swells during sexual arousal because of vasocongestion, and vasocongestion increases clitoral sexual sensations, thus moving somewhat in step with sexual interest and lubrication. This device creates a gentle suction over the clitoris, increasing vasocongestion and sexual sensations (Leland, 2000).
• The psychological portion of treatment is directed at teaching how to focus on pleasurable thoughts and feelings about sex
• It is recommended that the sufferer discuss this matter with her gynecologist.