gynecology and obstetrics
Sexual Interest Arousal Disorder
Etiology of Sexual Interest Arousal Disorder
Common causes of sexual interest/arousal disorder are Psychological factors (eg, depression, anxiety, low self-esteem, stress, anxiety, distractibility, lack of communication between partners, other relationship problems) Unrewarding sexual experiences (eg, due to lack of sexual skills or poor communication of needs) Primarily physical factors (eg, disorders such as genitourinary syndrome of menopause and vulvar dystrophies, changes in sex hormone levels, certain medications, fatigue, debility) Use of certain medications, such as selective serotonin reuptake inhibitors (SSRIs) particularly, some antiseizure medications, and beta-blockers, can reduce sexual interest, as can drinking excessive amounts of alcohol. Certain chronic disorders (eg, diabetes, multiple sclerosis) can damage autonomic or somatic nerves or their pathways, leading to decreased sensation in the genital area. Fluctuations and changes in hormone levels (eg, at menopause, during pregnancy, postpartum, with the menstrual cycle) can also affect sexual interest. For example, the decrease inestrogenthat occurs at menopause can cause genitourinary syndrome of menopause, which can cause dyspareunia and thus lessen sexual interest. Age-related reduction oftestosteronecan decrease the sex drive, as may hyperprolactinemia (which can also cause dyspareunia becauseestrogenlevels are decreased). Inadequate sexual stimulation or the wrong setting for sexual activity can also contribute to lack of sexual interest or arousal. 