gynecology and obstetrics
Sexual Interest Arousal Disorder
Introduction
Sexual interest/arousal disorder is characterized by absence of or a decrease in sexual interest, initiation of sexual activity, pleasure, thoughts, and fantasies; absence of responsive desire; and/or lack of subjective arousal or of physical genital response to sexual stimulation—nongenital, genital, or both. (See also Overview of Female Sexual Function and Dysfunction .) Women with sexual interest/arousal disorder have little or no interest in sex and do not respond subjectively or physically to sexual stimulation. The decrease in interest and ability to be sexually aroused is greater than what might be expected based on a woman’s age and the relationship duration. Lack of sexual interest and inability to be sexually aroused are considered a disorder only if they distress women and if interest is absent throughout the sexual experience. Decreased sexual arousal can be categorized as subjective, genital, or combined. These categories are clinically based, distinguished in part by the woman’s response to genital and nongenital stimulation, as follows: Subjective:Women do not feel aroused by any type of sexual genital or nongenital stimulation (eg, kissing, dancing, watching an erotic video, physical stimulation), despite the occurrence of physical genital response (eg, genital congestion). Genital:Subjective arousal occurs in response to nongenital stimulation (eg, an erotic video) but not in response to genital stimulation. This disorder typically affects postmenopausal women. Vaginal lubrication and/or genital sexual sensitivity is reduced. Combined:Subjective arousal in response to any type of sexual stimulation is absent or low, and women report absence of physical genital arousal (ie, they report the need of external lubricants and may state they know that swelling of the clitoris no longer occurs). 