Sexual Health and Wellness

DYSFUNCTIONS: SEXUAL AVERSION DISORDER

Features

  • Sexual aversion disorder (SAD) refers to persistent or recurrent active avoidance of genital sexual contact with a sexual partner or by masturbation.
  • SAD may be accompanied by interpersonal difficulty (e.g., relational dissatisfaction) and reports of disgust, fear or anxiety (including possible panic attacks: extreme anxiety, feelings of terror, faintness, nausea, palpitations, dizziness, and breathing difficulties).
  • SAD can be primary, in that the person has always experienced the aversion.
  • SAD can be secondary, in that the person used to have genital contact, but now avoids it.
  • SAD can be focused, in that the aversion relates to a specific aspect of sexual experience (e.g., genital secretions, vaginal penetration).
  • SAD may be general, in that the person experiences generalised revulsion to all sexual stimuli, including kissing and touching.
  • Avoidance may include going to bed early, neglecting personal appearance, using substances, and becoming overly involved in work, social or family activities.

Epidemiology There are relatively few statistics on the number of people with sexual aversion disorder because it is often confused with other sexual dysfunctions, or with the normal fluctuations in desire associated with life stress. Causes Many things can cause a sexual aversion; it can be a psychological problem, or a combination of a physical and psychological problem. The most common causes are interpersonal problems and traumatic experiences. Interpersonal problems could include underlying tension or dissatisfaction with the relationship. Discontent with the relationship may be triggered by infidelity, major disagreements, domestic violence, or a lack of personal hygiene on the partner’s side. Sexual aversion might also be caused by strict religious or cultural teachings that associate sexual activity with excessive feelings of shame and guilt. Traumatic experiences may include incest, sexual abuse and rape. In this context, sex may be strongly associated with the painful experience or memory of the trauma. Treatment Every woman will have a unique set of circumstances causing her sexual aversion, and likewise the treatment plan should be individually tailored to meet her special needs. A detailed medical, sexual and social history should be obtained and certain blood tests carried out. This may uncover any underlying medical or psychological condition. Based on the information uncovered the treatment plan will target at the factors that may be lowering sexual interest. When an underlying medical condition is found, this will be treated first. Treatment of a psychological cause usually involves a course of psychotherapy. Couples counselling may be deemed appropriate if the disorder concerns a partner. Anti-anxiety medications may be prescribed to manage associated panic attacks.