Sexual Health and Wellness

DYSFUNCTIONS: FEMALE SEXUAL AROUSAL DISORDER

Features

  • Female sexual arousal disorder (FSAD) refers to a persistent or recurrent inability to reach or maintain an adequate lubrication-swelling response of sexual excitement during sexual activity.
  • The arousal response generally consists of vasocongestion in the pelvis, vaginal lubrication and expansion, and swelling of the external genitallia.
  • FSAD may be associated with Sexual Desire Disorder and Female Orgasmic Disorder.
  • FSAD may be accompanied by reports of little or no subjective sense of sexual arousal, interpersonal difficulty (e.g., relational dissatisfaction), and result in painful intercourse and sexual avoidance.
  • FSAD can be primary, in that the person has always experienced little or no arousal.
  • FSAD can be secondary, in that the person used to experience arousal, but no longer does.
  • FSAD can be focused, in that a specific aspect of the sexual experience or the partner does not lead to arousal.
  • FSAD may be general, in that the person does not experience any arousal no matter what the sexual stimuli.

Epidemiology It is roughly estimated that among women experiencing a sexual dysfunction, that approximately 17-35% report a difficulty in reaching or maintaining an adequate lubrication-swelling response. Causes Many things can cause an arousal disorder; it can be a psychological problem, or a combination of a physical and psychological problem. Female sexual arousal disorder has been associated with possible damage to the blood vessels of the pelvic region resulting in reduced blood flow. It may also be caused by damage to the nerves in the pelvic area resulting in diminished arousal capacity. General medical conditions, such as coronary artery disease, high blood pressure, diabetes mellitus, thyroid disorders, and adrenal gland disorders have also been seen to play a role. It may also be exacerbated by removal of the ovaries or lower levels of sex hormones due to aging. The side-effects of certain medications (such as antidepressants and antihypertensive medications) may also contribute. The most common psychological causes include chronic mild depression, persistent emotional stress, past sexual trauma, emotional abuse, bereavement, self-image problems, and ongoing relationship problems. Treatment Every woman will have a unique set of circumstances causing her loss of arousal, 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.