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Female Sexual Arousal Disorder: Break the Shackles and Seek Help

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This article throws light on Female Sexual Interest/Arousal Disorder, a common but least discussed sexual health topic among females.

Written by

Dr. Bharat Udey

Medically reviewed byDr. Chithranjali Ravichandran

Published At July 20, 2015
Reviewed AtMay 21, 2024
Female Sexual Arousal Disorder: Break the Shackles and Seek Help

Introduction:

Sexuality is taboo in most societies in this world. Men, on the one hand, consider their sexuality as a jewel of their manhood crown. On the other hand, women are forbidden to discuss about their sexuality. It is considered to be their duty and responsibility to fulfill the sexual needs of their male partner. By doing so, their sexual requirements and problems remain neglected. This has not happened in the last few years but has been a continuous problem since the origin of the human race. This article is one step towards improving understanding and thus creating awareness about sexual health among females.

What Is Female Sexual Interest/Arousal Disorder (FSIAD)?

It is a common, but least discussed sexual health topic among females. In males, the inability to experience sexual pleasure while having sexual intercourse or sexual practices and reduced desire for such activities is called male hypoactive sexual desire disorder (MHSDD). Similar to MHSDD, females experience FSIAD, the prevalence of which varies from 16 % to 55 % across different regions. FSIAD improves on its own once emotional and psychological well-being is established. However, with advancing age, this problem increases in prevalence due to hormonal changes. This article throws light on female sexual interest/arousal disorder, a common but least discussed sexual health topic among females.

What Causes FSIAD?

Multiple factors are responsible for FSIAD, which include the following:

  • Biological causes - thyroid dysfunction, diabetes mellitus, coronary artery disease, hypertension, arthritis, spinal cord injuries, multiple sclerosis, urogenital/pelvic cancers.

  • Medications also result in FSIAD. These include antipsychotics, mood stabilizers, SSRIs (selective serotonin reuptake inhibitors), antihypertensives, oral contraceptives, and reduced steroid hormone levels. Medications might result in reduced estrogen levels, hence resulting in reduced sexual desire.

  • Psychological causes include major depressive disorder, anxiety, relationship issues, conflict related to body self-image, substance abuse, and physical/sexual abuse.

  • Social/environmental causes include reduced partner sexual interest, partner sexual dysfunction, and lower socio-economic status.

What Could Be the Symptoms of FSIAD?

Female arousal disorder, also known as female sexual arousal disorder (FSAD), may include symptoms such as difficulty becoming sexually aroused or maintaining arousal during sexual activity, reduced vaginal lubrication, decreased genital sensation, and lack of interest or desire for sexual activity. These symptoms can lead to distress or difficulties in sexual relationships. It is essential to consult with a healthcare professional for a proper diagnosis and appropriate treatment options.

How to Diagnose FSIAD?

FSIAD is diagnosed on the following basis:

  • Absent or reduced sexual interest in sexual activity.

  • Absent or reduced erotic thoughts or fantasies.

  • Absence of or reduced initiation or receptivity to sexual activity.

  • Absent or reduced sexual excitement/pleasure during sexual activity in all or almost all (75 to 100 percent) encounters in contexts identified as problematic or, if the problem is generalized, in all contexts.

  • Absent or reduced sexual interest/arousal to sexual/erotic cues.

  • Absent or reduced sensations during sexual activity in all or almost all encounters in contexts identified as problematic or, if the problem is generalized, in all contexts.

At least three of the above-mentioned criteria should be present to make a diagnosis of FSIAD. It is also associated with painful intercourse, female orgasmic disorder, desire, and sexual preferences discrepancies in a couple. Also, attention needs to be paid to the assessment of associated mood disturbances, anxiety, physical and sexual abuse, relationship issues, and internalization of sexual conflicts.

How to Treat FSIAD?

Like most of the other sexual disorders, FSIAD is also treatable. Treatment includes the following measures:

1. Pharmacological Measures:

  • Hormonal replacement is done to increase the estrogen level. Either estrogen supplements alone or estrogen in combination with progesterone can be used. It will increase the lubrication and will reduce vaginal dryness and atrophy, thereby reducing the discomfort associated with coitus (sexual intercourse). It is more effective in menopausal cases. Testosterone supplements can also be used.

  • Flibanserin, an agonist and antagonist to serotonin receptors, can also be used.

  • Bupropion, used for SSRIs-induced FSIAD.

  • Phosphodiesterase 5 inhibitors (PDE5 inhibitors like Sildenafil, Tadalafil, Vardenafil) can also be used.

2. Psychological Measures:

  • Sensate focus therapy, which involves sexual exercises that promote awareness of self and partner's needs.

  • Sexual skill training.

  • Communication skill training.

3. A combination of both pharmacological and psychological measures can also be used to increase the response rate.

The main aim of these measures is to increase the reinforcing value of sexual activities via an increase in arousal, orgasm, pleasure, and physical and emotional satisfaction. This also aims at improving the non-sexual conditions such as relationship dynamics, stressors, timing, and context to facilitate sexual interactions.

When to Get a Medical Opinion?

On experiencing persistent difficulties with sexual arousal, such as becoming aroused or maintaining arousal, one must seek medical advice. Additionally, if these difficulties are causing distress or impacting your relationships, seeking medical advice is important. A healthcare professional can help diagnose any underlying issues and discuss potential treatment options or referrals to specialists, such as sex therapists or gynecologists, as needed.

How to Overcome the Situation?

Overcoming female sexual interest/arousal disorder (FSIAD) often involves a multifaceted approach, which may include therapy (such as cognitive-behavioral therapy or sex therapy), couples counseling, lifestyle changes (such as stress reduction techniques, or improving communication with the partner), and possibly medications or hormone therapy prescribed by a healthcare professional. It is essential to address any underlying physical or psychological factors contributing to FSIAD and to work closely with a healthcare provider to develop a personalized treatment plan that meets the needs.

Conclusion:

To conclude, FSIAD is a psychological disorder common to be found. It is not a matter of feeling shy, and hence, it has to be discussed. Rather, females have equal right to seek pleasure as do males. Female sexual interest/arousal disorder (FSIAD) can significantly impact a person’s quality of life and intimate relationships. Seeking medical attention is important if experiencing persistent difficulties with sexual arousal or interest, as a healthcare provider can offer diagnosis, support, and guidance on appropriate treatment options. Do not hesitate to reach out for help and support.

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Frequently Asked Questions

The physiological causes of FSAD (Female sexual arousal disorder) may include:
- Damage of the blood vessels in the pelvic region resulting in reduced blood flow.
- Damage of the nerves in the pelvic area resulting in diminished arousal.
- General medical conditions like high blood pressure, coronary artery disease, and diabetes mellitus can damage blood vessels.
- Nursing a baby (lactation).
- General medical conditions like adrenal gland disorders, thyroid disorders, and removal of the ovaries cause changes in the hormone level.
- Low levels of sex hormones due to aging.
- Side effects of medications like antidepressants, antipsychotic drugs, drugs to lower the blood pressure, birth control pills, sedatives, or other hormone-containing pills.
Sexual problems usually develop when the hormones are in flux, such as after having a baby or during menopause.
- Low levels of estrogen after menopause can also lead to changes in your genital tissues and sexual responsiveness.
- A decrease in estrogen level can lead to decreased blood flow to the pelvic region, resulting in less genital sensation and more time to build arousal and reach orgasm.
- The vaginal lining will become thinner and less elastic, mainly if not sexually active. These factors can lead to painful intercourse, also known as dyspareunia.
- The body's hormone levels also shift after giving birth and during breastfeeding, leading to vaginal dryness and can affect the desire to have sex.
Female sexual arousal disorder (FSAD) is the persistent, recurrent problems with sexual response, desire, orgasm, or pain that can cause distress or strain your relationship with your partner.
- Women with decreased blood flow to the genital area are believed to get FSAD similar to vascular disease in male erectile dysfunction.
- Female sexual arousal disorder (FSAD) can occur at any stage of life.
- Women who have depression or anxiety, heart, blood vessel disease, neurological conditions, gynecological conditions, certain medications, and a history of sexual abuse can get FSAD.
If you have a minimum of three of the following, you might have FSAD (Female Sexual Arousal Disorder):
- Less interest in sex.
- Fewer thoughts related to sex.
- Reduced start and denying of sex.
- Little pleasure during sex.
- Decreased interest in sex.
- Less genital sensations during sex most of the time.
The factors associated with female sexual arousal disorder are medical health, hormones, medications, and psychological factors, including stress, relationships, comorbid mental illness, and history of sexual abuse.
It is usual for females to have fluctuations in sexual desire in some part of life. However, a total loss of interest in sex, or difficulty responding to stimulation, may indicate female sexual arousal disorder (FSIAD). This condition can be lifelong or may be acquired, which needs medical attention.
The signs of female sexual arousal disorder are:
- Low sexual drive.
- Orgasmic disorder.
- Pain during sexual stimulation or vaginal contact.
- Lesser or no sexual thoughts.
- Decreased sexual pleasure during sexual activity.
- Lesser or no arousal in response to visual, written, or verbal cues.
- Infrequent or no beginning of sexual activity within a relationship.
- Reduced or no sensations in the genitals.
- Symptoms lasting for more than six months.
- Significant distress about the symptoms.
- Symptoms that are not more accurately explained by a nonsexual mental health disorder, domestic abuse, medication, substance abuse, or another medical condition.
- Difficulty in achieving orgasm after sufficient sexual arousal and continuous stimulation.
Female sexual interest arousal disorder prevalence is often unknown, although some older women report less distress about experiencing low sexual desire than younger women. About 3.3 percent of participants between the ages of 18 and 44 have female sexual arousal disorder, while 7.5 percent of participants between the ages of 45 and 64 experienced it. The prevalence also varies depending on the age, cultural background, duration of symptoms, and presence of distress.
The effective treatment for sexual dysfunction is often addressing an underlying medical condition or hormonal change. For example, the doctor may suggest changing a medication you are taking or replacing it with a new one. And possible treatments for female sexual dysfunction are usually with Estrogen therapy. The treatment is usually based on the type and severity of the pain, and it includes sex or relationship counseling and dilation exercises. For women in long-term relationships, physicians suggest that counseling should consist of both partners.
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Dr. Bharat Udey from iCliniq

Dr. Bharat Udey

Geriatrics

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