Female sexual arousal disorder
Female sexual arousal disorder (FSAD) is a disorder characterized by a persistent or recurrent inability to attain sexual arousal or to maintain arousal until the completion of a sexual activity. The diagnosis can also refer to an inadequate lubrication-swelling response normally present during arousal and sexual activity. The condition should be distinguished from a general loss of interest in sexual activity and from other sexual dysfunctions, such as the orgasmic disorder (anorgasmia) and hypoactive sexual desire disorder, which is characterized as a lack or absence of sexual fantasies and desire for sexual activity for some period of time.
Although female sexual dysfunction is currently a contested diagnostic, it has become more common in recent years to use testosterone-based drugs off-label to treat FSAD. Individual factors
There has been little investigation of the impact of individual factors on female sexual dysfunction. Such factors include stress, levels of fatigue, gender identity, health, and other individual attributes and experiences, such as dysfunctional sexual beliefs[2] that may affect sexual desire or response. Over exposure to pornography-style media is also thought to lead to poor body image, self-consciousness and lowered self-esteem.[3][failed verification] An individual's sexual activity is disrupted by overwhelming emotional distress resulting in inability to attain sexual pleasure. Sexual dysfunction can also occur secondary to major psychiatric disorders, including depression.
Relationship factors
A substantial body of research has explored the role of interpersonal factors in female sexual dysfunction, particularly in relation to orgasmic response. These studies have largely focused on the impact of the quality of the relationship on the sexual functioning of the partners. Some studies have evaluated the role of specific relationship variables, whereas others have examined overall relationship satisfaction. Some studies have explored events, while others have focused on attitudes as an empirical measure of relationship functioning. Subject populations have varied from distressed couples to sexually dysfunctional clients to those in satisfied relationships.
Social context
In addition to past experience and personal psychology, social context plays a factor:
Human sexual behavior also varies with hormonal state, social context, and cultural conventions. Ovarian hormones influence female sexual desire, but the specific sexual behaviors engaged in are affected by perceived pregnancy risk, suggesting that cognition plays an important role in human sexual behavior.
Physical factors
Estimates of the percentage of female sexual dysfunction attributable to physical factors have ranged from 30% to 80%. The disorders most likely to result in sexual dysfunction are those that lead to problems in circulatory or neurological function. These factors have been more extensively explored in men than in women. Physical etiologies such as neurological and cardiovascular illnesses have been directly implicated in both premature and retarded ejaculation as well as in erectile disorder,[7] but the contribution of physiological factors to female sexual dysfunction is not so clear. However, recent literature does suggest that there may be an impairment in the arousal phase among diabetic women. Given that diabetic women show a significant variability in their response to this medical disorder, it is not surprising that the disease's influence on arousal is also highly variable. In fact, the lack of a clear association between medical disorders and sexual functioning suggests that psychological factors play a significant part in the impact of these disorders on sexual functioning.
Kenneth Maravilla, Professor of Radiology and Neurological Surgery and Director of MRI Research Laboratory at the University of Washington, Seattle, presented research findings based on neuro-imaging of women's sexual function. In a small pilot study of four women with female sexual arousal disorder, Maravilla reported there was less brain activation seen in this group, including very little activation in the amygdala. These women also showed increased activation in the temporal areas, in contrast to women without sexual difficulties, who showed deactivation in similar areas. This may suggest an increased level of inhibition with an arousal stimulus in this small group of women with FSAD.
Several types of medications, including selective serotonin reuptake inhibitors (SSRIs), can cause sexual dysfunction and in the case of SSRI and SNRI, these dysfunctions may become permanent after the end of the treatment.
Interplay of causes
Kaplan proposed that sexual dysfunction was based on intrapsychic, interpersonal, and behavioural levels.[4] Four factors were identified that could have a role in the development of sexual dysfunction: 1) lack of correct information regarding sexual and social interaction, 2) unconscious guilt or anxiety regarding sex, 3) performance anxiety, and 4) failure to communicate between the partners.
Female sexual arousal disorder (FSAD) is a disorder characterized by a persistent or recurrent inability to attain sexual arousal or to maintain arousal until the completion of a sexual activity. The diagnosis can also refer to an inadequate lubrication-swelling response normally present during arousal and sexual activity. The condition should be distinguished from a general loss of interest in sexual activity and from other sexual dysfunctions, such as the orgasmic disorder (anorgasmia) and hypoactive sexual desire disorder, which is characterized as a lack or absence of sexual fantasies and desire for sexual activity for some period of time.Although female sexual dysfunction is currently a contested diagnostic, it has become more common in recent years to use testosterone-based drugs off-label to treat FSAD. Individual factors
Relationship factors
A substantial body of research has explored the role of interpersonal factors in female sexual dysfunction, particularly in relation to orgasmic response. These studies have largely focused on the impact of the quality of the relationship on the sexual functioning of the partners. Some studies have evaluated the role of specific relationship variables, whereas others have examined overall relationship satisfaction. Some studies have explored events, while others have focused on attitudes as an empirical measure of relationship functioning. Subject populations have varied from distressed couples to sexually dysfunctional clients to those in satisfied relationships.
Social context
In addition to past experience and personal psychology, social context plays a factor:
Human sexual behavior also varies with hormonal state, social context, and cultural conventions. Ovarian hormones influence female sexual desire, but the specific sexual behaviors engaged in are affected by perceived pregnancy risk, suggesting that cognition plays an important role in human sexual behavior.
Physical factors
Estimates of the percentage of female sexual dysfunction attributable to physical factors have ranged from 30% to 80%. The disorders most likely to result in sexual dysfunction are those that lead to problems in circulatory or neurological function. These factors have been more extensively explored in men than in women. Physical etiologies such as neurological and cardiovascular illnesses have been directly implicated in both premature and retarded ejaculation as well as in erectile disorder,[7] but the contribution of physiological factors to female sexual dysfunction is not so clear. However, recent literature does suggest that there may be an impairment in the arousal phase among diabetic women. Given that diabetic women show a significant variability in their response to this medical disorder, it is not surprising that the disease's influence on arousal is also highly variable. In fact, the lack of a clear association between medical disorders and sexual functioning suggests that psychological factors play a significant part in the impact of these disorders on sexual functioning.
Kenneth Maravilla, Professor of Radiology and Neurological Surgery and Director of MRI Research Laboratory at the University of Washington, Seattle, presented research findings based on neuro-imaging of women's sexual function. In a small pilot study of four women with female sexual arousal disorder, Maravilla reported there was less brain activation seen in this group, including very little activation in the amygdala. These women also showed increased activation in the temporal areas, in contrast to women without sexual difficulties, who showed deactivation in similar areas. This may suggest an increased level of inhibition with an arousal stimulus in this small group of women with FSAD.
Several types of medications, including selective serotonin reuptake inhibitors (SSRIs), can cause sexual dysfunction and in the case of SSRI and SNRI, these dysfunctions may become permanent after the end of the treatment.
Interplay of causes
Kaplan proposed that sexual dysfunction was based on intrapsychic, interpersonal, and behavioural levels.[4] Four factors were identified that could have a role in the development of sexual dysfunction: 1) lack of correct information regarding sexual and social interaction, 2) unconscious guilt or anxiety regarding sex, 3) performance anxiety, and 4) failure to communicate between the partners.
Diagnosis
Little interest in sex
Few thoughts related to sex
Decreased start and rejecting of sex
Little pleasure during sex most of the time
Decreased interest in sex even when exposed to erotic stimuli
Little genital sensations during sex most of the time
Few thoughts related to sex
Decreased start and rejecting of sex
Little pleasure during sex most of the time
Decreased interest in sex even when exposed to erotic stimuli
Little genital sensations during sex most of the time
References
"Female Sexual Arousal Disorder". BehaveNet. Retrieved 2013-05-16.
Nobre, Pedro J.; Pinto‐Gouveia, José (2006). "Dysfunctional sexual beliefs as vulnerability factors for sexual dysfunction". Journal of Sex Research. 43 (1): 68–75. CiteSeerX 10.1.1.551.3993. doi:10.1080/00224490609552300. PMID 16817069.
Serina, Sandhu. "One in three women watch porn at least once a week, survey finds". The Independent. Retrieved 2015-12-21.
Hales E and Yudofsky JA, eds, The American Psychiatric Press Textbook of Psychiatry, Washington, D.C.: American Psychiatric Publishing, Inc., 2003
Witting, Katarina; Santtila, Pekka; Alanko, Katarina; Harlaar, Nicole; Jern, Patrick; Johansson, Ada; Pahlen, Bettina von der; Varjonen, Markus; Ålgars, Monica (2008). "Female Sexual Function and Its Associations with Number of Children, Pregnancy, and Relationship Satisfaction". Journal of Sex & Marital Therapy. 34 (2): 89–106. doi:10.1080/00926230701636163. PMID 18224545.
Wallen, Kim (2001). "Sex and Context: Hormones and Primate Sexual Motivation". Hormones and Behavior. 40 (2): 339–57. CiteSeerX 10.1.1.22.5968. doi:10.1006/hbeh.2001.1696. PMID 11534996.
Hawton, K (1993). Sex Therapy. Oxford, UK: Oxford University Press.[page needed]
Melman et al. 1988[verification needed]
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (Fifth ed.). Arlington, VA: American Psychiatric Publishing. 2013. p. 433. ISBN 978-0-89042-554-1.
DSM-IV, American Psychiatric Association 1994, p. 502
McCabe, Marita P. (29 May 2006). "Female Sexual Arousal Disorder and Female Orgasmic Disorder". Armenian Medical Network.
Mullard, Asher (1 October 2015). "FDA approves female sexual dysfunction drug". Nature Reviews Drug Discovery. 14 (10): 669. doi:10.1038/nrd4757. PMID 26424353.
Nobre, Pedro J.; Pinto‐Gouveia, José (2006). "Dysfunctional sexual beliefs as vulnerability factors for sexual dysfunction". Journal of Sex Research. 43 (1): 68–75. CiteSeerX 10.1.1.551.3993. doi:10.1080/00224490609552300. PMID 16817069.
Serina, Sandhu. "One in three women watch porn at least once a week, survey finds". The Independent. Retrieved 2015-12-21.
Hales E and Yudofsky JA, eds, The American Psychiatric Press Textbook of Psychiatry, Washington, D.C.: American Psychiatric Publishing, Inc., 2003
Witting, Katarina; Santtila, Pekka; Alanko, Katarina; Harlaar, Nicole; Jern, Patrick; Johansson, Ada; Pahlen, Bettina von der; Varjonen, Markus; Ålgars, Monica (2008). "Female Sexual Function and Its Associations with Number of Children, Pregnancy, and Relationship Satisfaction". Journal of Sex & Marital Therapy. 34 (2): 89–106. doi:10.1080/00926230701636163. PMID 18224545.
Wallen, Kim (2001). "Sex and Context: Hormones and Primate Sexual Motivation". Hormones and Behavior. 40 (2): 339–57. CiteSeerX 10.1.1.22.5968. doi:10.1006/hbeh.2001.1696. PMID 11534996.
Hawton, K (1993). Sex Therapy. Oxford, UK: Oxford University Press.[page needed]
Melman et al. 1988[verification needed]
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (Fifth ed.). Arlington, VA: American Psychiatric Publishing. 2013. p. 433. ISBN 978-0-89042-554-1.
DSM-IV, American Psychiatric Association 1994, p. 502
McCabe, Marita P. (29 May 2006). "Female Sexual Arousal Disorder and Female Orgasmic Disorder". Armenian Medical Network.
Mullard, Asher (1 October 2015). "FDA approves female sexual dysfunction drug". Nature Reviews Drug Discovery. 14 (10): 669. doi:10.1038/nrd4757. PMID 26424353.
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