Female sexual interest/arousal disorder (FSIAD) is defined as absent/significantly reduced sexual interest or arousal in women. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (DSM-5), FSIAD is manifested by at least three of the following symptoms:
- Absent/reduced interest in sexual activity.
- Absent/reduced sexual/erotic thoughts or fantasies.
- No/reduced initiation of sexual activity, and typically unreceptive to a partner’s attempts to initiate.
- Absent/reduced sexual excitement/pleasure during sexual activity in almost all or all (approximately 75%–100%) sexual encounters (in identified situational contexts or, if generalized, in all contexts).
- Absent/reduced sexual interest/arousal in response to any internal or external sexual/erotic cues (e.g., written, verbal, visual).
- Absent/reduced genital or non-genital sensations during sexual activity in almost all or all (approximately 75%–100%) sexual encounters (in identified situational contexts or, if generalized, in all contexts).
Symptoms must persist for at least 6 months and cause clinically significant distress in the patient for a diagnosis of FSIAD to be given. To warrant a FSIAD diagnosis, the symptoms cannot be better explained by a nonsexual mental disorder, severe relationship distress, or other significant life stressors. Lastly, the patient’s complaints cannot be related to another medical condition, substance, or medication to receive a FSIAD diagnosis.
When diagnosing FSIAD in a patient, there are a few things that a medical professional should consider.
- It is important to determine whether the condition is lifelong (i.e., it has been present since the individual became sexually active) or acquired (i.e., it began after a period of relatively normal sexual functioning).
- The provider should identify whether the condition is generalized or situational.
- Generalized FSIAD occurs regardless of the type of stimulation, situation, or partner.
- Situational FSIAD occurs with certain types of stimulation, situations, or partners.
- FSIAD should be classified as mild, moderate, or severe, in accordance with the level of distress the patient exhibits regarding their symptoms.
FSIAD and other medical conditions that decrease a person’s sexual desire can have a negative impact on a patient’s sexual health and overall quality of life. Accurately diagnosing sexual interest and arousal disorders can be the first step towards improving sexual health outcomes for patients.
References:
Both S. (2017). Recent Developments in Psychopharmaceutical Approaches to Treating Female Sexual Interest and Arousal Disorder. Current sexual health reports, 9(4), 192–199. https://doi.org/10.1007/s11930-017-0124-3
Clayton, A.H., & Valladares Juarez, E.M. (2019). Female Sexual Dysfunction. The Medical clinics of North America, 103(4), 681–698. https://doi.org/10.1016/j.mcna.2019.02.008
Faubion, S.S., & Rullo, J.E. (2015). Sexual Dysfunction in Women: A Practical Approach. American family physician, 92(4), 281–288.
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