Female Sexual Arousal Disorder: Break the Shackles and Seek Help

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.

Mindfulness-based CBT (cognitive behavioral therapy).

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.