• Female Sexual Dysfunction

According to a June 2015 report by U.S. Food and Drug Administration’s Patient-Focused Drug Development Initiative: “Female sexual dysfunction (FSD) is a complex and multi-faceted disorder that has a wide spectrum of symptoms and severity. … For a woman to be diagnosed with FSIAD [Female sexual interest/arousal disorder], her symptoms of reduced sexual interest/arousal must have been present for at least six months, and must be severe enough to be a source of personal distress. FSIAD can be lifelong or acquired, range from mild to severe, and may be generalized or situational.”

According to an excerpt from the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-5, accessed on 5/29/2018), those sexual dysfunctions specific to females include:

-Female sexual interest/arousal disorder,

-Female orgasmic disorder,

-Genito-pelvic pain/penetration disorder.

There are also the non-gender specific substance/medication-induced sexual dysfunction, and sexual dysfunction NOS (Not Otherwise Specified).

The sourced articles below should provide you more information on female sexual dysfunctions from identifying symptoms, to when to consult a doctor, to possible treatment plans.

  1. 1 In 10 Women Has This Sexual Disorder—And Doesn’t Even Know It

    “‘Hypoactive sexual desire disorder (HSDD) is a common form of sexual dysfunction when women have no or a low desire to have sex, and it causes distress,’ says Lauren Streicher, MD, founder and medical director of the Northwestern Medicine Center for Sexual Health and Menopause. HSDD can manifest from both physical and psychological elements. … Signs you might have HSDD …
    [1.] You’re on birth control …
    [2.] You’re on antidepressants …
    [3.] You’re closing in on menopause …
    [4.] You’re post-menopausal …
    [5.] You’ve had traumatic experiences in the past …
    [6.] Sex is painful for you …”

    Emily Shiffer, rd.com, 2/7/2019

  2. Sexuality & Sexual Problems: Other Sexual Dysfunction Disorders

    “Substance/Medication-Induced Sexual Dysfunction: To be diagnosed with this condition, there must be significant disturbance in sexual function. There must also be evidence from the person’s history, physical exam or lab findings of both of the following:
    -The disturbance developed during or soon after substance intoxication or withdrawal or after exposure to a medication
    -The involved substance or medication is capable of producing sexual dysfunction
    The disturbance cannot happen exclusively during delirium and must cause significant stress in the person’s life.”

    Lorraine Benuto, PhD, edited by C. E. Zupanick, PsyD, gracepointwellness.org, accessed on 5/30/2018

  3. Female Sexual Dysfunction: New Treatments On The Way

    “Hypoactive sexual desire disorder (HSDD) is the most common type of female sexual dysfunction, affecting approximately 10% of all adult women. In certain populations of women that we see in our clinic, including women treated with serotonergic antidepressants and perimenopausal women, rates of sexual dysfunction are even higher. Currently, flibanserin is the only medication approved by the Food and Drug Administration to treat women with HSDD.”

    Ruta Nonacs, MD, PhD, womensmentalhealth.org, accessed 3/15/2018

  4. Sexual Desire Disorder

    “Sexual desire disorder is a psychiatric condition marked by a lack of desire for sexual activity over a prolonged period. … In the DSM-5, Sexual Desire Disorder has been broken down into two separate conditions: Female Sexual Interest/Arousal Disorder and Male Hypoactive Sexual Desire Disorder. Both of these refer to a low level of sexual interest resulting in a failure to initiate or respond to sexual intimacy. … A diagnosis of sexual desire disorder in men and women refers to a lack of, or significantly reduced, sexual interest or desire for sexual activity. This can include an absence of sexual thoughts or fantasies, reduced or absent pleasure during sexual activity, and absent or reduced interest in internal or external erotic cues.”

    Online Resource, psychologytoday.com, 3/6/2018

  5. Orgasmic Disorder

    “Orgasmic disorder, now referred to as female orgasmic disorder, is the difficulty or inability for a woman to reach orgasm during sexual stimulation. This disturbance must cause marked distress or interpersonal difficulty for it to be diagnosed. The diagnosis given to men is not orgasmic disorder but rather erectile dysfunction, premature ejaculation or delayed ejaculation … Healthy attitudes toward sex as well as education about sexual stimulation and response tend to minimize problems.”

    Online Resource, psychologytoday.com, 3/6/2018

  6. Genito-Pelvic Pain Or Penetration Disorder (Sexual Pain Disorder)

    “Genito-pelvic pain/penetration disorder refers to a condition in which people experience difficulty having intercourse and feel significant pain upon penetration. The severity of the condition ranges from a total inability to experience vaginal penetration in any situation to the ability to easily experience penetration in one situation but not in another. For example, a women might not feel pain when inserting a tampon but might experience intense discomfort when attempting to have vaginal intercourse. … The nature of treatment and outcome of genito-pelvic pain/penetration disorder depends on the cause of the pain.”

    Online Resource, psychologytoday.com, 3/6/2018

  7. Women With Hypoactive Sexual Desire Disorder Versus Sexual Interest/Arousal Disorder: An Empirical Test Of Raising The Bar.

    “In 2013, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published with a major revision to the sexual dysfunction categories, and the diagnosis of female hypoactive sexual desire disorder (HSDD) was replaced with female sexual interest/arousal disorder (SIAD). Since being introduced, concern has been expressed that SIAD inappropriately ‘raises the bar’ for diagnosis. To address these concerns, we sought to evaluate the number of women with a diagnosis of HSDD who also met criteria for SIAD.”

    JI O’Loughlin, R. Basson, and LA Brotto, ncbi.nlm.nih.gov, 11/2/2017

  8. Low Sex Drive In Women: Symptoms, Diagnosis, And Treatment

    “Hypoactive sexual desire disorder (HSDD), now known as female sexual interest/arousal disorder, is a sexual dysfunction that causes a lowered sex drive in women. … There are various methods used to treat HSDD. To find the right treatment, it’s key to understand the underlying cause of your symptoms.”

    Rachel Nall, RN, BSN, CCRN, Medically reviewed by Janet Brito, PhD, LCSW, CST, healthline.com, 10/24/2017

  9. Helping Female Clients Reclaim Sexual Desire

    “The disturbance can be moderate, mild or severe, lifelong or acquired, generalized or situational. Furthermore, according to the DSM-5, ‘Women in relationships of longer duration are more likely to report engaging in sex despite no obvious feelings of sexual desire at the outset of a sexual encounter compared with women in shorter-duration relationships.’ … Estimates on how many women suffer from female sexual interest/arousal disorder vary widely, in part because there is so much complexity, variability and subjectivity to how sexual desire issues and arousal problems are measured and experienced.”

    Alicia Muñoz, counseling.org, 10/2/2017

  10. Types Of Female Sexual Dysfunction

    “As outlined in the ACOG guidelines, there are four main categories of FSD: sexual desire disorder, sexual arousal disorder, orgasmic disorder, and sexual pain disorders. Sexual dysfunction is diagnosed when symptoms of these types of sexual dysfunction cause marked distress in women or create interpersonal difficulties.”

    Mary Beth Nierengarten, MA, contemporaryobgyn.net, 8/14/2017

  11. Female Sexual Dysfunction

    “Female sexual dysfunction (FSD) is a term which is used when dissatisfaction with your sex life is causing you real unhappiness or distress. It includes problems with sex drive, with getting aroused and with achieving orgasm, but it also covers sex which is uncomfortable or painful. … FSD is common and can have many different, interacting causes. Ageing, physical illness and emotional factors can all play a large part. Lack of fitness, obesity, cardiovascular disease, diabetes and (in older women) low hormone levels play significant parts. Treatment depends on the main causes. Talking therapies and relationship counselling can be very helpful.”

    Dr Mary Lowth, patient.info, 8/1/2017

  12. Flibanserin In Postmenopausal Women With Hypoactive Sexual Desire Disorder: Results Of The PLUMERIA Study.

    “CONCLUSION: Flibanserin was generally well tolerated in this population of naturally postmenopausal women. Despite the greatly decreased power to detect improvement compared with placebo on the efficacy measurements used, results suggest that flibanserin could be efficacious in postmenopausal women with HSDD.”

    DJ Portman, L. Brown, J. Yuan, R Kissling, SA Kingsberg, ncbi.nlm.nih.gov, 6/14/2017

  13. We Need To Talk About Female Sexual Dysfunction

    “While men can take a simple drug to trigger an erection, the problem is more complex for women. While there is treatment for physical causes of FSD, and drugs that can boost female hormone production (and of course you can buy lubricant if you’re experiencing dryness), there is no drug that can cause vaginal muscles to relax. As such, female sexual dysfunction is something that often needs to be treated via therapy, or worked on within a loving and trusting relationship. There is no quick fix.”

    Abigail Chandler, metro.co.uk, 5/29/2017

  14. Hypoactive Sexual Desire Disorder Might Be Behind Your Low Libido

    “But millions of women are struggling with female sexual dysfunction, a collection of conditions that essentially lay their sex lives to waste out of nowhere. FSD is divided into four categories: arousal issues, problems reaching orgasm, pain during sex, and desire problems, Leah S. Millheiser, M.D., clinical assistant professor of obstetrics and gynecology and director of the Female Sexual Medicine Program at Stanford University Medical Center, tells SELF.”

    Zahra Barnes, self.com, 2/21/2017

  15. Female Sexual Interest/Arousal Disorders

    “Female Sexual Interest/Arousal Disorder (FSIAD) is defined in the DSM-5 as lack of, or significantly reduced, sexual interest/arousal. A woman must have three of the following six symptoms in order to receive the diagnosis: absent or reduced interest in sexual activity; absent or reduced sexual thoughts or fantasies; no or reduced initiation of sexual activity, and typically unreceptive to a partner’s attempts to initiate; absent or reduced sexual excitement or pleasure in almost all or all sexual encounters; absent or reduced sexual interest/arousal in response to any internal or external sexual cues; and absent or reduced genital or non-genital sensations during sexual activity in all or almost all sexual encounters. These symptoms must cause clinically significant distress and have persisted for a minimum of six months.”

    Cindy Meston, Ph.D. and Amelia M. Stanton, utexas.edu, 10/15/2016

  16. 5 Signs Of Sexual Dysfunction in Women

    “Discover how to treat issues like vaginal dryness and low libido so you can have a happy and healthy sex life. … Sexual dysfunction — which includes problems with desire, arousal, orgasm, and resolution — is common in both women and men. … And while both genders may deal with issues during intercourse, it’s often easier to pinpoint the problem in men, says Brett Worly, MD, an ob/gyn at The Ohio State University Wexner Medical Center in Columbus.”

    Jessica Migala, Medically Reviewed by Kathryn Keegan, MD, everydayhealth.com, 9/13/2016

  17. Pharma’s Dysfunctional Relationship With Female Sexual Dysfunction

    “In 2013, the medical community updated the Diagnostic Statistical Manual of Mental Disorders, combining female hypoactive desire dysfunction (defined as a lack of interest or desire for sex, to the point where it causes distress) and female arousal dysfunction into a single syndrome known as sexual interest/arousal disorder. Of the medical studies registered on ClinicalTrials.gov, a website of the National Institutes of Health, 341 are on erectile dysfunction, whereas only 46 are on female sexual interest/arousal disorder. This oversimplification of the female libido also reflects science’s assumptions about what women want when the lights go off.”

    Jessica Firger, newsweek.com, 4/6/2016

  18. What Is Female Sexual Dysfunction & Can It Be Cured With Female Viagra?

    “Before we can even make a decision about the effectiveness of this new pink tablet, it’s useful to take a close look at what it’s supposedly treating — female sexual dysfunction. Is it a real disorder? If so, what are the symptoms and how are they determined? Medical professionals identify it as an official disorder, but there is a lot about the condition that might come as a surprise. Here are the facts you need to know about the condition.”

    Gina M. Florio, bustle.com, 8/19/2015

  19. The Voice Of The Patient … Female Sexual Dysfunction

    “Drug development for FSIAD [Female Sexual Interest/Arousal Disorder] is complicated due to many factors, such as the limited understanding of the underlying medical condition that may be responsible for the dysfunction, challenges in diagnosing the condition, difficulty in identifying outcomes that are both meaningful to patients and are measurable, and the complexity associated with designing trials that can reliably assess the drug’s efficacy and safety.”

    Online Resource, fda.gov, 10/27/2014

  20. DSM-5 Changes In Diagnostic Criteria Of Sexual Dysfunctions

    “There are now only three female dysfunctions and four male dysfunctions, as opposed to five and six, respectively, in the DSM-IV. Female hypoactive desire dysfunction and female arousal dysfunction were merged into a single syndrome called sexual interest/arousal disorder. Similarly, the formerly separate dyspareunia and vaginismus are now called genitopelvic pain/penetration disorder. Female orgasmic disorder remains in place.”

    Waguih William IsHak, MD, and Gabriel Tobia, omicsonline.org, 8/2/2013