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 sexual activity. The condition should be distinguished from a general loss of interest in sexual activity and from other sexual dysfunctions, such as orgasmic disorder and hypoactive sexual desire disorder. Although female sexual dysfunction is currently a contested diagnostic, it has become more common in recent years to use testosterone-based drugs off-label. Siddha Spirituality of Swami Hardas Life System appeals to all our valuable readers to get well acquainted with FSAD for well-being.
What is Female sexual arousal disorder?
Female sexual arousal disorder occurs when the body doesn’t respond to sexual stimulation. However, experts recently concluded it’s very difficult to distinguish between these two conditions. In response, doctors now use the term female sexual interest/arousal disorder (FSIAD), according to new guidelines in the new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
Female sexual arousal disorder Symptoms
For many women, the symptoms of FSIAD come and go. Some have symptoms every time they try to have intercourse or engage in sexual activity. Others may only experience them occasionally.
Symptoms of FSIAD include:
- Decreased sexual desire. You may begin to lose interest in sex. While this can be due to lack of arousal, it may also be a symptom of stress and anxiety from having FSIAD.
- Few thoughts related to sex. You may rarely think about sex.
- Less initiation of sexual activity. You may not initiate sex and maybe unreceptive to a partner’s attempts to initiate sex.
- Decreased sexual excitement or pleasure during sex. Sexual stimulation or other things that used to turn you on no longer do.
- Reduced arousal from internal or external sexual cues. You may no longer be aroused by cues like psychological intimacy, reading about enjoyable sex, or recalling an erotic fantasy.
- Lack of genital or non-genital sensations during sex. When having sex, you might not feel much in your genital area or other erogenous zones.
Female sexual arousal disorder Causes
A number of studies have explored the factors that contribute to female sexual arousal disorder and female orgasmic disorder. These factors include both psychological and physical factors. Psychologically, possible causes of the disorder include the impact of childhood and adolescence experiences and current events – both within the individual and within the current relationship.
Individual factors of Female sexual arousal disorder
There has been little investigation of the impact of individual factors on female sexual dysfunction. Such factors include:
- Levels of fatigue
- Gender identity
- Other individual attributes and experiences
- Dysfunctional sexual beliefs that may affect sexual desire or response
- Overexposure to pornography-style media is also thought to lead to poor body image
- Self-consciousness, and
- Lowered self-esteem.
An individual’s sexual activity is disrupted by overwhelming emotional distress resulting in an inability to attain sexual pleasure. Sexual dysfunction can also occur secondary to major psychiatric disorders, including depression.
Relationship factors of Female sexual arousal disorder
A substantial body of research has explored the role of interpersonal factors in female sexual dysfunction, particularly in relation to the 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 satisfying relationships.
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.
Female sexual arousal disorder Physical factors
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 erectile disorder, 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 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.
Female sexual arousal disorder Interplay of causes
Kaplan proposed that sexual dysfunction was based on intrapsychic, interpersonal, and behavioral levels. Four factors were identified that could have a role in the development of sexual dysfunction:
- Lack of correct information regarding sexual and social interaction,
- Unconscious guilt or anxiety regarding sex,
- Performance anxiety, and
- Failure to communicate between the partners.
Female sexual arousal disorder Diagnosis
The DSM-5 lists the diagnostic criteria as including a minimum of three of the following:
- 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
The DSM-IV (American Psychiatric Association 1994) diagnostic criteria were:
- Persistent or recurrent inability to attain, or to maintain until completion of the sexual activity, an adequate lubrication-swelling response of sexual excitement,
- The disturbance causes marked distress or interpersonal difficulty, and
- The sexual dysfunction is not better accounted for by another Axis I disorder and is not due exclusively to the direct physiological effects of a substance e.g. a drug of abuse, a medication, or a general medical condition.
Marita P. McCabe noted:
Difficulties arise with this definition in terms of what constitutes an adequate lubrication-swelling response. There is no “gold standard” regarding the length of time it should take to become aroused or the level of arousal that should be achieved. These responses may vary from one woman to another and are dependent on a range of factors, which include her general mood when sexual stimulation commences and her partner’s skill in stimulating her.
There may also be differences in physiological and subjective levels of arousal, with some women reporting no feelings of sexual arousal despite evidence of vaginal vasocongestion and others reporting arousal in the absence of such evidence. The expectations and past experiences of clinicians and clients may also lead them to classify the same symptoms as female sexual arousal disorder in one woman but not in another.
Subtypes of Female sexual arousal disorders
There are several subtypes of female sexual arousal disorders. They may indicate onset: lifelong (since birth) or acquired. They may be based on context: they may occur in all situations or be situation-specific. For example, the disorder may occur with a spouse but not with a different partner.
The length of time the disorder has existed and the extent to which it is partner- or situation-specific, as opposed to occurring in all situations, may be the result of different causative factors and may influence the treatment for the disorder. It may be due to psychological factors or a combination of factors.
Female sexual arousal disorder Treatment
The FDA has approved flibanserin and bremelanotide for low sexual libido in women.
Treatment for FSIAD focuses on identifying any underlying causes and treating them. Many women find that a combination of treatments seems to work best.
Depending on the underlying cause, treatments often include medication, therapy, or a combination of both.
Some medication-related treatments include:
- Hormone therapy. If the underlying cause is hormonal, hormone therapy may help treat low estrogen or testosterone, vaginal dryness, or pain during intercourse.
- Changing the medication dosage. If a medication you take, such as an antidepressant, is causing your symptoms, adjusting your dosage may help.
Working with a therapist who specializes in sexual health, either on your own or with your partner, can also help address some of the psychological elements of FSIAD.
Even if you don’t have any underlying mental health conditions, a therapist can help you identify what actually stimulates you and any barriers that are getting in the way. They can also provide guidance on how to build trust and intimacy with your partner, which can play a large role in arousal.
When looking for a therapist, consider seeing someone who’s a sex therapist. These are mental health professionals who focus on different aspects of sexuality, from dealing with past trauma to helping people identify what arouses them.
Experiment with different elements, such as soft lighting, relaxing music, or soft fabrics. If you’re in a partnered relationship, you can also try talking to your partner about trying sexual activities outside of intercourse, such as massage or showering together.
A sex therapist can also assign homework, such as masturbation and fantasy training. They can also provide you with tools to help improve sexual communication.
Foods for Female sexual arousal disorder
Certain foods, including herbs, have been shown to increase sex drive in at least a handful of studies. Just keep in mind that most of these studies haven’t been very big or rigorous, so don’t put all your hopes and dreams on them.
One more tidbit to remember when it comes to herbal supplements: Doses vary from product to product, so be sure to follow the manufacturer’s guidelines.
On that note, it’s also a good idea to check in with your healthcare provider or a pharmacist about how any of these supplements may interact with:
- Prescription medications
- Over-the-counter medications
- Other herbal supplements
Ginkgo biloba is a popular herbal supplement that can be consumed in many forms. Preliminary research suggests that ginkgo may be effective as a natural aphrodisiac. However, the results of a study on the use of ginkgo are inconclusive on whether or not it actually boosts sexual function in females.
Looking for another easy-to-find supplement? Ginseng is one that has many potential health benefits.
A small, recent study concluded that ginseng outperformed the placebo to help combat sexual dysfunction in people using methadone. How will this affect people who aren’t using methadone? More research is needed, but it may be worth a shot.
According to one Study Trusted Source, maca may have some potential for treating antidepressant-induced sexual dysfunction in postmenopausal women. Plus, maca has historically been used to boost fertility and sexual desire.
While research is promising, a recent review notes that some of the claims surrounding maca may be a bit overblown.
Another herbal supplement that may be effective for increasing libido is Tribulus Terrestris. One study Trusted Source assessed whether 7.5 milligrams (mg) of Tribulus Terrestris extract was effective for female sexual interest/arousal disorder.
After 4 weeks, those who took the extract reported an improvement in their sexual desire, arousal, and satisfaction.
A popular and expensive spice, saffron is often recommended as an aphrodisiac — and early research backs it up. In one study, women taking antidepressants saw a significant improvement in sexual arousal after taking saffron for 4 weeks.
However, while this study found an improvement in sexual arousal, it did not see an improvement in sexual desire.
Red wine is a widely recommended aphrodisiac. In addition to its other potential benefits, red wine may also improve sexual function, according to a 2009 study.
However, it’s important to note that these findings were self-reported by small sample size. Plus, other studies suggest that consuming too much alcohol may have the reverse effect on libido, so moderation is key.
Believe it or not, apples may have a positive effect on female sex drive. One study found that women who consumed an apple a day reported a better quality of sex life.
While this sounds promising, this study only suggests a correlation between apple consumption and sexual health. It’s not totally clear if eating apples directly affects sexual function. Plus, there are no other major studies on whether apples may increase libido.
Some research suggests it may help boost libido. A study concluded that fenugreek may be an effective treatment to increase female sex drive. However, most of the current research on fenugreek covers male sexual health.