Female Sexual Interest/Arousal Disorder – A New Mental Health Diagnosis

Female sexual interest/arousal disorder is a mental health condition first defined in May 2013 in the new fifth edition of the reference guide called the Diagnostic and Statistical Manual of Mental Disorders or DSM. It replaces two other conditions, called female hypoactive sexual desire disorder and female sexual arousal disorder, listed in the now obsolete fourth edition of the DSM. The shift to female sexual interest/arousal disorder reflects a growing scientific consensus that desire and arousal are not necessarily easily distinguished from one another in sexual situations.

Background Information

The Diagnostic and Statistical Manual comes from a professional organization called the American Psychiatric Association (APA), which traditionally takes the lead on providing definitions for various forms of mental illness in the United States. According to the guidelines established by the APA, all conditions that primarily involve a lack of sexual desire or sexual arousal belong to a group of disorders called sexual dysfunctions. Conditions that center on an inability to experience or control an orgasm and conditions that center on some form of intercourse-related pain also belong to this group. Some cases of sexual dysfunction have underlying mental/psychological causes such as depression, anxiety, occupational stress, performance-related insecurities, interpersonal difficulties with an intimate partner or guilt. Other cases of dysfunction have underlying physical causes such as heart disease, chronic illness, disruptions in the endocrine (hormone) system, medication side effects, or the effects of substance abuse or addiction.

Female Hypoactive Sexual Desire Disorder Basics

The fourth edition of the Diagnostic and Statistical Manual, otherwise known as DSM IV, lists female hypoactive sexual desire disorder as a specific example of a larger category called “sexual dysfunction due to a general medical condition.” Women affected by the disorder have a partial or complete lack of sexual desire that causes them mental anguish or substantially disrupts their relationships with their intimate partners. Before making a diagnosis, a doctor must determine that the lack of sexual desire has a clearly identifiable physical cause and does not stem from some sort of mental health problem. When making a diagnosis, a doctor must list the physical cause of the condition in his or her patient’s records.

Female Sexual Arousal Disorder Basics

According to the old DSM IV guidelines, female sexual arousal disorder occurs when a woman doesn’t experience the vaginal swelling and lubrication normally associated with increased sexual desire, or when a woman can’t sustain vaginal swelling and lubrication throughout sexual activity. In order to qualify for a diagnosis, an affected woman must also suffer mentally/emotionally from her inability to experience or sustain arousal, or experience interpersonal problems stemming from the same cause.  In addition, a person diagnosed with female sexual arousal disorder must not have a physical problem that accounts for her condition, or have a contributing mental/psychological problem other than sexual dysfunction. The DSM IV criteria state that some women experience sexual arousal problems starting with their first sexual activity, while others only start experiencing problems at some later date. The criteria also state that some women experience a lack of desire in every sexual situation, while others only experience this lack in certain situations.

Female Sexual Interest/Arousal Disorder

After reviewing the scientific research and clinical findings gathered since the publication of the last version of DSM IV, the American Psychiatric Association committee responsible for overseeing the sexual dysfunctions category concluded that people naturally have significant variances in their normal levels of sexual desire and sexual arousal. The members of this committee also concluded that the line between desire and arousal is not necessarily as clear-cut as the definitions used in DSM IV would make it seem. In line with these conclusions, the APA decided to jettison female hypoactive sexual desire disorder and female sexual arousal disorder from the newly published fifth edition of the DSM (DSM 5) and replace them with female sexual interest/arousal disorder. This move also essentially eliminates the distinction between desire- or arousal-related problems that have physical causes and desire- or arousal-related problems that have mental/emotional causes. The definition for female sexual interest/arousal disorder establishes a minimum timeframe of six months from the onset of symptoms before a doctor can officially diagnose the condition. It also requires doctors to make note of the severity of symptoms they find in each patient. In addition, the definition for the disorder does not distinguish between women who only experience symptoms in some sexual situations and women who experience symptoms in all sexual situations. All of these secondary criteria are now also in effect for all other conditions in the sexual dysfunctions category.

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