SEXUAL AROUSAL PROBLEMS IN WOMEN

DEFINITION


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Definition:
Sexual arousal disorder means: a persistent or recurrent inability to attain or maintain adequate lubrication and a swelling response in the genitals and feel sexual excitement until completion of the sexual activity.

This problem causes distress and interpersonal difficulties.

Three types of sexual arousal disorder are recognised [1]
  1. Subjective arousal disorder: absent or markedly diminished feelings of sexual arousal [sexual excitement and sexual pleasure] from any type of sexual stimulation. Vaginal lubrication and other signs of physical response [e.g. nipple erection] still occur.
  2. Genital arousal disorder: absent or minimal swelling of the vulva [lips surrounding the opening to the vagina], and little or no vaginal lubrication from any type of sexual stimulation, and reduced sensations from having her genitals caressed. She can still feel erotic arousal [be subjectively aroused] for instance by viewing an erotic film or being caressed, kissed, or receiving breast stimulation by her partner, but she complains of loss of intensity of genital arousal as her awareness of throbbing, swelling and lubrication is absent or markedly diminished.
  3. Combined genital and subjective arousal dysfunction: absent or markedly diminished feelings of sexual arousal [sexual excitement or pleasure] from any type of sexual stimulation as well as impaired genital arousal [vulval swelling, lubrication].
Physical changes don’t always correlate with subjective feelings. It is the lack of subjective arousal that causes distress rather than failure of genital congestion. Research has shown that women could watch erotic movies and have swelling of the genitals and lubrication, but they were not aware of feeling aroused.

When a woman speaks of absent sexual arousal or distress about low sexual arousal she is usually referring to absence of subjective feelings of sexual excitement, and vaginal lubrication is not significant. However, absence of lubrication may result in discomfort during intercourse and lead to avoidance.

In order for a woman to be considered to have a sexual disorder her symptoms must be persistent and pervasive, and her problem must cause her personal distress [not only distress her partner].

Sexual Arousal problems may be:
  1. Primary: arousal has never been experienced
  2. Secondary: lack of arousal follows on previous normal function
  3. Generalisedl: no arousal under any circumstances
  4. Situational: arousal in certain circumstances: masturbation, certain partners, places, times etc.
Women with sexual arousal problems may also have:
  1. loss of libido
  2. inability to have orgasms

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