Sexual Desire/Interest Disorder
What is sexual desire/interest disorder?
The favored definition defines sexual desire/interest disorder as characterized by absent or diminished feelings of sexual interest or desire, absent sexual thoughts of fantasies, and a lack of responsive desire. Motivations for attempting to become sexually aroused ar scare or absent. Lack of interest goes beyond a normal lessening with increasing age and relationship duration.
What factors are involved with sexual desire?
The basis of desire in women is poorly understood. It appears to involve interactions among multiple neurotransmitters, sex hormones and environmental factors.
Several factors have been closely linked to women’s sexual satisfaction and desire. These include stable past and current mental health, positive emotional well being and self image, rewarding past sexual experiences, positive feelings for the partner, and positive expectations for the relationship. The partner’s sexual dysfunction, increased perceived stress, a history of infertility especially after extensive investigation, and increased duration of relationship are all linked with reduced desire.
Certain diseases have a strong association with sexual dysfunction.
How is sexual desire/interest disorder diagnosed?
A detailed history and examination are required to identify the problem and any possible causes or factors. Some laboratory tests may be indicated to exclude medical problems.
How is sexual desire/interest disorder managed?
The management is guided by the history and examination findings.
A range of psychological interventions are often indicated. These focus on identifying and modifying factors that contribute to sexual dysfunction, such as maladaptive thoughts, unreasonable expectations, behaviors that reduce the partners interest or trust, insufficient erotic stimuli, and insufficient non genital physical stimulation. Strategies are suggested to improve the couple’s emotional closeness and communication and enhance erotic stimulation.
Sex therapy for couples is usually focused on similar issues, but also includes sensate focus techniques.
Psychotherapy may be indicated to explore past issues an childhood issues which may or may not be sexual, but have an effect on the current sexual function.
There is limited options with approved medications. Oestrogen may help vaginal symptoms in a post menopausal woman. A range of medications have been examined in small trials but none are currently approved for use in female sexual dysfunction.