Sexual arousal disorder

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Sexual arousal disorder is characterized by a lack or absence of sexual fantasies and desire for sexual activity in a situation that would normally produce sexual arousal, or the inability to attain or maintain typical responses to sexual arousal. The disorder is found in the DSM-IV. [1] The condition should not be confused with a sexual desire disorder.

Contents

The term is often used in the diagnosis of women (female sexual arousal disorder), while the term erectile dysfunction (ED) is often used for men.

Signs and symptoms

In women, the symptoms of the disorder include:

However, whether lack of physiological arousal is a reliable symptom of the disorder is questionable. Research has shown that women with arousal deficits and women without arousal deficits show equivalent increases in physiological response during experience of erotic stimuli. [2] [3]

Causes

Contrary to popular belief, the disorder is not always caused from a lack of sexual arousal. Possible causes of the disorder include psychological and emotional factors, such as depression, anger, and stress; relationship factors, such as conflict or lack of trust; medical factors, such as depleted hormones, reduced regional blood flow, and nerve damage; and drug use. The lack of sexual arousal may be due to a general lack of sexual desire or due to a lack of sexual desire for the current partner (i.e., situational). A person may always have had no or low sexual desire or the lack of desire may have been acquired during the person's life.

Certain medications like SSRIs may contribute to a loss of sexual arousal, either while taking the medication or during withdrawal. In seemingly rare cases, SSRIs have been reported to cause an reduction in sexual arousal that last months or years after discontinuation, a condition termed post-SSRI sexual dysfunction (PSSD).

Diagnosis

A psychologist will first consider any psychological or emotional problems; while a sex therapist will examine relationship issues; after which a medical doctor will investigate medical causes for the disorder. In order to receive this diagnosis, a woman must, for at least 6 months, report at least 3 of the following symptoms: absent or significantly reduced interest in sexual activity, in sexual or erotic thoughts or fantasies, in initiation of sex or receptiveness to sex, in excitement or pleasure in most sexual encounters, in sexual responsiveness to erotic cues, or in genital or non-genital responses to sexual activity. This can be either lifelong or acquired. [4]

Treatment

Depending on the cause of the disorder, hormone therapy or a blood-flow enhancing medication, like Viagra, may be appropriate.

Bremelanotide (formerly PT-141) is being studied in clinical tests to increase sexual desire in women. In 2014, Palatin, the company developing the drug, announced the beginning of a Phase 3 clinical trial to determine its effectiveness. [5]

Vibrators have also been found to be effective at addressing sexual arousal disorder. [6] Sometimes described as a massager, the vibrator is used on the body to produce sexual stimulation. Examples of FDA registered vibrators for sexual arousal disorder include MysteryVibe's Crescendo. [6] [7]

Related Research Articles

In psychology, libido is psychological drive or energy, usually conceived as sexual in nature, but also includes other forms of desire. The term was originally used in psychoanalytic theory, where the neurologist and pioneering psychoanalyst Sigmund Freud began by employing the term in reference to the energy of the sexual drive, later generalising the concept to refer to the fundamental energy of all expressions of love, pleasure, and self-preservation.

<span class="mw-page-title-main">Orgasm</span> Intense physical sensation of sexual release

Orgasm, or sexual climax, is the sudden discharge of accumulated sexual excitement during the sexual response cycle, resulting in rhythmic, involuntary muscular contractions in the pelvic region characterized by sexual pleasure. Experienced by males and females, orgasms are controlled by the involuntary or autonomic nervous system. They are usually associated with involuntary actions, including muscular spasms in multiple areas of the body, a general euphoric sensation, and, frequently, body movements and vocalizations. The period after orgasm is typically a relaxing experience, attributed to the release of the neurohormones oxytocin and prolactin as well as endorphins.

Sexual desire is an emotion and motivational state characterized by an interest in sexual objects or activities, or by a drive to seek out sexual objects or to engage in sexual activities. It is an aspect of sexuality, which varies significantly from one person to another and also fluctuates depending on circumstances.

Anorgasmia is a type of sexual dysfunction in which a person cannot achieve orgasm despite adequate stimulation. Anorgasmia is far more common in females than in males and is especially rare in younger men. The problem is greater in women who are post-menopausal. In males, it is most closely associated with delayed ejaculation. Anorgasmia can often cause sexual frustration.

Dyspareunia is painful sexual intercourse due to medical or psychological causes. The term dyspareunia covers both female dyspareunia and male dyspareunia, but many discussions that use the term without further specification concern the female type, which is more common than the male type. In females, the pain can primarily be on the external surface of the genitalia, or deeper in the pelvis upon deep pressure against the cervix. Medically, dyspareunia is a pelvic floor dysfunction and is frequently underdiagnosed. It can affect a small portion of the vulva or vagina or be felt all over the surface. Understanding the duration, location, and nature of the pain is important in identifying the causes of the pain.

Persistent genital arousal disorder (PGAD), previously called persistent sexual arousal syndrome, is spontaneous, persistent, unwanted and uncontrollable genital arousal in the absence of sexual stimulation or sexual desire, and is typically not relieved by orgasm. Instead, multiple orgasms over hours or days may be required for relief.

Hypoactive sexual desire disorder (HSDD), hyposexuality or inhibited sexual desire (ISD) is sometimes considered a sexual dysfunction, and is characterized as a lack or absence of sexual fantasies and desire for sexual activity, as judged by a clinician. For this to be regarded as a disorder, it must cause marked distress or interpersonal difficulties and not be better accounted for by another mental disorder, a drug, or some other medical condition. A person with ISD will not start, or respond to their partner's desire for, sexual activity. HSDD affects approximately 10% of all pre-menopausal women in the United States, or about 6 million women.

Sexual dysfunction is difficulty experienced by an individual or partners during any stage of normal sexual activity, including physical pleasure, desire, preference, arousal, or orgasm. The World Health Organization defines sexual dysfunction as a "person's inability to participate in a sexual relationship as they would wish". This definition is broad and is subject to many interpretations. A diagnosis of sexual dysfunction under the DSM-5 requires a person to feel extreme distress and interpersonal strain for a minimum of six months. Sexual dysfunction can have a profound impact on an individual's perceived quality of sexual life. The term sexual disorder may not only refer to physical sexual dysfunction, but to paraphilias as well; this is sometimes termed disorder of sexual preference.

<span class="mw-page-title-main">Vaginal lubrication</span> Vaginal lubrication

Vaginal lubrication is a naturally produced fluid that lubricates the vagina. Vaginal lubrication is always present, but production increases significantly near ovulation and during sexual arousal in anticipation of sexual intercourse. Vaginal dryness is the condition in which this lubrication is insufficient, and sometimes artificial lubricants are used to augment it. Without sufficient lubrication, sexual intercourse can be painful. The vaginal lining has no glands, and therefore the vagina must rely on other methods of lubrication. Plasma from vaginal walls due to vascular engorgement is considered to be the chief lubrication source, and the Bartholin's glands, located slightly below and to the left and right of the introitus, also secrete mucus to augment vaginal-wall secretions. Near ovulation, cervical mucus provides additional lubrication.

The human sexual response cycle is a four-stage model of physiological responses to sexual stimulation, which, in order of their occurrence, are the excitement, plateau, orgasmic, and resolution phases. This physiological response model was first formulated by William H. Masters and Virginia E. Johnson, in their 1966 book Human Sexual Response. Since that time, other models regarding human sexual response have been formulated by several scholars who have criticized certain inaccuracies in the human sexual response cycle model.

<span class="mw-page-title-main">Bremelanotide</span> Chemical compound

Bremelanotide, sold under the brand name Vyleesi, is a medication used to treat low sexual desire in women. Specifically it is used for low sexual desire which occurs before menopause and is not due to medical problems, psychiatric problems, or problems within the relationship. It is given by an injection just under the skin of the thigh or abdomen.

Sex therapy is a therapeutic strategy for the improvement of sexual function and treatment of sexual dysfunction. This includes dysfunctions such as premature ejaculation and delayed ejaculation, erectile dysfunction, lack of sexual interest or arousal, and painful sex ; as well as problems imposed by atypical sexual interests (paraphilias), gender dysphoria, highly overactive libido or hypersexuality, a lack of sexual confidence, and recovering from sexual abuse ; and also includes sexual issues related to aging, illness, or disability.

Sexual medicine or Psychosexual medicine as defined by Masters and Johnsons in their classic Textbook of Sexual Medicine, is "that branch of medicine that focuses on the evaluation and treatment of sexual disorders, which have a high prevalence rate." Examples of disorders treated with sexual medicine are erectile dysfunction, hypogonadism, and prostate cancer. Sexual medicine often uses a multidisciplinary approach involving physicians, mental health professionals, social workers, and sex therapists. Sexual medicine physicians often approach treatment with medicine and surgery, while sex therapists often focus on behavioral treatments.

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 a sexual activity. The diagnosis can also refer to an inadequate lubrication-swelling response normally present during arousal and sexual activity. The condition should be distinguished from a general loss of interest in sexual activity and from other sexual dysfunctions, such as the orgasmic disorder (anorgasmia) and hypoactive sexual desire disorder, which is characterized as a lack or absence of sexual fantasies and desire for sexual activity for some period of time.

Sex and drugs date back to ancient humans and have been interlocked throughout human history. Both legal and illegal, the consumption of drugs and their effects on the human body encompasses all aspects of sex, including desire, performance, pleasure, conception, gestation, and disease.

Delayed ejaculation (DE) describes a man's inability or persistent difficulty in achieving orgasm, despite typical sexual desire and sexual stimulation. Generally, a man can reach orgasm within a few minutes of active thrusting during sexual intercourse, whereas a man with delayed ejaculation either does not have orgasms at all or cannot have an orgasm until after prolonged intercourse which might last for 30–45 minutes or more. Delayed ejaculation is closely related to anorgasmia.

<span class="mw-page-title-main">Vibrator (sex toy)</span> Electric-powered sex toy

A vibrator, sometimes described as a massager, is a sex toy that is used on the body to produce pleasurable sexual stimulation. There are many different shapes and models of vibrators. Most modern vibrators contain an electric-powered device which pulsates or throbs. Vibrators can be used for both solo play and partnered play by one or more people. Devices exist to be used by couples to stimulate the genitals of both partners. They can be applied to erogenous zones, such as the clitoris, the vulva or vagina, penis, scrotum or anus, for sexual stimulation, for the release of sexual frustration and to achieve orgasm. Vibrators may be recommended by sex therapists for women who have difficulty reaching orgasm through masturbation or intercourse.

PL-6983 is a synthetic peptide and selective MC4 receptor agonist which is under development by Palatin Technologies for the treatment of female sexual dysfunction and erectile dysfunction. It was developed as a successor to/replacement of bremelanotide (PT-141) due to concerns of the side effect of increased blood pressure seen with the latter in clinical trials. Relative to bremelanotide, PL-6983 produces significantly lower increases in blood pressure in animal models. The drug has reportedly been in pre-clinical development for all medical indications since 2008. Palatin has stated that "We are focusing development efforts on bremelanotide for [female sexual dysfunction], but are continuing evaluation of PL-6983." The chemical structure of PL-6983 has yet to be made public.

<span class="mw-page-title-main">Sexual arousal</span> Physiological and psychological changes in preparation for sexual intercourse

Sexual arousal describes the physiological and psychological responses in preparation for sexual intercourse or when exposed to sexual stimuli. A number of physiological responses occur in the body and mind as preparation for sexual intercourse, and continue during intercourse. Male arousal will lead to an erection, and in female arousal the body's response is engorged sexual tissues such as nipples, vulva, clitoris, vaginal walls, and vaginal lubrication. Mental stimuli and physical stimuli such as touch, and the internal fluctuation of hormones, can influence sexual arousal.

<span class="mw-page-title-main">MysteryVibe</span>

MysteryVibe is a British-American firm that focuses on sexual health devices. In 2023, their laboratory was featured in Popular Science and recognized by The Guardian as the "only facility in vibrator research and development in the UK". According to Femtech Insider, they are the "first pleasure-focused brand to offer FSA & HSA eligible vibrators". They beat Apple Watch at the 2018 Design Week Awards.

References

  1. DSM-IV, American Psychiatric Association 1994
  2. Morokoff PJ, Heiman JR (1980). "Effects of Erotic Stimuli on Sexually Functional and Dysfunctional Women". Behaviour Research and Therapy. 18 (2): 127–137. doi:10.1016/0005-7967(80)90107-2. PMID   7189397.
  3. Laan E, van Driel EM, van Lunsen RH (June 2008). "Genital Responsiveness in Healthy Women With and Without Sexual Arousal Disorder". Journal of Sexual Medicine. 5 (6): 1424–1435. doi:10.1111/j.1743-6109.2008.00827.x. PMID   18410301.
  4. Hoeksema, S. (2007). Abnormal psychology (4th ed.). Boston: McGraw-Hill.
  5. "Palatin Announces Start of Bremelanotide Phase 3 Program For Female Sexual Dysfunction" (Press release). PR Newswire . Retrieved 17 February 2015.
  6. 1 2 Dr. Jesús E, Rodríguez; Lucrecia, Martínez; Natalia, Bonachera (6 July 2023). "A Cognitive Behavioral Intervention For Female Sexual Arousal Disorders Using A Vibrating Device". The Journal of Sexual Medicine . 20 (4). doi: 10.1093/jsxmed/qdad062.038 . Archived from the original on 19 July 2023. Retrieved 19 July 2023.
  7. Geddes, Linda (9 June 2023). "'Between pleasure and health': how sex-tech firms are reinventing the vibrator". The Guardian. ISSN   0261-3077 . Retrieved 18 July 2023.

See also