Female Sexual Interest/Arousal Disorder
A sexual dysfunction characterized by a lack of, or significantly reduced, sexual interest and/or arousal. This manifests as reduced sexual thoughts, fantasies, initiation, and physiological response to sexual cues. To be diagnosed, these symptoms must cause significant distress.
Prevalence: Estimated at 10% of women (specifically the disorder with distress, not just low desire). Low desire without distress is much more common.
Common Symptoms
- Absent or reduced interest in sexual activity
- Absent or reduced sexual thoughts or fantasies
- No or reduced initiation of sexual activity
- Receptivity to partner's attempts is absent or reduced
- Absent or reduced sexual excitement/pleasure during sexual activity
- Absent or reduced sexual interest/arousal in response to internal or external sexual cues
- Absent or reduced genital or non-genital sensations during sexual activity
- Distress or interpersonal difficulty regarding these changes
- Feelings of guilt or inadequacy about low desire
- Avoidance of situations that might lead to sex
Risk Factors
- Menopause (estrogen drop)
- Depression or use of antidepressants
- Relationship duration (long-term relationships often see decline)
- History of sexual trauma
- Poor physical health
- High stress lifestyle
- Smoking and alcohol use
Treatment Approaches
- Cognitive Behavioral Therapy (CBT) for negative thoughts/body image
- Mindfulness-Based Cognitive Therapy (MBCT)
- Sex Therapy (individual or couples)
- Medication review (switching antidepressant to bupropion or adding it)
- Hormone therapy (systemic or local estrogen, testosterone off-label for post-menopausal)
- Flibanserin (Addyi) - FDA approved for pre-menopausal women
- Bremelanotide (Vyleesi) - FDA approved injection
- Treatment of painful sex issues
Self-Help & Natural Approaches
- Mindfulness-based interventions (staying present during intimacy)
- Sensate focus exercises (building intimacy without pressure for sex)
- Scheduled intimacy (making time for connection)
- Stress reduction techniques (yoga, meditation)
- Use of erotica or fantasy to jumpstart desire
- Open communication with partner about needs
- Use of lubricants to improve comfort
- Pelvic floor therapy
- Regular exercise (improves body image and blood flow)
- Date nights to rekindle romance
- Bibliotherapy (reading books like 'Come As You Are')
When to Seek Professional Help
- Lack of desire causes you personal distress
- Your relationship is threatened by the mismatch in desire
- Desire was previously present and has been lost
- You experience pain during sex
- You suspect medication is the cause
Crisis Resources
- NAMS (North American Menopause Society)
- AASECT therapist finder
- Planned Parenthood
- ISSWSH (International Society for the Study of Women's Sexual Health)
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.