Female sexual interest and arousal disorder

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Summary of Female sexual interest and arousal disorder

Female sexual arousal disorder (FSAD) is a class of disorders 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 only FDA-approved drug so far for disorders of female libido is flibanserin.

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Female sexual interest and arousal disorder

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FEMALE SEXUAL INTEREST/ AROUSAL DISORDER osms.it/female-arousal-disorder PATHOLOGY & CAUSES ▪ Disorder characterized by either absence or ↓ frequency/intensity of sexual/erotic activity or thoughts in biological females SIGNS & SYMPTOMS ▪ Self-reported ↓/absent sexual pleasure, genital/nongenital sensations, ↓ vaginal lubrication → anxiety/distress DIAGNOSIS OTHER DIAGNOSTICS ▪ Absence of/↓ frequency/intensity of at least three of following; persisting for ≥ six months → distress; not better explained by non-sexual factors ▫ Interest in sexual activity ▫ Sexual/erotic thoughts ▫ Sexual activity initiation; partner initiation receptivity ▫ Pleasure/excitement during ≥ 75% of sexual encounters ▫ Interest/arousal in sexual/erotic-cue settings ▫ Genital/non-genital sensation during ≥ 75% of sexual encounters TREATMENT MEDICATIONS ▪ Flibanserin, bupropion PSYCHOTHERAPY ▪ Cognitive-behavioral and/or psychosexual therapy GENITO-PELVIC PAIN AND/OR PENETRATION DISORDER osms.it/genito-pelvic-pain PATHOLOGY & CAUSES ▪ Disorder characterized by difﬁculty with intercourse due to vulvovaginal/pelvic pain, anticipatory fear of pain during penetration, pelvic ﬂoor muscle tension during penetration ▪ Penetration concerns may be related to vaginal intercourse/other situations 740 OSMOSIS.ORG (gynecological exams, tampon insertion) Associated factors ▪ Medical conditions ▫ E.g. anatomic anomalies, atrophic vaginitis, obstetric perineal injury (e.g. episiotomy) ▪ Sexually-transmitted disease history ▪ Vulvodynia (persistent idiopathic vulvar pain)

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Female sexual interest and arousal disorder

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A 28-year-old woman comes to the clinic because of decreased sexual desire for the past year. She has been happily married to her husband for the past 5 years, but this is now causing significant relationship distress. She says that her libido used to be stronger, but now she has no desire for sexual relations and is unable to become sufficiently aroused when she attempts to. She is an artist and a stay-at-home mother to her two healthy children. Her medical history is noncontributory. She takes no medications. She drinks one glass of wine each weekend night, and denies tobacco or recreational drug use. Her temperature is 37.0°C (98.6°F), pulse is 70/min, respirations are 10/min, and blood pressure is 118/80 mm Hg. Physical examination shows a well-appearing young female in no apparent distress. Extensive laboratory studies show no abnormalities. Which of the following is the most likely diagnosis?

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