Disorders of Sexual interest, Desire and arousal
Disorders of Sexual interest/Desire or Arousal:" Persistent or lack of, or significantly reduced, interest in sexual activity and/or lack of arousal in response to sexual activity (Nolen & Hoeksema, 2014 pg. 367)".
In order to for a woman to be diagnosed with a sexual dysfunction the disorder must be more than six months, must cause significant distress or impairment and must not be due to another nonsexual psychiatric problem. This can be lifelong or acquired. (Nolen & Hoeksema, 2014).
"Sexual desire can manifest in a person's thoughts, or fantasies, a person's interest in initiating or participating in sexual activities, and a person's awareness of sexual cues from others (Nolen & Hoeksema, 2014)." Low sexual desire or arousal are the most common reason that people seek help (Nolen & Hoeksema, 2014).
"In a study of 31,000 women, unusually low sexual desire was diagnosed in 9.5 percent of them. Rates of desire increased to 26 percent in postmenopausal women (Nolen & Hoeksema, 2014)."
Numerous medical conditions have been to blame for the sexual interest or arousal in women. Neurologic, cardiovascular, gynological and endocrine (Maass, 2007, p. 30).
Neurologic disease usually alters sexual response. Injuries to the spinal column and peripheral nerves can affect desire and orgasmic function. In cardiovascular and peripheral disease blood flow is limited to the genital area causing decreased arousal (Maass, 2007, p. 30)
l Along with medical conditions there are also many other reasons that a woman may lose sexual desire. Hormonal changes due to menopause can make sexual arousal difficult. The lack of estrogen lost during menopause a woman can have many physical and psychological changes. These changes are loss of desire, depression, sleep disturbances and mood swings (Borgelt & American Society of Health-System Pharmacists, 2010, p 549-550)
The physical changes are thinning of the virginal walls, dryness, and pain during intercourse.
Disorders of sexual interest and desire are some of the most complicated ones for therapist to treat due to the emotional and psychological aspects (Borgelt & American Society of Health-System Pharmacists, 2010, p.549-550)
In addition to the medical reasons mentioned above there are also relationship issues that can cause lack of desire (Borgelt & American Society of Health-System Pharmacists, 2010, p 549-550)
Treatments: In a recent study women were treated with antidepressant (Wellbutrin). 60% of the men and women that were treated showed improved sexual desire, indicating that it is not a physical aliment. Another treatment used was over the counter DHEA. The patients that took the supplement showed a small improvement in desire. (Borgelt & American Society of Health-System Pharmacists, 2010, p.549-550).
Relationship therapist should focus on current relationship problems such as fidelity, loss of trust, control issues and communication problems. (Borgelt & American Society of Health-System Pharmacists, 2010, p.31)
.Through discussion the therapist will be able to assist the patient in determining the cause of the sexual disorder.
A physical exam is necessary when the patient complains of painful sex. There may be vaginal infections, autrophy, or certain bladder conditions present. This can also assist the therapist in narrowing down the cause and give the patient peace of mind if tests are negative(Maass, 2007, p. 30).
Sexual dysfunction is usually presented to the therapist in diaries or self-questionnaires.
The goals and treatment guidelines are to educate the women on normal anatomy, normal sexual function, and sexual changes as we age, pregnancy and menopause.
The healthcare provider may suggest adult videos, adult toys, sexual arousal books or magazines and self-pleasuring.
Medications may be prescribed such as antidepressants, testosterone, and oral estrogen; however the best treatments have been biological therapies and Individual and couples therapy. (Nolen-Hoeksema, 2014).
-Nolen-Hoeksema, S. (2014). Abnormal psychology (6th ed.). New York: McGraw-Hill.
Borgelt, L. M., & American Society of Health-System Pharmacists. (2010). Women's health across the lifespan: A pharmacotherapeutic approach. Bethesda, MD: American Society of Health-System Pharmacists.
Maass, V. S. (2007). Facing the complexities of women's sexual desire. New York: Springer.