Diagnosis

Psychological
The APA classifies sexual disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM IV) because they tend to disrupt interpersonal relationships and cause psychological distress. All disorders listed in the DSM in some way disturb the process of arousal and the sexual response cycle. Although controversial, it is the standard approach used by many psychiatrists and clinicians in the United States and other countries to female sexual problems.

Hypoactive sexual desire disorder is characterized by an absence of libido. There is no interest in initiating sex and little desire to seek stimulation. Sexual aversion disorder is characterized by an aversion to or avoidance or dismissal of sexual prompts or sexual contact. It may be acquired following sexual or physical abuse or trauma and may be life-long. The main feature of female sexual arousal disorder is an inability to achieve and progress through the stages of "normal" female arousal. Female orgasmic disorder is defined as the delay or absence of orgasm after "normal" arousal. Dyspareunia is marked by genital pain before, during, or after intercourse. Vaginismus is the involuntary contraction of the perineal muscles around the vagina as a response to attempted penetration. Contraction makes vaginal penetration difficult or impossible.

These disorders must cause personal distress and must not be accounted for by a medical condition. A distinction is made between disorders that are life-long and those that are acquired, as well as those that are situational and generalized.

Female Sexual Arousal Disorder

Female Sexual Arousal Disorder is described as the inability of a woman to complete sexual activity with adequate lubrication. Swelling of the external genitalia and vaginal lubrication are generally absent. These symptoms must cause problems in the interpersonal relationship to be considered a disorder. It is not unusual for the woman with female sexual arousal disorder to have almost no sense of sexual arousal. Habitually, these women experience pain with intercourse and avoid sexual contact with their partner.

Chronically or recurrently, the patient cannot lubricate enough to complete the sexual activity. It is not directly caused by substance use (medication or drug of abuse) or by a general medical condition. It causes marked distress or interpersonal problems.

Some disorders have similar or even the same symptoms. The clinician, therefore, in his/her diagnostic attempt has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis. Inadequate Genital Stimulation.

Sexual Desire Disorders may be associated with specific settings, situations and relationships or generally present in all sexual settings. It may be due to psychological factors or a combination of psychological and physical factors. It is characterized by inability to attain or maintain adequate physical response to sexual excitement. It is considered a disorder when it causes distress or interpersonal conflict, and it must be differentiated from other psychological problems for which it may be simply a symptom rather than the primary problem.

Contrary to popular belief, a lack of lubrication is not always caused from a failure to be aroused. The exact causes of female sexual arousal disorder are not known. It has been associated with illness, a lack of the hormone estrogen, and side effects from medications. Possible psychological explanations include guilt, hostility, and anxiety.

Relaxation techniques and various creams and jellies are suitable lubricants and may help to alleviate the discomfort.