Diagnostic Features
The essential feature of Female Sexual Arousal Disorder is a persistent or recurrent inability to attain, or to maintain until completion of the sexual activity, an adequate lubrication-swelling response of sexual excitement (Criterion A). The arousal response consists of vasocongestion in the pelvis, vaginal lubrication and expansion, and swelling of the external genitalia. The disturbance must cause marked distress or interpersonal difficulty (Criterion B). The dysfunction is not better accounted for by another Axis I disorder (except another Sexual Dysfunction) and is not due exclusively to the direct physiological effects of a substance (including medications) or a general medical condition (Criterion C).
Subtypes
Subtypes are provided to indicate onset (Lifelong versus Acquired), context (Generalized versus Situational), and etiological factors (Due to Psychological Factors, Due to Combined Factors) for Female Sexual Arousal Disorder.
Associated Features and Disorders
Limited evidence suggests that Female Sexual Arousal Disorder is often accompanied by Sexual Desire Disorders and Female Orgasmic Disorder. The individual with Female Sexual Arousal Disorder may have little or no subjective sense of sexual arousal. The disorder may result in painful intercourse, sexual avoidance, and the disturbance of marital or sexual relationships.
Differential Diagnosis
Female Sexual Arousal Disorder must be distinguished from a Sexual Dysfunction Due to a General Medical Condition. The appropriate diagnosis would be Sexual Dysfunction Due to a General Medical Condition when the dysfunction is judged to be due exclusively to the physiological effects of a specified general medical condition (e.g., menopausal or postmenopausal reductions in estrogen levels, atrophic vaginitis, diabetes mellitus, radiotherapy of the pelvis). Reduced lubrication has also been reported in association with lactation. This determination is based on history, laboratory findings, or physical examination. If both Female Sexual Arousal Disorder and a general medical condition are present but it is judged that the sexual dysfunction is not due exclusively to the direct physiological consequences of the general medical condition, then Female Sexual Arousal Disorder, Due to Combined Factors, is diagnosed.
In contrast to Female Sexual Arousal Disorder, a Substance-Induced Sexual Dysfunction is judged to be due exclusively to the direct physiological effects of a substance (e.g., reduced lubrication caused by antihypertensives or antihistamines). If both Female Sexual Arousal Disorder and substance use are present but it is judged that the sexual dysfunction is not due exclusively to the direct physiological effects of the substance use, then Female Sexual Arousal Disorder, Due to Combined Factors, is diagnosed.
If the arousal problems are judged to be due exclusively to the physiological effects of both a general medical condition and substance use, both Sexual Dysfunction Due to a General Medical Condition and Substance-Induced Sexual Dysfunction are diagnosed.
Female Sexual Arousal Disorder may also occur in association with other Sexual Dysfunctions (e.g., Female Orgasmic Disorder). If so, both should be noted. An additional diagnosis of Female Sexual Arousal Disorder is usually not made if the sexual arousal problem is better accounted for by another Axis I disorder (e.g., Major Depressive Disorder, Obsessive-Compulsive Disorder, Posttraumatic Stress Disorder). The additional diagnosis may be made when the problem with sexual arousal predates the Axis I disorder or is a focus of independent clinical attention. Occasional problems with sexual arousal that are not persistent or recurrent or are not accompanied by marked distress or interpersonal difficulty are not considered to be Female Sexual Arousal Disorder. A diagnosis of Female Sexual Arousal Disorder is also not appropriate if the problems in arousal are due to sexual stimulation that is not adequate in focus, intensity, and duration.
Diagnostic criteria for 302.72 Female Sexual Arousal Disorder
A. Persistent or recurrent inability to attain, or to maintain until completion of the sexual activity, an adequate lubrication-swelling response of sexual excitement.
B. The disturbance causes marked distress or interpersonal difficulty.
C. The sexual dysfunction is not better accounted for by another Axis I disorder (except another Sexual Dysfunction) and is not due exclusively to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.
Specify type:
Lifelong Type
Acquired Type
Specify type:
Generalized Type
Situational Type
Specify:
Due to Psychological Factors
Due to Combined Factors
