Interpersonal factors. If interpersonal or significant contextual factors, such as severe relationship distress, intimate partner violence, or other significant stressors, explain the sexual interest/arousal symptoms, then a diagnosis of female sexual interest/arousal dis- order would not be made.
Other sexual dysfunctions. The presence of another sexual dysfunction does not rule out a diagnosis of female sexual interest/arousal disorder. It is common for women to ex- perience more than one sexual dysfunction. For example, the presence of chronic genital pain may lead to a lack of desire for the (painful) sexual activity. Lack of interest and arousal during sexual activity may impair orgasmic ability. For some women, all aspects of the sexual response may be unsatisfying and distressing.
Inadequate or absent sexual stimuli. When differentialdiagnoses are being considered, it is important to assess the adequacy of sexual stimuli within the woman’s sexual experi- ence. In cases where inadequate or absent sexual stimuli are contributing to the clinical pic- ture, there may be evidence for clinical care, but a sexual dysfunction diagnosis would not be made. Similarly, transient and adaptive alterations in sexual functioning that are second- ary to a significant life or personal event must be considered in the differential diagnosis.
extremely common. Sexual distress and dissatisfaction with sex life are also highly cor— related in women with low sexual desire. Distressing low desire is associated with depres- sion, thyroid problems, anxiety, urinary incontinence, and other medical factors. Arthritis and inﬂammatory or irritable bowel disease are also associated with sexual arousal prob- lems. Low desire appears to be comorbid with depression, sexual and physical abuse in adulthood, global mental functioning, and use of alcohol.
Diagnostic Criteria 302.76 (F52.6)
A. Persistent or recurrent difficulties with one (or more) of the following: 1. Vaginal penetration during intercourse.
2. Marked vulvovaginal or pelvic pain during vaginal intercourse or penetration attempts.
3. Marked fear or anxiety about vulvovaginal or pelvic pain in anticipation of, during, or as a result of vaginal penetration.
4. Marked tensing or tightening of the pelvic floor muscles during attempted vaginal penetration.
B. The symptoms in Criterion A have persisted for a minimum duration of approximately 6 months.
C. The symptoms in Criterion A cause clinically significant distress in the individual.
D. The sexual dysfunction is not better explained by a nonsexual mental disorder or as a consequence of a severe relationship distress (e.g., partner violence) or other signifi- cant stressors and is not attributable to the effects of a substance/medication or an- other medical condition.
Specify whether:
Lifelong: The disturbance has been present since the individual became sexually active.
Acquired: The disturbance began after a period of relatively normal sexual function.
Specify current severity:
Mild: Evidence of mild distress over the symptoms in Criterion A.
Moderate: Evidence of moderate distress over the symptoms in Criterion A.
Severe: Evidence of severe or extreme distress over the symptoms in Criterion A.
Genito-pelvic pain/ penetration disorder refers to four commonly comorbid symptom di- mensions: 1) difficulty having intercourse, 2) genito-pelvic pain, 3) fear of pain or vaginal penetration, and 4) tension of the pelvic ﬂoor muscles (Criterion A). Because major diffi- culty in any one of these symptom dimensions is often sufficient to cause clinically sig- nificant distress, a diagnosis can be made on the basis of marked difficulty in only one symptom dimension. However, all four symptom dimensions should be assessed even if a diagnosis can be made on the basis of only one symptom dimension.