3. No/reduced initiation of sexual activity, and typically unreceptive to a partner’s at- tempts to initiate.
4. Absent/reduced sexual excitemenl/pleasure during sexual activity in almost all or or, if generalized, in all contexts).
5. Absent/reduced sexual interest/arousal in response to any internal or external sex- ual/erotic cues (e.g., written, verbal, visual).
6. Absent/reduced genital or nongenital sensations during sexual activity in almost all texts or, if generalized, in all contexts).
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 nonsexuai mental disorder or as a consequence of severe relationship distress (e.g., partner violence) or other significant stressors and is not attributable to the effects of a substance/medication or another 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 whether:
Generalized: Not limited to certain types of stimulation, situations, or partners.
Situational: Only occurs with certain types of stimulation, situations, or partners.
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.
In assessing female sexual interest/arousal disorder, interpersonal context must be taken into account. A "desire discrepancy," in which a woman has lower desire for sexual activ- ity than her partner, is not sufficient to diagnose female sexual interest/arousal disorder.
In order for the criteria for the disorder to be met, there must be absence or reduced fre- quency or intensity of at least three of six indicators (Criterion A) for a minimum duration of approximately 6 months (Criterion B). There may be different symptom profiles across women, as well as variability in how sexual interest and arousal are expressed. For exam- ple, in one woman, sexual interest/arousal disorder may be expressed as a lack of interest in sexual activity, an absence of erotic or sexual thoughts, and reluctance to initiate sexual activity and respond to a partner’s sexual invitations. In another woman, an inability to be- come sexually excited, to respond to sexual stimuli with sexual desire, and a correspond- ing lack of signs of physical sexual arousal may be the primary features. Because sexual desire and arousal frequently coexist and are elicited in response to adequate sexual cues, the criteria for female sexual interest/arousal disorder take into account that difficulties in desire and arousal often simultaneously characterize the complaints of women with this disorder. Short-term changes in sexual interest or arousal are common and may be adaptive responses to events in a woman’s life and do not represent a sexual dysfunction. Diagnosis of female sexual interest/arousal disorder requires a minimum duration of symptoms of approximately 6 months as a reﬂection that the symptoms must be a persistent problem.
The estimation of persistence may be determined by clinical judgment when a duration of 6 months cannot be ascertained precisely.