Female Sexual Medicine
Female Sexual Arousal Disorder
Female Sexual Arousal Disorder is the second most common sexual dysfunction in women, following desire disorder. It can be broken down into three subsets: genital arousal disorder, subjective arousal disorder, and combined arousal disorder. Genital arousal disorder occurs when a woman is aware of feelings of pleasure in her mind while simultaneously experiencing a decrease in or lack of genital lubrication, swelling, or sensation of genital tingling/warmth. Subjective arousal disorder occurs when there is a genital response to sexual stimulation; however, there is no mental awareness of sexual pleasure. Combined sexual arousal disorder is when both the genital and mental response to sexual stimulation is lacking or absent.
There are both psychological and biological causes of female sexual arousal disorder, with these two often overlapping. Prolonged illnesses such as diabetes, multiple sclerosis, and vascular disease can lead to genital arousal disorder by causing peripheral neuropathy and decrease/loss of genital sensation. Depression, hormonal imbalance following menopause or childbirth, certain medications such as birth control pills, or relationship problems can lead to both genital and subjective arousal disorder.
A woman with sexual arousal disorder should be evaluated by a clinician who is familiar with the field of female sexual medicine. A thorough psychosocial and medical evaluation should be carried out. Once the diagnosis is made, treatment options are reviewed. These include but are not limited to: sex therapy, relationship therapy, discontinuation of certain medications, off-label use of Viagra, Wellbutrin, and testosterone, Zestra lotion, EROS clitoral therapy device, herbal treatments such as ArginMax, vibrator therapy, lubricant use, and hormone therapy, such as topical estrogen.