Essentials of Female Sexual Dysfunction from a Sex Therapy Perspective

Linda E. Ohl, MSW, CSW, ACH


Urol Nurs. 2007;27(1):57-63. 

In This Article

Sexual Desire Disorders

Hypoactive sexual desire disorder (HSDD) is defined as a persistent or recurrent deficiency (or absence) of sexual fantasies and or desire for, or receptivity to, sexual activity that causes personal distress. Age and context of a person's life are taken into consideration. The lack of sexual desire must cause distress, and there are no other medical conditions or drugs involved as causative agents.

Paik and Laumann (2006) surveyed the American literature published since 1970 to summarize the incidence of various sexual dysfunctions. In their analysis, the lifetime incidence of HSDD ranged from 7% to 31%. Short duration problems were less common, indicating that some women may suffer from lack of desire for temporary time periods. Most of the studies were survey-based epidemiologic studies, begging the question about whether the studied populations represent the type of individuals seeking medical attention. One "real-life" gynecology clinic-based study, however, gave a similar lifetime incidence of desire disorder of 29% (Nusbaum, Gamble, Skinner, & Heiman, 2000).

The difference between HSDD and sexual aversion is that with sexual aversion, the female will do almost anything to disengage from all sexual contact with a sexual partner. The woman experiences anxiety, fear, or disgust when confronted with sexual advances. She may at times feel terror, faintness, nausea, and heart palpitations. It is not uncommon for a woman to experience marital discord due to avoidance of sexual situations. She may go out of her way to avoid sexual situations by traveling, going to sleep early, overextending herself in social or work situations, and not caring for her personal appearance.


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