Sexual Aversion Disorder - Classification, Symptoms, Causes, and Treatment

What Is Sexual Aversion Disorder?

Sexual aversion disorder (SAD) is a persistent aversion or repulsion to sexual contact with a partner and the consequent avoidance of any such sexual contact or intimacy. This is especially true for genital sexual contact but may include all other forms of sexual contact. The affected individual usually shows signs of extreme distress at their condition and may experience interpersonal difficulty or conflict with their partner. While it is classified as sexual dysfunction, arguments have been made in favor of grouping it as an anxiety disorder instead. This is because the condition is characterized by an unwillingness toward sexual contact rather than any dysfunction.

Who Is Affected by Sexual Aversion Disorder?

Both males and females are affected by sexual aversion disorder. However, there have been findings that women generally display lower sex drives and less inclination towards sex than men - this has been true for SAD too. Studies have shown a greater prevalence of SAD among women - these women tend to avoid relationships.

How Is Sexual Aversion Disorder Classified?

• Lifelong Aversion: Lifelong aversion is characterized by an aversion to all forms of sexual contact from the first sexual experience. The affected individual actively avoids any form of touching in the fear that it might lead to sexual contact.

• Acquired Aversion: Develops after a specific experience or after a period of normal sexual functioning. Affected individuals can often experience sexual pleasure as long as the phobia-causing factor is avoided. They may also experience a sexually satisfying life outside of their committed relationship - this would lead to blaming the partner for their failings since they are able to function well sexually with another person. Often, secondary sexual aversion may occur in tandem with extreme anxiety and fear of displeasing their partner sexually. This is common when the relationship is bound by commitment, and both partners are trying to make an effort to keep their relationship going.

• Generalized Aversion: Sexual aversion that is common to all individuals and situations.

• Situational Aversion: This may occur in response to a particular individual or situation rather than a generalized aversion.

• Psychological Factors: Sexual aversion arises purely due to psychological reasons.

• Combined Factors: Aversion arises as a result of psychological factors in combination with other factors such as unpleasant physical sensations (vaginismus or pain during intercourse) and other factors.

There have been attempts to classify sexual aversion disorder based on conditioning:

• Primary Aversion: Primary aversion is typified by the development of fear and anxiety even before beginning a healthy sexual relationship.

• Secondary Aversion: In secondary aversion, symptoms of fear and anxiety develop after beginning a sexual relationship.

These classifications are not co-existent but, in fact, mutually exclusive. The classification of sexual aversion as lifelong and acquired, specifically with respect to the idea of a lifelong disorder, is questionable since it is supposed to occur after conditioning. That is why some have preferred the classification that terms sexual aversion disorder as either primary or secondary - it references the fear and anxiety developed before or after a sexual relationship rather than assuming a lifelong disorder without conditioning.

What Are the Signs and Symptoms of Sexual Aversion Disorder?

Typically, people suffering from SAD display extreme unwillingness to touch or communicate in any manner that might lead to sex. This is expressed as fear, disgust, anxiety, and occasional panic attacks when faced with sexual situations. This might be compounded by:

• Low to negligible libido (desire for sexual activity).

• Inhibition of sexual desires.

• Low sex drive.

• Arousal dysfunction.

Some psychopathological features may co-exist with primary SAD:

• Obsessive compulsive behavior.

• Hysteria.

• Suicidal tendencies.

• Neuroses.

• Paranoia.

• Schizophrenia.

What Causes Sexual Aversion Disorder?

The mechanism that causes sexual aversion in SAD is attributed to conditioning. In other words, specific experiences and stimuli contribute to the way people respond to sex.

Avoidance With Reinforcement: Avoiding sexual contact, and continuing to reinforce this avoidance with self-motivation, in order to avoid distress is a common feature of SAD.

Suggestions on possible causative factors have ranged from abuse to psychologically motivated phobias:

• Sexual stimuli coupled with traumatic sexual stimuli.

• Childhood sexual abuse or trauma.

• Strict upbringing and fear of being caught indulging in sexual activity by parents who discouraged it.

• Neurotic anxiety.

What Is the Difference Between Hypoactive Sexual Desire Disorder and Sexual Aversion Disorder?

Hypoactive sexual desire disorder (HSDD) and sexual aversion disorder (SAD) are both classified as sexual desire disorders. However, HSDD is characterized by low sexual desire or an absence of sexual desire altogether, while SAD presents as active fear, anxiety, and avoidance when confronted with sexual situations.

What Is a Sexual Response Cycle and Why Is It Important for Sexual Aversion Disorder?

The sexual response cycle is a series of changes and responses that occur during sexual activity, whether intercourse or masturbation - there may be evident physical arousal and emotional changes. The cycle occurs in four stages:

• Excitement (Desire): Increased heart rate, muscle tension, and blood flow, resulting in swollen or erect genitals.

• Plateau: Intensification of the changes of the excitement phase.

• Orgasm: The shortest phase, characterized by involuntary muscle contractions and release of sexual tension.

• Resolution: The body gradually reverts to normal functioning, and partners may experience emotional intimacy.

Understanding the sexual response cycle is key to understanding the stages at which sexual dysfunction occurs in different people. For sexual aversion disorder, it is the excitement or desire phase of the response cycle that plays a part. Aside from the physical changes experienced, sexual desire itself is composed of sexual drive, motivation, and wish. These components are lacking in sexually averse individuals - understanding this would make the diagnosis of sexual aversion disorder easier.

How Is Sexual Aversion Disorder Treated?

Treating sexual aversion disorder is extremely difficult, as it is known to be resistant to treatment, particularly in advanced stages. The focus must, however, not be on “fixing” the individual but on providing support, understanding the psychological motivation behind the issue, and therapy as well as counseling.

• Behavioral therapy has been known to provide relief in some cases.

• Systematic desensitization has also been used with some success. It is a form of behavioral therapy that addresses the conditioned response and provides counter-conditioning.

• Drug therapy may not have a direct role in treatment. Medication directed at anxiety and depression may be of some help, but otherwise, there is no role for pharmacotherapy.

• Cognitive behavioral therapy (CBT) helps to reframe negative thoughts and with the treatment of anxiety and depression.

• Analytically oriented sex therapy combines sex therapy with psychologically-mediated treatment - this is useful in those with developmental issues.

Can Sexual Aversion Disorder Be Treated At Home?

Attempting to treat sexual aversion disorder at home may not give results. At the core of such disorders is a conditioned response that could be hard to identify. Seeking out a therapist at the earliest would provide better results and possible reversal of symptoms.

How To Support Partners Who Have or Develop Sexual Aversion Disorder?

Partners must remember that the sexual aversion experienced by their significant other may have nothing to do with them - it is the result of psychological causes that are usually unrelated to emotional feelings towards the partner. Trying to play a supportive role during therapy and putting the suggestions of the counselor or therapist into practice would ease the mind of already apprehensive or resistant partners.

Conclusion:

Living with a persistent fear of sexual contact is neither easy nor conducive to maintaining healthy relationships. Often, it is hard to treat - but it is not impossible. With time, support, patience, proper diagnosis, partner support, and therapy, a better sexual life may be achieved.