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Female Sexual Arousal Disorder: Break the Shackles and Seek Help!!

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Female Sexual Arousal Disorder: Break the Shackles and Seek Help!!

3 min read


This article throws light on Female Sexual Interest/Arousal Disorder, a common but least discussed sexual health topic among females.

Written by

Dr. Bharat Udey

Medically reviewed by

Dr. Chithranjali Ravichandran

Published At July 20, 2015
Reviewed AtAugust 2, 2023


Sexuality is a taboo in most of the societies in this world. Men on one hand consider their sexuality as a jewel of their manhood crown. On the other hand women are forbidden to discuss about their sexuality. It is considered to be their duty and responsibity to fulfil the sexual needs of their male partner. By doing so, their own sexual requirements and problems remain neglected. This is not happening since last few years, but has been a continous problem since the origin of the human race. This article is one step taken towards improvement in the understanding and thus creating awareness about sexual health among females.

What Is Female Sexual Interest/Arousal Disorder (FSIAD)?

It is a common but least discussed sexual health topic among females. In males inability to experience sexual pleasure while having sexual intercourse or sexual practices and reduced desire for such activities is called Male Hypoactive Sexual Desire Disorder (MHSDD). Similar to MHSDD, females experience FSIAD the prevalence of which varies from 16 % to 55 % across different regions. FSIAD improves on its own once the emotional and psychological well-being is established. However, with advancing age this problem increases in prevalence due to hormonal changes. This article throws light on Female Sexual Interest/Arousal Disorder, a common but least discussed sexual health topic among females.

How to Diagnose FSIAD?

FSIAD is diagnosed on the following basis:

  • Absent or reduced sexual interest in sexual activity.
  • Absent or reduced erotic thoughts or fantasies.
  • Absence of or reduced initiation or receptivity to sexual activity.
  • Absent or reduced sexual excitement/pleasure during sexual activity in all or almost all (75–100%) encounters in contexts identified as problematic or, if the problem is generalized, in all contexts.
  • Absent or reduced sexual interest/arousal to sexual/erotic cues.
  • Absent or reduced sensations during sexual activity in all or almost all encounters in contexts identified as problematic or, if the problem is generalized, in all contexts.

At least 3 of the above mentioned criterias should be present to make a diagnosis of FSIAD. It is also associated with painful intercourse, female orgasmic disorder, desire and sexual preferences discrepancies in a couple. Also attention needs to be paid towards assessment of associated mood disturbances, anxiety, physical and sexual abuse, relationship issues, internalization of sexual conflicts.

What Causes FSIAD?

Multiple factors are responsible for FSIAD, which include the following:

  • Medications also result in FSIAD. These include antipsychotics, mood stabilizers, SSRIs (Selective Serotonin Reuptake Inhibitors), antihypertensives, oral contraceptives, reduced steroid hormone levels. Medications might result in reduced estrogen levels, hence resulting in reduced sexual desire.
  • Psychological causes includes major depressive disorder, anxiety, relationship issues, conflict related to body self image, substance abuse, physical/sexual abuse.

How to Treat FSIAD?

Like most of the other sexual disorders, FSIAD is also treatable. Treatment includes the following measures:

1. Pharmacological Measures:

  • Hormonal replacement is done to increase the estrogen level. Either estrogen supplements alone or estrogen in combination with progesterone can be used. It will increase the lubrication, will reduce the vaginal dryness and atrophy thereby reducing the discomfort associated with coitus (sexual intercourse). It is more effective in menopausal cases. Testosterone supplements can also be used.
  • Flibanserin, an agonist and antagonist to serotonin receptors can also be used.
  • Bupropion, used for SSRIs induced FSIAD.
  • Phosphodiesterase 5 inhibitors (PDE5 inhibitors like Sildenafil, Tadalafil, Vardenafil) can also be used.

2. Psychological Measures:

  • Sexual skill training.
  • Communication skill training.

3. Combination of both pharmacological and psychological measures can also be used in increasing the response rate.

The main aim of these measures is to increase the reinforcing value of sexual activities via increase in arousal, orgasm, pleasure and physical and emotional satisfaction. This also aims at improving the non sexual conditions such as relationship dynamics, stressors, timing and context so as to facilitate the sexual interactions.

To conclude with, FSIAD is a psychological disorder common to be found. It is not a matter to feel shy and hence has to be discussed. Rather females have equal right to seek pleasure as do the males.

Frequently Asked Questions


What Can Be the Physiological Causes of Female Sexual Arousal Disorder?

The physiological causes of FSAD (Female sexual arousal disorder) may include:
- Damage of the blood vessels in the pelvic region resulting in reduced blood flow.
- Damage of the nerves in the pelvic area resulting in diminished arousal.
- General medical conditions like high blood pressure, coronary artery disease, and diabetes mellitus can damage blood vessels.
- Nursing a baby (lactation).
- General medical conditions like adrenal gland disorders, thyroid disorders, and removal of the ovaries cause changes in the hormone level.
- Low levels of sex hormones due to aging.
- Side effects of medications like antidepressants, antipsychotic drugs, drugs to lower the blood pressure, birth control pills, sedatives, or other hormone-containing pills.


What Can Be the Hormonal Causes of Female Sexual Arousal Disorder?

Sexual problems usually develop when the hormones are in flux, such as after having a baby or during menopause.
- Low levels of estrogen after menopause can also lead to changes in your genital tissues and sexual responsiveness.
- A decrease in estrogen level can lead to decreased blood flow to the pelvic region, resulting in less genital sensation and more time to build arousal and reach orgasm.
- The vaginal lining will become thinner and less elastic, mainly if not sexually active. These factors can lead to painful intercourse, also known as dyspareunia.
- The body's hormone levels also shift after giving birth and during breastfeeding, leading to vaginal dryness and can affect the desire to have sex.


Who Can Get Female Sexual Arousal Disorder?

Female sexual arousal disorder (FSAD) is the persistent, recurrent problems with sexual response, desire, orgasm, or pain that can cause distress or strain your relationship with your partner.
- Women with decreased blood flow to the genital area are believed to get FSAD similar to vascular disease in male erectile dysfunction.
- Female sexual arousal disorder (FSAD) can occur at any stage of life.
- Women who have depression or anxiety, heart, blood vessel disease, neurological conditions, gynecological conditions, certain medications, and a history of sexual abuse can get FSAD.


How Is Female Sexual Arousal Disorder Diagnosed?

If you have a minimum of three of the following, you might have FSAD (Female Sexual Arousal Disorder):
- Less interest in sex.
- Fewer thoughts related to sex.
- Reduced start and denying of sex.
- Little pleasure during sex.
- Decreased interest in sex.
- Less genital sensations during sex most of the time.


What Are the Factors Associated With Female Sexual Arousal Disorder?

The factors associated with female sexual arousal disorder are medical health, hormones, medications, and psychological factors, including stress, relationships, comorbid mental illness, and history of sexual abuse.


When To Seek Help for Female Sexual Arousal Disorder?

It is usual for females to have fluctuations in sexual desire in some part of life. However, a total loss of interest in sex, or difficulty responding to stimulation, may indicate female sexual arousal disorder (FSIAD). This condition can be lifelong or may be acquired, which needs medical attention.


What Can Be The Signs of Female Sexual Arousal Disorder?

The signs of female sexual arousal disorder are:
- Low sexual drive.
- Orgasmic disorder.
- Pain during sexual stimulation or vaginal contact.
- Lesser or no sexual thoughts.
- Decreased sexual pleasure during sexual activity.
- Lesser or no arousal in response to visual, written, or verbal cues.
- Infrequent or no beginning of sexual activity within a relationship.
- Reduced or no sensations in the genitals.
- Symptoms lasting for more than six months.
- Significant distress about the symptoms.
- Symptoms that are not more accurately explained by a nonsexual mental health disorder, domestic abuse, medication, substance abuse, or another medical condition.
- Difficulty in achieving orgasm after sufficient sexual arousal and continuous stimulation.


How Prevalent Is Female Sexual Interest Arousal Disorder?

Female sexual interest arousal disorder prevalence is often unknown, although some older women report less distress about experiencing low sexual desire than younger women. About 3.3 percent of participants between the ages of 18 and 44 have female sexual arousal disorder, while 7.5 percent of participants between the ages of 45 and 64 experienced it. The prevalence also varies depending on the age, cultural background, duration of symptoms, and presence of distress.


How To Treat Female Sexual Arousal Disorder?

The effective treatment for sexual dysfunction is often addressing an underlying medical condition or hormonal change. For example, the doctor may suggest changing a medication you are taking or replacing it with a new one. And possible treatments for female sexual dysfunction are usually with Estrogen therapy. The treatment is usually based on the type and severity of the pain, and it includes sex or relationship counseling and dilation exercises. For women in long-term relationships, physicians suggest that counseling should consist of both partners.
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Dr. Bharat Udey

Dr. Bharat Udey



sexual health
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