Sexual arousal disorders

Sexual arousal has a few components to it, so a sexual arousal disorder simply means one of those components has been interrupted. 

In plain English, this means a broad range of ‘is my body responding appropriately when I have sex?’.

There are so many avenues for the interruption. Diagnosing a sexual arousal disorder means trying to isolate the problem so as to find a solution.

There are three classifications of sexual arousal disorders.

  1. Subjective sexual arousal disorder
  2. Genital sexual arousal disorder
  3. Both subjective and genital sexual arousal disorder

Subjective sexual arousal disorder

Subjective means you don’t feel aroused by any form of sexual genital or non-genital stimulation – kissing, dancing, watching porn, being touched erotically – even though your vagina is responding.

That is, your mind and emotions are separate from your vagina. Your body is responding, but your mind is not. That makes it subjective.

Genital sexual arousal disorder

Subjective arousal occurs – so you are loving the kissing, dancing, porn, erotic touch – but your vagina is not responding to those feelings.

This situation is common in postmenopausal women where low oestrogen results in atrophic vaginitis, and the vagina doesn’t function optimally anymore (genital deadness). Sensitivity is reduced and vaginal lubrication is scarce.

Combined sexual arousal disorder

This is a situation where nobody is home sexually – you aren’t into kissing or porn, and your vagina doesn’t respond either. The clitoris is away on vacation.

Causes of sexual arousal disorders

As you can imagine, the causes of sexual arousal disorders are many and varied. Psychological causes are frequent – depression, anxiety, low self-esteem, stress, distractions) – and physical conditions are also important – disease, disability, fatigue. Not having the right sexual stimulation or the setting being inappropriate for arousal can also be a factor.

Hormonally, genital arousal disorder can happen with low oestrogen levels after menopause or having a baby. Testosterone reduces as we age, however vulvar dystrophy (for example lichen sclerosus) can also contribute.

Nerves may have been damaged by disease or injury (including surgery), leading to decreased sensation and genital arousal. Blood supply issues could also have an impact.

Treatment for sexual arousal

The treatment depends on the cause, with physical causes being somewhat simpler to diagnose and treat than psychological causes.

If a woman is pre or postmenopausal, oestrogen creams or DHEA vaginally may help; if a woman is disabled in some way and finds sex difficult, strategies can be discussed to try to overcome those obstacles; if nerves have been damaged, treatments will focus on what can be achieved.

Hormone treatments can help, but it isn’t for everyone. Psychological causes need to be addressed using whatever means feels best for the person – a counsellor, psychotherapist, EFT/NLP therapy, getting a massage every week, taking time to reconnect with a partner, whatever it is.

Specialist appointments with a pelvic physiotherapist may be advised.

A doctor can help with referrals to lots of practitioners, however there are many treatments that can help to bring sexuality – both subjective and genital – back to life.  

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Jessica Lloyd - Vulvovaginal Specialist Naturopathic Practitioner, BHSc(N)

Jessica is a degree-qualified naturopath (BHSc) specialising in vulvovaginal health and disease, based in Melbourne, Australia.

Jessica is the owner and lead naturopath of My Vagina, and is a member of the:

  • International Society for the Study of Vulvovaginal Disease (ISSVD)
  • International Society for the Study of Women's Sexual Health (ISSWSH)
  • National Vulvodynia Association (NVA) Australia
  • New Zealand Vulvovaginal Society (ANZVS)
  • Australian Traditional Medicine Society (ATMS)