Female Sexual Interest/Arousal Disorder

The symptoms of female sexual arousal disorder (FSAD) and hypoactive sexual desire disorder (HSDD) are included in the symptoms of FSIAD. Female sexual dysfunction concerns, including female orgasmic disorder¹ and other types of sexual disorders and female sexual function concerns, often fall under the category of FSIAD as well.

FSIAD can be recognized by certain signs and symptoms, which vary in severity and frequency over time. Individuals can learn to identify the symptoms of FSIAD in themselves or their partners, including the following: 

• Little or no interest in the initiation of sexual activity
• Difficulty becoming sexually aroused
• Reduced pleasure or excitement during sexual activity 
• Few or no thoughts or fantasies about sex
• Limited or no response to sexual stimuli, such as touch or visual cues
• Little to no genital sensations during sexual activity

For the condition to be properly diagnosed, at least three of these symptoms must be present. In addition, the symptoms must be persistent, lasting for at least six months, and can't be caused by other factors, such as stress, medication, or relationship challenges.  

In some cases, those living with FSIAD may also experience physical symptoms associated with the disorder. These might include:

• Insufficient lubrication or vaginal dryness during sexual activity
• Discomfort or pain during intercourse
• Difficulty achieving orgasm, despite adequate stimulation

The disorder may also involve distress and other emotional symptoms, which may include:

• Frustration or guilt
• Negative self-image or low self-esteem
• Strained relationships with partners due to mismatched sexual desires or expectations
• Avoidance of sexual situations or discussions

FSIAD is a complex condition with a range of signs and symptoms that can significantly impact a woman's emotional health and sexual relationships. It may be helpful to seek guidance from a healthcare provider if these symptoms arise. A healthcare provider may help you determine the underlying cause and recommend appropriate treatment options.

FSIAD can have various causes and risk factors, including physical, psychological, and social factors. Recognizing the possible reasons behind FSIAD may help you determine the proper treatment and management strategies.

Physical causes 

Physical factors that might lead to FSIAD include:

• Changes in hormone² levels, such as reduced estrogen or androgen levels, which may happen during menopause or after childbirth
• Certain medical conditions, such as diabetes, multiple sclerosis, or chronic kidney disease
• Prescription medications, especially those used to treat depression or high blood pressure
• Misuse of alcohol or drugs, which may negatively affect sexual desire and arousal
• Low blood flow to the genital region 

Psychological causes 

Psychological factors may also play a role in FSIAD. These may include:

• Mental health conditions, such as anxiety or depression, which may reduce sexual interest and pleasurable experiences
• Stress, particularly chronic stress, which can affect a woman's ability to engage fully in sexual activities
• Negative thoughts or expectations about sex due to cultural or religious beliefs, past trauma,³ or inadequate sex education
• Relationship problems, such as poor communication, lack of emotional intimacy, or unresolved conflicts with a partner

Social risk factors 

Although less commonly discussed, social factors can sometimes affect sexual desire and arousal. Some examples include:

• Cultural norms or societal expectations around female sexuality
• Job-related stress or fatigue
• Limited access to sexual health information

These causes may interact, compounding the potential effects of the condition. Treating the condition may involve identifying and resolving the underlying causes, which can be complex and multifaceted. 

The goal of treatment for FSIAD is to improve sexual desire and arousal through various methods. There are several common treatments, including therapy, medication, and self-care.

Medications

While there are limited FDA-approved medications for treating FSIAD, specific options may improve sexual desire and arousal. Bremelanotide, an injection, and flibanserin, an oral tablet, are FDA-approved prescription drugs that may help treat FSIAD. The exact way in which they work is not entirely known. However, they may target certain neurotransmitters involved with arousal and are designed to help increase sex drive. 

Hormone replacement therapy with testosterone may be considered for some people experiencing FSIAD, as hormonal imbalances can contribute to low sexual desire. 

Medication treatment and hormonal therapy for FSIAD requires a prescription and the guidance of a healthcare professional. Consult a healthcare provider for potential side effects, warnings, and precautions of using medication treatment options. 

Consult a medical doctor before starting, changing, or stopping a medication for any condition. The above information is not a replacement for medical advice or diagnosis. 

Other treatment options

For some people, alternative treatments may be used for FSIAD. Options may include:

• Acupuncture: This form of traditional Chinese medicine uses thin needles inserted into specific points on the body and is believed to improve energy flow and promote overall well-being, which may enhance sexual desire.
• Pelvic floor physical therapy: Pelvic floor dysfunction may contribute to FSIAD. A physical therapist can help you find exercises and techniques to strengthen the pelvic floor muscles and improve sexual function.

Self-care

Self-care practices may also be a critical part of managing FSIAD, as physical and emotional health may be involved in sexual desire and arousal. Some suggestions for self-care may include:

• Regular exercise: Physical activity may improve overall health, mood, and energy levels, which may boost sexual desire.
• Stress management: Relaxation techniques like deep breathing exercises and meditation may reduce stress and promote a positive mindset.
• Open communication: Discussing sexual concerns and desires with a partner may create a more satisfying and trusting sexual relationship.
• Exploration: Becoming more familiar with preferences and desires may lead to a better understanding of what is pleasurable and arousing.

One or a combination of these treatments may help treat FSIAD, depending on the symptoms and the individual’s overall medical condition. Exploring various options while working closely with a healthcare provider to find the most suitable approach may be helpful.

Therapy platforms may be a helpful resource for those experiencing FSIAD. Online therapy platforms like BetterHelp can provide a safe and supportive environment for individuals to explore their concerns, learn about potential underlying causes, and improve their coping skills. A therapist may be able to provide CBT or mindfulness-based therapy online to address symptoms related to FSIAD.

The International Society for the Study of Women’s Sexual Health (ISSWSH) is another resource for individuals looking to learn more about FSIAD and other aspects of women’s sexual health. As a global organization committed to scientific inquiry and education, ISSWSH provides information on various sexual health problems faced by women and those with a gynecological reproductive system. It offers several resources, including research articles, professional education, and information about upcoming events focused on women’s sexual health.

Online and local support groups may also be available as a helpful resource for people experiencing FSIAD. Support groups may provide a space to connect with others facing similar challenges, share experiences, and receive mutual support. Local healthcare providers may also be able to connect individuals to support groups and other resources for managing FSIAD.

For help with substance use, contact SAMHSA’s National Helpline at 1-800-662-HELP (4357).

A recent study evaluated a new program called mindfulness-based cognitive therapy for sexuality (MBCT-S) involvings 26 women with FSIAD. The program, conducted in eight group sessions, taught participants mindfulness, which helps people focus on the present moment. After the program, these women reported improved sexual desire, enhanced overall sexual function, and less distress related to sex. These initial results suggest that the eight-session MBCT-S program could be a viable treatment option to improve sexual function in women with FSIAD.

After engaging in weekly online group counseling sessions, the following sexual parameters showed significant improvement: sexual desire, sexual satisfaction, sexual function, sexual distress, sexual communication, and frequency of sexual intercourse.

In addition to exploring therapeutic methods for FSIAD, researchers are investigating the underlying factors that may lead to FSIAD. A recent study examined the role of emotion regulation in couples affected by the disorder. By including partners in the research, the study provided insight into the effects of FSIAD on the emotional dynamics within romantic relationships. This information may help clinicians provide support for the challenges faced by couples living with FSIAD.

The field of FSIAD research continues to evolve, with new findings potentially improving the lives of those living with this condition. While current research offers promising directions, further studies may be beneficial to fully grasp the potential causes and develop effective treatments.

Below are several statistics on FSIAD:

• Roughly one out of every ten women in the United States experiences a decrease in sexual desire, which leads to distress. Low sexual desire may affect 8.9% of women between 18 and 44 years old, 12.3% of women between 45 and 65 years old, and 7.4% of women who are 65 years old or older. 
• Around 58% of women are unaffected by sexual dysfunction, whereas 22% experience low desire, 14% face arousal challenges, and 7% experience sexual pain. 
• A study covering 29 nations revealed that the level of self-reported low sexual interest varied between 26% and 43%
• Psychological treatment options, such as psychotherapy, are effective for FSIAD. One meta-analysis of 20 studies found that the improvement in symptom severity after the psychological treatment was 58%, and the improvement in sexual satisfaction following the treatment was 47%.