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Handbook On Female Sexual Health And Wellness


Female Sexual Dysfunctions: DSM-IV-TR Definitions

The DSM IV TR criteria for female sexual dysfunction:

  • Classified as persistent or recurrent and causing “marked distress” or “interpersonal difficulty”
  • Not better accounted for by a general medical or psychiatric condition (i.e., anxiety and depression)
  • Not due exclusively to the direct physiologic effects of a substance or medication
  • Sexual Dysfunction may be:

    — Lifelong: has been present since the onset of sexual functioning
    — Acquired: develops only after a period of normal functioning
    — Situational: is limited to certain types of stimulation, situations, or partners
    — Generalized: is not limited to certain types of stimulation, situations, or partners

Clinical Pearls

  • Overlapping sexual disorders are very common (e.g., hypoactive sexual desire disorder often results in decreased arousal and difficulty with orgasm)
    • When one dysfunction is revealed, ask about others
    • Treatment of disorders may be concurrent or sequential
  • Discuss the chronology of the sexual concerns; it is imperative to uncover which sexual problem presented first
  • The key is to define the primary disorder and discuss with the patient which disorder should be addressed first