Article: FSD Categories and Prevalance

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Article: FSD Categories and Prevalance
There are four overlapping categories of female sexual dysfunction (FSD) according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). (1) The most common is Hypoactive Sexual Desire Disorder (HSDD). Lack of sexual interest, also known as sexual desire, was the most frequently reported female sexual complaint in a study published by Laumann et al.(2)

Hypoactive Sexual Desire Disorder (HSDD) – persistently or recurrently deficient (or absent) sexual thoughts and desire for sexual activity. The disturbances cause marked distress and interpersonal difficulty.

The sexual dysfunction is not better accounted for by another mental or medical disorder (except another sexual dysfunction) and is not due exclusively to the direct physiological effects of a substance (e.g., drug or alcohol abuse, a prescription medication) or a general medical condition.

Female Sexual Arousal Disorder (FSAD) – persistent or recurrent inability to attain, or to maintain until completion of the sexual activity, an adequate lubrication-swelling response of sexual excitement. This disturbance causes marked distress or interpersonal difficulty.

Like HSDD, this sexual dysfunction is not better accounted for by another mental or medical disorder (except another sexual dysfunction) and is not due exclusively to the direct physiological effects of a substance (e.g., drug or alcohol abuse, a prescription medication) or a general medical condition.

Female Orgasmic Disorder – persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement phase. This disturbance causes marked distress or interpersonal difficulty.

The orgasmic dysfunction is not better accounted for by another mental or medical disorder (except another sexual dysfunction) and is not due exclusively to the direct physiological effects of a substance (e.g., drug or alcohol abuse, a prescription medication) or a general medical condition.

Sexual Pain Disorders – includes vaginismus (recurrent or persistent involuntary spasm of the musculature of the outer third of the vagina that interferes with vaginal penetration) and dyspareunia (recurrent or persistent genital pain associated with sexual intercourse). This disturbance causes marked distress or interpersonal difficulty.

A diagnosis of dyspareunia requires that the pain is not caused exclusively by vaginismus or lack of lubrication, is not better accounted for by another mental or medical disorder (except another sexual dysfunction), and is not due exclusively to the direct physiological effects of a substance (e.g., drug or alcohol abuse, a prescription medication) or a general medical condition.

A diagnosis of vaginismus requires a recurrent or persistent involuntary spasm of the muscle of the outer one-third of the vagina that interferes with intercourse.

Prevalence of FSD

Studies in the United States indicate that FSD affects an estimated 43% of women.(2) While significant advances have been made in diagnosis and treatment of male sexual dysfunction, the physiological and psychological mechanisms of female sexual response are not as well understood at this time.

Lack of sexual interest, also known as sexual desire, was the most frequently reported female sexual complaint.
The prevalence of FSD in community studies ranges from 25% to 63%.
This population study, a substudy of the National Health and Social Life Survey, was conducted in 1992. It is a probability sample among 1749 women and 1410 men, aged 18 to 59 years, in the United States.
It is based on face-to-face interviews with trained interviewers.
The population is similar to U.S. Census Bureau Current Population Survey, representative for age, education level, and marital status.
Following are the ranges of dysfunctions across the age groups:

- Lack of interest in sex: ~27-32%

- Unable to achieve orgasm: ~22-28%

- Pain during sex: ~8-21%

- Sex not pleasurable: 17-27%
Using latent class analysis to group symptoms in categories, the study found that sexual dysfunction is more prevalent in women than men (43% vs. 31%).
Sexual problems are highly prevalent among women; lack of interest is the most prevalent form of FSD.
Although loss of sexual desire can occur at any age, menopause is associated with an increased incidence of FSD.

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References
1. American Psychiatric Association. DSM-IV-TR: Diagnostic and Statistical Manual for Mental Disorders. 4th ed. Arlington, Va; 2000.
2. Laumann EO, Paik A, Rosen RC. JAMA. 1999;281:537-544.
Information used by permission: fsdeducation.com