Definitions

Literate Systems

Definitions

Sexual disorders (dysfunctions) are defined in the Diagnostic and Statistical Manual of the American Psychiatric Association, Version IV (Text Revised). The more common DSM-IV(TR) definitions are given below. Some of the terms used are not those used in clinical practice and the definitions have significant limitations in clinical practice. However, they remain part of the most widely-used system of nomenclature. These definitions refer primarily to problems experienced by heterosexual couples with vaginal intercourse; their validity in other sexual relationships and with other sexual behaviours is uncertain.

There are treatment programmes that can help with all of these disorders. Most of those affected benefit from a combination of medical, psychological and behavioural therapies. An initial assessment by a Sexual Physician is likely to be of benefit to all.

Hypoactive Sexual Desire Disorder (HSDD): Persistently or recurrently deficient (or absent) sexual fantasies and desire for sexual activity. The judgment of deficiency or absence is made by the clinician, taking into account factors that affect sexual functioning, such as age and the context of the person's life.

Sexual Aversion Disorder: Persistent or recurrent extreme aversion to, and avoidance of, all (or almost all) genital sexual contact with a sexual partner.

Sexual Arousal Disorders:

In women, 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.

In men, Male Erectile Disorder (Erectile Dysfunction, ED, impotence): Persistent or recurrent inability to attain, or to maintain until completion of the sexual activity, an adequate erection.

In women, Female Orgasmic Disorder: Persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement phase. Women exhibit wide variability in the type or intensity of stimulation that triggers orgasm. The diagnosis of Female Orgasmic Disorder should be based on the clinician's judgment that the woman's orgasmic capacity is less than would be reasonable for her age, sexual experience, and the adequacy of sexual stimulation she receives.

In men, Male Orgasmic Disorder: Persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement phase during sexual activity that the clinician, taking into account the person's age, judges to be adequate in focus, intensity, and duration.

Premature Ejaculation: Persistent or recurrent ejaculation with minimal sexual stimulation before, on, or shortly after penetration and before the person wishes it. The clinician must take into account factors that affect duration of the excitement phase, such as age, novelty of the sexual partner or situation, and recent frequency of sexual activity. This definition is not universally accepted; some definitions include a specific time limit of one or two minutes between vaginal penetration and ejaculation.

Sexual Pain Disorders:

Dyspareunia: Recurrent or persistent genital pain associated with sexual intercourse in either a male or a female.

Vaginismus: Recurrent or persistent involuntary spasm of the musculature of the outer third of the vagina that interferes with sexual intercourse.

Persistent Genital Arousal Disorder (PGSD, PSAD, PSAS): Spontaneous, intrusive, and unwanted genital arousal (e.g., tingling, throbbing, pulsating), which occurs in the absence of sexual interest and desire. Any awareness of subjective arousal is typically but not invariably unpleasant. The arousal is unrelieved by one or more orgasms and the feelings of arousal persists for hours or days. This condition is not defined in DSM-IV(TR); almost all reported cases have been in women.

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