Sexual arousal disorders are mental, emotional and/or physical barriers to normal sexual response. Depression, poor body image, stress, anxiety and relationship challenges can all get in the way of arousal.
Women in particular suffer from sexual arousal disorder. Some do not experience mental sexual excitement, others do not have the physical responses–vaginal secretions, labia/clitoris/breast swelling and tingling– common to arousal.
People with this disorder are often not stimulated by kissing, dancing, watching erotic videos, or being genital touching. Sometimes physical response happens, but not noticed by the person.
Psychological factors, medications and relationship issues often interfere with arousal. Insufficient stimulation or a setting not conducive to sexual activity can also contribute.
Additional causes include:
- Low estrogen, such as after childbirth
- Thinning and drying of vaginal tissues post-menopause
- Infection of the vagina or bladder
- Disorders that cause changes in the skin around the vulva, such as lichen sclerosus
- Age-related dips in testosterone
Arousal disorders may also develop when chronic diseases such as diabetes and multiple sclerosis cause nerve damage.
Diagnosis and Treatment
A doctor’s diagnosis starts with a discussion of the woman’s sexual history and her description of the problem. Usually, a pelvic exam follows.
If the problem involves the woman’s primary sexual relationship, the steps below can be helpful. A sex therapist can serve as a guide to help the couple achieve them:
- Build trust and intimacy in the relationship
- Make the setting as conducive to sexual activity as possib
- Teach the woman focusing techniques
- Identify and communicate to the partner what stimulates the woman
Couples may experiment with vibrators, fantasies or erotic videos. They may also try sexual activities other than vaginal intercourse.
Sensate Focus Exercises
Therapists like Kim Ronk often prescribe Sensate focus exercises in helping sexual related issues. In these exercises, partners touch each other (taking turns) to elicit pleasure. The genitals are off-limits at the beginning, and the focus is sensual vs. sexual. The person being touched guides their partner. The touch progresses to other parts of the body (sensually, then sexually), and finally to genital stimulation. These exercises have been widely successful in enhancing intimacy and reducing sexual anxiety.
If a selective serotonin reuptake inhibitor is the cause, substituting another drug may help. If the cause is atrophic vaginitis or low estrogen, doctors often recommend adding estrogen via a cream, tablet or ring similar to a diaphragm.