The sexual response is divided into four phases: Desire, excitement, orgasm and resolution. Hypoactive sexual desire is a disorder that we would frame in the first phase and is defined as a repeated and persistent state of lack of desire and / or interest or fantasies of a sexual nature. The decrease or absence of desire is the most common sexual dysfunction in women, although it is a problem that although to a lesser extent, some men may also present. Its etiology is complex and can cover biological, psychological and social elements. This dysfunction that in the DSM-IV was known as Hypoactive Sexual Desire Disorder, in the DSM-V is called as a disorder of interest and female arousal.
- 1 Definition of the disorder
- 2 Etiology
- 3 Evaluation and treatment
Definition of the disorder
Next, we will analyze the paradigm shift in the definition of the disorder:
Hypoactive sexual desire disorder is defined as persistent or recurrent deficiency (or absence) of sexual fantasies and desire for sexual activity that causes significant distress or intrapersonal difficulties.
The definition has been reformulated, hypoactive sexual desire disorder and female sexual arousal disorders have been combined into a single disorder, now called disorder of interest and female sexual arousal. This conception has been based on data that suggests that the sexual response is not always a linear process and that the distinction of certain phases, particularly desire and excitement, may be artificial.
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This new change only refers to women, for men, little desire is still referred to as hypoactive. There is some controversy in this regard, as an example, in issue 46 of the digital magazine Aperturas in his article “The goodness and ethics of care in female subjectivity. Implications of DSM-V for women's sexuality ” we find opposing visions, on the one hand Brotto defends this new conceptualization and argues that the concept of "interest" describes women rather than "desire" because it emphasizes a broader construct than impulse, which has a more biological connotation of sexual desire. SpugasInstead, he complains that this way of understanding female sexuality becomes normative. Something that can be related to frigidity (Cryle and More 2011). According to Spugas, this would be the product of women's lack of knowledge and that normally implies intolerance to forms of joy that do not conform to the narrative of heterosexual intercourse, leaving the rest of sexual practices as peripheral.
We will define the disorder following the DSM-V, since it is the standardized user manual.
There are many causes that can lead to hypoactive sexual desire or disorder of interest and female sexual arousal, here we expose the most frequent.
- Chronic diseases, anemias, heart disease
- Hormonal disorders: androgen deficit, hyperthyroidism
- Estrogen Deficit (climacteric)
- Cardiovascular and neuroendocrine diseases (diabetes)
- Breast surgery uterus, ovaries, prostate; that in addition to hormonal problems generate feelings of castration and devaluation that lead to a disorder of mood and erotic desire
- Some drugs (antidepressants, antiandrogens)
- Substance use like alcohol, tobacco, marijuana, opiates.
- Individual: Restrictive sexual education, lack of sexual interest due to negative experiences, undefined or unaccepted sexual orientation, psychological disorders.
- Secondary to the relationship: Lack of communication, discrepancies in the way of understanding sexuality, physical, psychological or aesthetic changes that inhibit desire in the other.
- Sexual dysfunctions of the couple: Erectile dysfunction, premature ejaculation.
- Transit per loss period: Duels, economic and labor difficulties or periods of vital crisis; marriage, pregnancy, postpartum, empty nest syndrome.
Evaluation and treatment
Given the great diversity of causes that can cause hypoactive sexual desire or the disorder of interest and female sexual arousal, it will be necessary to carry out a good evaluation that find out what your real cause is, because this will vary the treatment if it is for physical reasons (in which treatment with drugs will be recommended) or it is a depression or a stressful moment for the subject
In the event that there is any type of disorder, it must be treated identifying the way it is affecting the person in their desire. Likewise, there are many cases in which sexual information must be provided, fears or phobias work, as well as anticipatory anxiety.
The couple therapy It is highly recommended for this type of disorder. Improving communication and sexual skills to facilitate the overcoming of fears or obstacles is also, in many cases, helpful to address the problem.
Garriga, c (April 2014.3). The goodness and ethics of care in female subjectivity. Implications of DSM-V for women's sexuality. Psychoanalytic openings. Retrieved from //www.aperturas.org/articulos.php?id=843&a=La-bondad-y-la-etica-del-cuidado-en-la-subjetividad-femenina-Implicaciones-del-DSM-V-para- the-sexuality-of-women
Sandín, b (2013). DSM-5: Change of paradigm in the classification of mental disorders? Recovered from: //revistas.uned.es/index.php/RPPC/article/viewFile/12925/11972