Diagnosis of Female Sexual Disorders

APA, American Psychological Association, classifies sexual disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM IV) as disturbances tend to interrupt the mutual relations and cause psychological distress. All disorders listed in DSM interfere in any way arousal and the sexual response cycle. Although they are controversial, it is the standard used for female sexual problems by many psychiatrists and doctors in the U.S. and other countries.

Hypoactive sexual desire disorder is characterized by an absence of libido. There is no interest for sex and little stimulation needs. Sexual aversion is characterized by an aversion to or avoidance of sexual advances and sexual contact. It may be sexual or physical abuse or trauma and may be for life. The main feature of female sexual arousal disorder is the inability to achieve and implement the various phases of “normal” female arousal. Female orgasmic disorder is defined as a delay or absence of orgasm after “normal” arousal. Dyspareunia is characterized in genital pain before, during and after intercourse. Vaginismus is the involuntary contraction of the pelvic floor muscles around the vagina as a response to attempted penetration. Contraction makes vaginal penetration difficult or impossible. These disturbances may be due to personal problems and you do not seek medical attention for it. A distinction is made disturbances that lasts a lifetime and those that are acquired, and the disturbances caused by the situation and the present always.


In cases where you suspect a medical condition as the underlying cause, whether it is due to insufficient blood flow, nerve-related sensitivity loss or reduced hormone levels, a specialist an appropriate diagnosis. Sexual problems can be symptoms of diseases that require treatment, such as diabetes, endocrine disorders of the hypothalamic-pituitary-gonadal axis, and neurological disorders.

American Foundation of Urologic Disease (AFUD) characterizes APA criteria in these four types of disturbances:

  • Hypoactive sexual desire disorder; include sexual aversionFemale-Sexual-Dysfunction
  • Sexual arousal disorder
  • Orgasm disorder
  • Sexual pain; include vaginismus, dyspareunia

Contrary to APA standards, dyspareunia (pain during intercourse) diagnosed as a result of inadequate vaginal lubrication, which can be seen as an arousal disorder and treated like that. Pain associated with recurrent health conditions, including cystitis.

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 Physiological Diagnostic Tests

Vaginal blood flow and engorgement (swelling of the vaginal tissue) can be measured by vaginal photoplethysmography, where an acrylic fiber instrument is inserted into the vagina, reflect light and measures the flow and temperature. It cannot be used to measure levels of arousal, such as during orgasm, as it needs to be completely still for the measurements to be performed. Also, information about normal vaginal engorgement is limited and one can only speculate on what is normal when it comes down to such matters. A vaginal pH testing, usually performed by gynecologists and urologists to detect bacteria that cause vaginitis, can be useful. A probe is inserted into the vagina to measure. Decreased hormone levels and diminished vaginal secretion associated with menopause causes a rise in pH (over 5) which is easily detected by the test. A biothesiometer, a small cylindrical instrument, is used to measure the sensitivity of the clitoris and labia to pressure and temperature. Measurements are made before and after the subject watches erotic movies and masturbates with a vibrator about 15 minutes.