Arousal Disorder/Lack of lubrication: Overview

Content Written By: Irwin Goldstein, MD and Michael Krychman, MD

Women with female sexual arousal disorder have a persistent or recurrent inability to attain, or maintain until completion of the sexual activity, an adequate lubrication swelling response of sexual excitement, that causes marked distress or interpersonal difficulty and is not better accounted for by such conditions as depression, anxiety, bipolar disorder, attention deficit hyperactivity disorder, etc, and is not due exclusively to the direct physiological effects of a drug of abuse, or a medication such as an anti-androgen, etc or a general medical condition.

Women with female sexual arousal disorder can be subclassified as having a subjective sexual arousal disorder. A subjective sexual arousal disorder is consistent with an absence or markedly diminished feeling of sexual excitement or sexual pleasure from any type of sexual stimulation, however, vaginal lubrication or other signs of physical response, such as throbbing, pulsations, engorgement, and swelling still occur.

Women with female sexual arousal disorder can be subclassified as having a genital sexual arousal disorder. A genital sexual arousal disorder is consistent with an absence or impaired genital sexual arousal that may include problems with limited vulvar swelling or vaginal lubrication from any type of sexual stimulation and reduced sexual sensations from stroking or touching the genitalia, however, subjective sexual excitement still occurs from non-genital sexual stimuli, such as from the breast.

Women with female sexual arousal disorder can be subclassified as having a combined genital and subjective arousal disorder. A combined genital and subjective arousal is consistent with an absence or markedly diminished feeling of sexual excitement or sexual pleasure from any type of sexual stimulation as well as complaints of absent or impaired genital sexual arousal involving problems with vulval swelling, throbbing, pulsations, engorgement and/or vaginal lubrication.

In a national survey of women in heterosexual relationships. over 30% of the sample complained of lubrication while 7% reported personal distress about poor lubrication. Often women female sexual arousal disorder will complain that they have dead genitals. The prevalence of the female sexual arousal dif?culties, with lack of “lubrication-swelling response” has been reporte range between 11% and 31%. The prevalence of subjective sexual arousal dif?culties is less well known except for one study which found a prevalence of approximately 17%. Like desire complaints, when distress is also considered, the prevalence of arousal impairment drops markedly to approximately 6-7%.

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