Sexual Dysfunctions – Decreased Sexual Desire

To describe sexual dysfunctions, I won’t follow the order used in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Instead, I’ll adopt a logic that helps me explain the concepts more clearly—starting from decreased sexual desire, moving through difficulties during intercourse, and ending with problems related to orgasm.

Sexual desire is the willingness to engage in sexual activity, which involves both initiating and being receptive to erotic or sexual stimuli. Desire can change over the course of life: age, health status, life events, and social pressures are all factors that can influence sexual desire.

According to the DSM-5, female sexual interest/arousal disorder is characterized by:

• A significant reduction or absence of sexual interest or arousal, evidenced by at least 3 out of the following 6 indicators:
  • Reduced interest in sexual activity
  • Fewer sexual/erotic thoughts or fantasies
  • Lack of initiation or reduced receptivity to sexual advances
  • Reduced pleasure during sexual activity
  • Decreased arousal in response to sexual/erotic cues
  • Decreased genital or non-genital sensations during sexual activity
• These symptoms must persist for at least 6 months and cause clinically significant distress
• The symptoms are not better explained by another condition

According to the DSM-5, male hypoactive sexual desire disorder is characterized by:

• A significant reduction or absence of sexual desire and sexual/erotic fantasies
• The condition lasts at least 6 months and causes clinically significant distress
• The symptoms are not better explained by another condition.

Sources:

• American Psychiatric Association (2013) – Diagnostic and Statistical Manual of Mental Disorders (5th ed.)
• Bernhill, J. W. (2014) – DSM-5 Clinical Cases

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