Female Sexual Interest / Arousal Disorder (FSIAD)

Female Sexual Interest/Arousal Disorder (FSIAD) is referred to as lack or absence of sexual interest, while the beginning of sexual intercourse, there is a noticeable lack of thoughts, fantasies, pleasure, and absence of responsive desire and deprivation of subjective excitement and genital response to a genital or non-genital sexual stimulus or both.


FSIAD is one of the numerous conditions that fall under the category of sexual dysfunction. This disorder can lead to feeling isolated. About 40 percent of women experience FSIAD in their life at some point. Although FSIAD can be frustrating, it is treatable.


Symptoms of FSIAD

For many women, the symptoms of FSIAD come and go over time. Some have symptoms every time they try to have intercourse while others occasionally experience them. Symptoms of FSIAD include:

  • Decreased sexual desire i.e. loss of interest in sex.
  • Decreased thoughts about sex i.e. one may rarely think about sex.
  • Lesser initiation of sexual activity one might not initiate sex and may also be non-willing to the partner’s efforts to initiate sex.
  • Decreased pleasure during sex sexual stimulation that used to turn one (female) on no longer works.
  • Reduced arousal from internal or external sexual signals one may no longer be aroused by stimulations like psychological intimacy and erotic fantasy.
  • Absence of genital or non-genital senses during sex. When having sex, one might not feel much in genitalia.

Causes of FSIAD

In a female body, sexual arousal increases blood flow to the tissues around the vaginal lining and clitoris, leading to swelling of tissues. In turn, the vagina produces natural lubricants. Any disruption in this process can lead to FSIAD. Psychological and physical factors both can disturb the arousal process.

Psychological factors

  • Low self-confidence, poor body image, anxiety, depression, stress, trauma, guilt, negative thoughts, and relationship problems.
  • Hormonal factors. Fluctuations in hormone levels can affect the ability to be aroused, the factors that can cause hormonal changes and possibly FSIAD include birth control pills, menopause, and pregnancy, etc.

Anatomical factors

Problems with the circulatory or neurological system of the body may cause FSIAD as arousal depends greatly on these systems. Some of the causative anatomical factors include reduced blood flow to the vagina, damage in the pelvic nerves, vaginal or bladder infection, abnormal drying or thinning of vaginal tissues.

Other causes of female sexual interest/arousal disorder are:

  • Medications: (SSRI) Selective serotonin reuptake inhibitors i.e. antidepressants, may lead to FSIAD.
  • Medical treatments: Chemotherapy, radiation, a recent surgery may affect arousal and normal sexual stimulation.
  • Inadequate sexual simulation: The sexual stimulation received from oneself or the partner is not enough.
  • Diabetes: As it affects the nervous and vascular system it may make arousal more difficult and the body is not capable of sending the essential signals and hormones for arousal.

Who gets Female Sexual Interest/Arousal Disorder?

Individuals with heart and blood vessel disease, depression or anxiety, gynecological issues, like vulvovaginal atrophy, infections, or lichen sclerosis may lead to FSIAD. Other potential factors are neurological issues such as a spinal cord injury or multiple sclerosis, medications like antidepressants or hypertensive medications, emotional stress, relationship stress, and history of sexual abuse. 

Diagnosis of Female Sexual Interest / Arousal Disorder

Diagnosis of sexual interest/arousal disorder based on DSM-5 criteria requires an absence of or a significant decrease in at least 3 of the following:

  • Interest in sexual activity
  • Sexual or sensual imaginations or fantasies
  • Beginning of sexual activity and response to the partner’s initiation
  • Excitement or pleasure is achieved during less than 75% of sexual activity
  • Interest or sexual stimulation as a response to sexual (internal or external) erotic stimuli (e.g., written, verbal, visual)
  • Genital or non-genital sensations during 75% of sexual activity

These symptoms must have been present for ≥ 6 months and should be causing noteworthy distress for the female. The diagnosis is not made if a physical or another psychological cause (including relationship distress) is accountable for the symptoms. A pelvic examination is also required to be done if the penetration during sexual activity causes pain.

Treatment of Female Sexual Interest / Arousal Disorder?

Treatment for FSIAD mainly emphases recognizing any underlying causative factors and treating them. Many females find that a combination of treatments (i.e. medical and psychological) seems to work best for them.

In accordance with the underlying cause, the treatment strategy often includes psychological therapy, medicines, or a combination of both. Some medications for the treatment of FSIAD (female sexual arousal/interest disorder) include:

  • Hormone therapy. If the underlying cause of FSIAD is hormonal, hormone therapy might help to regulate the level of hormones by treating low estrogen or testosterone level, vaginal dryness, or pain during sexual intercourse.
  • Changing the dosage of prescribed medicine. If a prescribed medication such as an anti-anxiety medicine, is causing the symptoms of FSIAD, adjusting your dosage or switching to another type of medicine may help.
  • Consulting with a psychotherapist who specializes in sexual health, either on your own or with your partner, can also help with many of the psychological elements of FSIAD. Even if you do not seem to have any underlying related mental health issues, a psychotherapist can help you in identifying that what stimulates you and can help fight the barriers that are getting in the way. A psychotherapist can also provide directions on how to develop trust and intimacy with your partner, which can play a major role in sexual arousal.