Only in recent decades has this disorder been called female libido deficiency. In traditional medical and popular thought, sexual dysfunction in women was called frigidity (coldness of the sexes). Modern sexology and sex therapy find the term 'frigidity' imprecise, unintelligible and condemnatory. Instead, it has come to be understood as a disorder of sexual desire, need, arousal and satisfaction.
Reasons for the development of sexual dysfunction
Biological causes: hormonal problems, organ disorders, drug effects, alcohol, drug abuse
Causes of psychological origin: Anxiety, Anger, Fear, Depression, Intimacy problems, Unhappy relationship, Extreme religious orientation, Strict, punitive parenting, Stress, Childhood abuse, Consequences of changing age, After the birth of a child, the father may lose sexual interest.
Physical reasons: anaemia, diabetes, hormonal fluctuations, certain medicines. Decreased sexual desire is also common in alcoholics and drug users.
Life situations: the postpartum period, the days before menstruation, emotionally distressing events such as bereavement.
Age: contrary to popular belief, it is not inevitable that the libido decreases before and during menopause" "Although menopause weakens the ability to orgasm, the ability to get wet, it does not necessarily mean that desire decreases.
Increase intimacy: the decrease in desire may be due to an increase in intimacy within the relationship. "The increase in intimacy, when a couple feels almost united, when it is as if they are stroking their own thighs when they touch each other, can also work against passion," says the sex psychiatrist. "It's hard to maintain the two great values in a relationship, intimacy and passion, at the same time. Esther Perel writes a solution to this in her recently published book.Translated with DeepL.com (free version)
Female desire is much less targeted than male desire. Women, on the other hand, were aroused by both same-sex and opposite-sex couples, and to a lesser extent by "animal sex". It was also found that female sexuality is more malleable than male sexuality and that it is influenced by cultural influences, positive or negative experiences, feelings of love or attachment.
There are four basic stages of sexual function in women.
1.The phase of desire: the need to be loved, to be satisfied.
There is no objective measure of "normal" desire. What is essential in this respect is that both members of the couple are nearly satisfied with the frequency of intercourse.
2. The excitement phase: under the right conditions, sexual arousal develops. It is important to know that the arousal curve differs considerably between the two sexes. the female arousal rises more slowly, remaining at the same level for longer (Plato section)
3. The phase of satisfaction, the orgasm. The physiological basis of the experience is the repeated, rhythmic contraction and relaxation of the muscles around the vagina. For the majority of women, the clitoral stimulation is the primary condition for this. The experience of orgasm is highly variable and depends on many factors. Its quality ranges from "just right" to an ecstatic, complex experience. If it is successful, of course, it is good, but it is not advisable to force simultaneous orgasms as a goal. This attitude can lead to a loss of experience.
4. The calming phase. After satisfaction, women in this phase also return more slowly, gradually, to the physical and mental state they were in before lovemaking.
Disorders may occur in the first three stages, in some cases lifelong, in others in relation to a specific situation.
1.Disorders of the desire phase
a) A primary disorder is when the patient has never felt the need for sex in any stimulus situation. If sexual intercourse did take place, it was indifferent or unpleasant. This type of disorder is extremely rare.
b) A secondary, consequential (secondary) disorder is when there was a need or desire, but it has gradually or suddenly decreased or disappeared. This is the most common complaint.
2. Disorders of the arousal phase
Arousal phase disorder is when arousal does not develop, intensify, stagnate or relapse under good conditions (acceptable partner, circumstances, stimuli). The primary version of this problem (never, nowhere, with anyone, from anything) is rare. The secondary, consequential form is very common. It may be caused by the regular absence of orgasm, infrequent, occasional gratification, gynaecological conditions (e.g. vaginitis), depression, use of certain drugs, alcohol, drugs. The prolonged deterioration of the partner relationship, the need to force "the good sex response", the need to conform can also lead to a disturbance of the arousal phase.
3. The satisfaction phase - orgasm disorders
If there is a desire for sexual intercourse, arousal is unproblematic, but orgasm is not achieved, we speak of a disorder of the satisfaction phase. It is important to know that it is entirely individual (and varies within the individual) what kind of stimulation is needed to achieve satisfaction and for how long. Painful intercourse, inability to have intercourse, vaginismus. The immediate cause of the complaint is spasmodic contraction of the muscles around the vaginal opening.
Ranked summary of causes of female sexual dysfunction
a) Ignorance - misinformation - beliefs
b) Performance anxiety - must meet the requirement of good sexual response
c) Communication breakdown between partners
d) The consequence of a relationship breakdown
We distinguish between two types of lack of desire:
- Temporary lack of desire: some temporary situation is causing the disturbance. Examples include stressful events, exhaustion at work, pregnancy or post-natal conditions. The condition may resolve or worsen.
- Persistent lack of desire: in this case, the desire was there, but something made it go away. 1: the person has no desire for anything other than their partner 2: the person has a desire for something else but not for their partner
Hypoactive sexual desire disorder
Psychological causes: stress at work, problems at home, relationship problems. Persistent conflict between the couple, past traumas, excessive expectations of the partner, inadequate sex education, misconceptions.
Physical causes include a variety of illnesses, including thyroid problems, cysts, bladder inflammation, brain disorders, diabetes, cardiovascular disease, prostate and internal medicine problems. Low levels of the sex hormone testosterone can also cause HSDD in both sexes. Various medications (e.g. some antihypertensives, antidepressants, tranquillisers), alcohol and drugs
Sexual aversion (formerly known as sexual phobia)
The prospect of sexual contact causes fear or anxiety to such an extent that the individual avoids sexual contact.
- Primary aversion: can be the result of sexual trauma or over-conservative upbringing, but can also be triggered by the first sexual experience, which the woman experiences as unpleasant or painful
- Secondary aversion: avoidance behaviour occurs after a normally experienced sexual life stage due to trauma, pain or relationship problems
- Intermittent aversion: we talk about this type when the aversion occurs only with a certain partner
- Persistent aversion: we talk about this type when the problem becomes persistent
Women are the most affected, with a lower incidence in men. This is largely due to upbringing, with women often having a stricter upbringing. Research suggests that between 20 and 35 percent of women suffer from the disease, compared to between 1 and 15 percent of men. It is more likely to affect older age groups than young people. However, the figures for men are increasing year on year.
There are many reasons for sexual aversion. In most cases, psychological problems may be at the root. It can be caused by stressful situations, fear of failure, fear of not being able to perform, or fear of pregnancy. Problems at work can also be included, or other relationship problems. Sexual aversion can also be the result of childhood trauma, which can alienate a person from sexual intercourse. It can also be a serious problem if the person is sexually inexperienced and frustrated. Many couples also have different needs, and when these meet, sometimes the desire is lost. Often the birth of a first child can also trigger a loss of desire.
Cultural factors, such as strong religious beliefs or poor upbringing, may also play a role. Biological factors can also trigger sexual aversion. In this case, the role of hormones should be mentioned, as they are the cause of sexual desire itself. Too much and too little hormones can also lead to problems. In women, menopause can also play a role. Even contraceptives, which contain female hormones, can cause sexual aversion. Drugs, alcohol or drugs can also reduce desire.
It can be a physical cause in women:
Orgasms to the clitoris are easy to achieve and learn, because of its rich nerve supply. But it is difficult to project the orgasmic experience onto a much less neurally well-supplied area if the girl is already fixated on clitorally oriented gratification. During intercourse, the stimulus is applied to the vagina, which is much less sensitive, because of the neural supply mentioned above.
Description of female arousal phase disorder:
Decreased response to sexual stimulation, lack of vaginal lubrication and other characteristics (swelling, engorgement) during intercourse. In practice, however, the symptoms are often not noticeable due to the use of vaginal lubricants.
Research shows that 43% of women experience the disorder occasionally.
There are several reasons for the reduced response to sexual stimulation. Among the psychological causes are body image and self-doubt, which unfortunately are nowadays very common. Previous unpleasant sexual experiences, trauma, abuse can also lead to a lack of vaginal lubrication. Anxiety and depression may also be present. Those who have inadequate sexual experience or a lack of confidence in their genitals may develop an arousal phase disorder. Physical factors include hormonal imbalances, contraceptive use and neurological conditions.
Source:Elvira Lux: Sexual Psychology
