Female sexual arousal disorder
Female sexual arousal disorder (FSAD) is a disorder characterized by a persistent or recurrent inability to attain sexual arousal or to maintain arousal until the completion of a sexual activity. The diagnosis can also refer to an inadequate lubrication-swelling response normally present during arousal and sexual activity. The condition should be distinguished from a general loss of interest in sexual activity and from other sexual dysfunctions, such as the orgasmic disorder (anorgasmia) and hypoactive sexual desire disorder, which is characterized as a lack or absence of sexual fantasies and desire for sexual activity for some period of time.
For other uses, see Hypoactive sexual desire disorder.Female sexual arousal disorder
Candace syndrome,[1] female sexual interest/arousal disorder
Although female sexual dysfunction is currently a contested diagnostic, it has become more common in recent years to use testosterone-based drugs off-label to treat FSAD. It is a subtype of female sexual dysfunction. It occurs in distress due to the inability to attain or maintain adequate vaginal lubrication.
Types[edit]
There are three types of FSAD which have been identified: genital arousal disorder, subjective arousal disorder, and combined arousal disorder.
With genital arousal disorder, there is still a mental feeling of arousal, but it is not matched by any physical response. For example, a woman may be "turned on" by her partner, but her vagina does not produce lubrication and there is little-to-no increase in blood flow to the genitals. Subjective arousal disorder is the reverse issue, where there is a physical response to sexual circumstances, but an inability to feel mentally aroused. Combined arousal disorder combines both genital arousal disorder and subjective arousal disorder, presenting as a lack of sexual feeling altogether, both mentally and physically.[2]
Treatment[edit]
The FDA has approved flibanserin[14] and bremelanotide[15] for low sexual libido in women.
One problem with the current definition in the DSM-IV [16] is that subjective arousal is not included. There is often no correlation between women's subjective and physiological arousal.[17] With this in mind, recently, FSAD has been divided up into sub-types:
The third sub-type is the most common in clinical settings.[18]
One criticism is that "the meaningful benefits of experimental drugs for women's sexual difficulties are questionable, and the financial conflicts of interest of experts who endorse the notion of a highly prevalent medical condition are extensive."[19]
Professor of bioethics and sociology Jennifer R. Fishman argues that the categorization of female sexual dysfunction as a treatable disease has only been made possible through the input of academic clinical researchers. Through ethnographic research, she believes she has shown how academic clinical researchers have provided the scientific research needed by pharmaceutical companies to bio-medicalize female sexual dysfunction and consequently identify a market of consumers for it. She questions the professional ethics of this exchange network between researchers and pharmaceutical companies, as the clinical research trials are funded by pharmaceutical companies and researchers are given considerable financial rewards for their work. She argues that the conferences where definition of the disease and diagnostic criteria are defined and research is presented to clinicians are also ethically ambiguous, as they are also funded by pharmaceutical companies.[20]
Heather Hartely of Portland State University, Oregon is critical of the shift from female sexual dysfunction being framed as an arousal problem to a desire problem. In her article, "The 'Pinking' of Viagra Culture", she states that the change from female sexual arousal disorder to hypoactive sexual desire disorder is indicative of "disease mongering" tactics by the drug industry through an effort to match up a drug to some subcomponent of the DSM classification.[21]
Additionally, Leonore Tiefer of NYU School of Medicine voiced concerns that the success of Viagra, in combination with feminist rhetoric, were being used as a means of fast-tracking public acceptance of pharmaceutical treatment of female sexual arousal disorder. The justification behind this, she says, is that "the branding of Viagra has succeeded so thoroughly in rationalizing the idea of sexual correction and enhancement through pills that it seems inevitable and only fair that such a product be made available for women," giving a dangerous appeal to "nonapproved drugs though off-label prescribing".[22]