Revised Definitions of Women's Sexual Dysfunction
Authors: Rosemary Basson; Sandra Leiblum1; Lori Brotto2; Leonard Derogatis3; Jean Fourcroy4; Kerstin Fugl-Meyer5; Alessandra Graziottin6; Julia R. Heiman2; Ellen Laan7; Cindy Meston; Leslie Schover8; Jacques van Lankveld9; Willibrord Weijmar Schultz10
Source: The Journal of Sexual Medicine, Volume 1, Number 1, July 2004 , pp. 40-48(9)
Publisher: Blackwell Publishing
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Abstract:
Summary of Committee. For the complete report please refer to the Second International Consultation on Sexual Medicine: Sexual Dysfunctions in Men and Women, edited by T.F. Lue, R. Basson, R. Rosen, F. Giuliano, S. Khoury, F. Montorsi, Health Publications, Paris 2004. ABSTRACT Introduction. Existing definitions of women's sexual disorders are based mainly on genitally focused events in a linear sequence model (desire, arousal and orgasm). Aim. To revise definitions based on an alternative model reflecting women's reasons/incentives for sexual activity beyond any initial awareness of sexual desire. Methods. An International Definitions Committee of 13 experts from seven countries repeatedly communicated, proposed new definitions and presented at the 2nd International Consultation on Sexual Medicine in Paris July 2003. Main Outcome Measure. Expert opinions/recommendations are based on a process that involved review of evidence-based medical literature, extensive internal committee discussion, informal testing and re-testing of drafted definitions in various clinical settings, public presentation and deliberation. Results. Women have many reasons/incentives for sexual activity. Desire may be experienced once sexual stimuli have triggered arousal. Arousal and desire co-occur and reinforce each other. Women's subjective arousal may be minimally influenced by genital congestion. An absence of desire any time during the sexual experience designates disorder. Arousal disorder subtypes are proposed that separate an absence of subjective arousal from all types of sexual stimulation, from an absence of subjective arousal when the only stimulus is genital. A new arousal disorder has provisionally been suggested, namely that of persistent genital arousal. Orgasm disorder is limited to absence of orgasm despite high subjective arousal. Dyspareunia includes partial painful vaginal entry attempts as well as pain with intercourse. Variable reflex muscle tightening around the vagina and an absence of abnormal physical findings are noted in the definition of vaginismus. Women's sexuality is highly contextual and descriptors are recommended re past psychosexual development, current context, as well as medical status. Diagnosing sexual disorders need not imply intrinsic dysfunction of the woman's own sex response system. Conclusions. The International Definitions Committee has recommended a number of fundamental changes to the existing definitions of women's sexual disorders.Keywords: Women's Sexual Dysfunction; Revised Definitions; Diagnosis; Arousal Subtypes; Persistent Genital Arousal; Distress
Document Type: Research article
DOI: 10.1111/j.1743-6109.2004.10107.x
Affiliations: 1: Department of Psychiatry, University of Medicine and Dentistry of New Jersey, New Brunswick, NJ, USA; 10: Department of Obstetrics and Gynecology, University Hospital Groningen, Groningen, the Netherlands 2: Department of Psychiatry, University of Washington Medical School, Seattle, WA, USA; 3: Johns Hopkins University School of Medicine, Baltimore, MD, USA; 4: Washington, DC, USA; 5: Sexology Unit, University Hospital, Upssala, Sweden; 6: Milan, Italy; 7: Department of Clinical Psychology, University of Amsterdam, Amsterdam, the Netherlands; 8: Department of Urology, Taussig Cancer Centre, Cleveland, OH, USA; 9: Maastricht University, AX Maastricht, The Netherlands;
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