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Ebook ABC of sexual heath (3E): Part 2

(BQ) Part 2 book “ABC of sexual heath” has contents: Erectile dysfunction, problems of orgasm in the female, sexual pain disorders–male and female, forensic sexology, ethnic and cultural aspects of sexuality, gender dysphoria and transgender health, psychosexual thrapy and couples thrapy, and other contents. | C H A P T E R 15 Problems of Sexual Desire and Arousal in Women Lori A. Brotto1 and Ellen T.M. Laan2 1 University 2 of British Columbia, Vancouver, Canada Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands OVERVIEW • Problems with sexual desire and sexual arousal are no longer considered to be separate sexual problems • Sexual desire/arousal results from an interplay of a sensitive sexual response system and effective stimuli that activate this system • In the context of a sexual relationship, problems that are presented as a lack, or loss, of sexual desire can usually be reframed as differences in sexual desire and in differences in what kind of sex is desired • A biopsychosocial sexual history from a longitudinal perspective is mandatory for making the diagnosis • Because most problems become manifest in, are associated with, or are caused by the relational context, the partner needs to be involved in assessment and treatment • Enhancing sexual pleasure of both partners is a crucial factor in long-lasting improvement of the sexual relationship Introduction A distressing lack of interest in sexual activity that persists is the most common reason why women seek sex therapy. Early studies show that at least one-third of women younger than 59 reported low sexual desire over the past year. Because less than 28% of sexual difficulties (defined as being present for 1 month) persist for 6 months or more, only enduring and distressing symptoms should be considered representative of a desire disorder. When one takes into account the presence of clinically significant distress associated with low sexual desire, the prevalence drops to approximately 8–12%. Multinational studies have found higher rates of low sexual interest in Middle East and Southeast Asian countries, emphasizing the importance of cultural sensitivity when assessing sexual interest and arousal (see Table 15.1). There is considerable research interest in women’s low .