FSD Diagnosis

Psychological

Hypoactive sexual desire disorder is characterized by an absence of libido. There is no interest in initiating sex and little desire to seek stimulation.

Sexual aversion disorder is characterized by an aversion to or avoidance or dismissal of sexual prompts or sexual contact. It may be acquired following sexual or physical abuse or trauma and may be life-long. The main feature of female sexual arousal disorder is an inability to achieve and progress through the stages of "normal" female arousal.

Female orgasmic disorder is defined as the delay or absence of orgasm after "normal" arousal.

Vaginismus is the involuntary contraction of the perineal muscles around the vagina as a response to attempted penetration. Contraction makes vaginal penetration difficult or impossible.

These disorders must cause personal distress and must not be accounted for by a medical condition. A distinction is made between disorders that are life-long and those that are acquired, as well as those that are situational and generalized.

Medical

In cases where a medical condition is suspected as the underlying cause, whether it causes inadequate blood flow, nerve-related loss of sensitivity, or reduced hormone levels, a specialist conducts an appropriate diagnosis. Sexual problems may be symptomatic of diseases that require treatment, like diabetes, endocrine disorders of the hypothalamic-pituitary-gonadal axis, and neurological disorders.

Physiological Diagnostic Tests

Vaginal blood flow and engorgement (pooling and swelling of vaginal tissue) can be measured with vaginal photoplethysmography, in which an acrylic tampon-shaped instrument inserted in the vagina uses reflected light to sense flow and temperature. It cannot be used to assess advanced levels of arousal, say, during orgasm, because movement skews its reading. Also, limited knowledge of normative vaginal engorgement levels makes for only speculative results.

Vaginal pH testing, commonly performed by gynecologists and urologists to detect bacteria-causing vaginitis, may be useful. A probe inserted into the vagina takes the reading. Decreasing hormone levels and diminished vaginal secretion associated with menopause cause a rise in pH (over 5), which is easily detected with the test.

A biothesiometer, a small cylindrical instrument, may be used to assess the sensitivity of the clitoris and labia to pressure and temperature. Readings are taken before and after the subject watches erotic video and masturbates with a vibrator for approximately 15 minutes.