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Hypoactive sexual desire disorder and sexual aversion disorder are the two types of sexual desire disorders. These conditions impact the level of interest or fear/aversion about sexual contact. They are diagnostically different from each other and have unique treatment strategies. Both illnesses can cause profound distress, and they also negatively impact social engagements and relationships.
Of the sexual desire disorders, hypoactive sexual desire disorder is most common. It is defined by the American Psychiatric Association’s Diagnostic and Statistical Manuals® (DSM®) , as a continuing or frequently episodic almost total or complete lack of interest in sex. This disinterest often extends to sexual fantasies, and results in severe distress on the part of the affected patient. The condition cannot be solely attributed to a medical disorder or the use of substances that might reduce sexual desire, such as antidepressants.
One of the most frequent presentations with sexual desire disorders of this type occurs in long-term partnerships. Often, one partner has lost most or all sexual interest, which even affects fantasy life, so that the person has no desire for intercourse with anyone. This can be very difficult to treat successfully.
Sometimes couples counseling and guided sexual activities restore desire and interest within the relationship. Any medical or substance problems contributing to the condition need to be evaluated, too, when possible. These interventions aren’t always successful. Occasionally, the disorder resolves when the affected individual leaves the partnership and establishes a new relationship with someone else.
In contrast, sexual aversion disorder isn’t simply a profound lack of interest. It is panic, terror, or disgust that surrounds most of the physical acts of intimacy, especially in regard to genital contact. Patients may even experience panic attacks at the thought of or during attempts at intercourse, and this generally leads to avoidance of any form of sex. Partnerships are difficult to maintain because of the severe fear or aversion accompanying this condition.
Treatment for sexual desire disorders like this one involves different recommendations. Many people with sexual aversion disorder experience it due to sexual trauma at some point in their pasts. Individual psychotherapy is often the most appropriate intervention. It’s unclear whether couples counseling is helpful. Some psychoeducation might elicit understanding from the partner who is not affected, but the principal way the disorder is addressed is through individual therapeutic work.
There are factors when diagnosing sexual desire disorders that can help give a more complete picture of a patient’s degree of impairment. Both these conditions can be further classified as lifelong or acquired, and situational or general. They may also be attributed to solely psychological or combined factors. Such specifiers are important because they define the scope of the problem and assist in treatment planning.
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