Female Sexual Interest / Arousal Disorder

FSD is prevalent in fertile females as much as in infertile females and is often overlooked.
The main cause of FSD in these females is psychological stress.
FSD is poorly understood or rather ignored in Indian female population, especially in
illiterate and low socioeconomic class. These females end up in being silent suffers of FSD.
It is important to address and discuss this issue with couples to overcome their inhibitions and
help them to lead healthy sexual life. The management of this condition requires equal
participation of couple, gynecologist, and psychiatrist.
In India
One rarely finds Indian women talking about their sexuality like this due to sex taboo in our
society. This does not mean that sexual dysfunction is uncommon in Indian women. Female
sexual dysfunction (FSD) is widely prevalent. However, the treatment is rarely sought. Many
women consider sex as a part of reproduction only without knowing its effect on the overall
physical and mental health. This field has been less commonly understood and studied and
hence, there are not many treatment options available.
Prevalence:
The prevalence of FSD was 55.55% among 153 fertile females. FSD was more prevalent in
the age group of 26–30 years and with duration of marriage >16 years. FSD was also more
common in females with middle education and those belonging to upper middle
socioeconomic status. Psychological stress was significantly associated with FSD.
An unpublished study from Chandigarh documented 13 female patients out of 464 patients
reported of sex-related problems. Vaginismus, dyspareunia, and lack of sexual desire were
the main problems reported. In 2007, a study from South India found orgasmic difficulties in
28.6% females.
In another cross-sectional survey of 149 married women in a medical outpatient clinic of a
tertiary care hospital, Singh et al. recently reported FSD in 73.2% subjects of the population.
The complaints elicited were difficulties with desire in 77.2%, arousal in 91.3%, lubrication
in 96.6%, orgasm in 86.6%, satisfaction in 81.2%, and pain in 64.4% of the subjects.
In another study, 63.67% patients with infertility and 46.35% women without infertility had
FSD. In a recent study done on 153 females in Ahmedabad between 2105–2016, 55.5%
women had one or the other sexual dysfunction. In a retrospective review by Pal et al. 2017,
of the 237 patients attending the sexual clinic, 235 (99.2%) were male and rest were female.
They concluded that there is a paucity of data regarding the prevalence of sexual dysfunction
in the clinical population from Eastern India and a high gender disparity among the patients
attending the special clinic.
More research and data are needed to determine the prevalence of each sexual dysfunction in
population of Indian women and the relations these dysfunctions have with different diseases
and drug therapies.
Scale:
 • Female Sexual Distress Scale (range 0–48): The 15-item FSDS-DAO retains the 13
items from the Likert-type FSDS-R scale, which has evidence supporting reliability
and validity [6, 7]. The FSDS-DAO includes 2 new items that ask women to rate their
level of distress related to arousal and orgasm.
• Sexual Satisfaction Scale for Women: The SSS-W is a brief, 30-item measure of
sexual satisfaction and sexual distress, composed of five domains supported by factor
analyses: contentment, communication, compatibility, relational concern, and
personal concern.
• Female Sexual Function Index: The Female Sexual Function Index (FSFI) is a 19-
item self-report inventory designed to assess female sexual function. It comprises six
domains: desire [two items], arousal [four items], lubrication [four items], orgasm,
satisfaction, pain [three items each].
• Scale for Quality of Sexual Function: The scale consists of 32 specific items and eight
general questions. Four dimensions were identified: "psycho-somatic quality of life,"
"sexual activity," "sexual (dys)function-self-reflection," and "sexual (dys)function-
partner's view."

References:
• Mishra, V. V., Nanda, S., Vyas, B., Aggarwal, R., Choudhary, S., & Saini, S. R.
(2016). Prevalence of female sexual dysfunction among Indian fertile females. Journal
of Mid-Life Health, 7(4). https://doi.org/10.4103/0976-7800.195692
• Singh, N., Sharma, P., & Mishra, N. (2020). Female Sexual Dysfunction: Indian
Perspective and Role of Indian Gynecologists. Indian Journal of Community
Medicine : Official Publication of Indian Association of Preventive & Social
Medicine, 45(3). https://doi.org/10.4103/ijcm.IJCM_365_19