What is sexual aversion disorder?

According to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, sexual aversion disorder (SAD) is the active avoidance of or aversion to genital sexual contact with a partner that may cause extreme interpersonal difficulty or distress. The person may be extremely fearful about sexual activity. Psychological factors, severe stress, and need for avoidant behavior as well as past history of emotional and sexual abuse have been implicated in the origin of this disorder.

Patients often implement various avoidant behaviors so that they may limit or circumvent sexual contact. Avoidant behaviors and strategies that have been linked to sexual aversion disorder include excessive traveling for both business and pleasure to avoid sexual partners, alteration of sleep patterns so that sexual activity is unlikely, neglecting personal hygiene, substance abuse, and appearing overtly involved with work commitments, social engagements, or family obligations. Patrick Carnes is a well-known author on the subject and discusses this disorder in his 1998 article "The Case for Sexual Anorexia: An Interim Report on 144 Patients with Sexual Disorders" in Sexual Addiction and Compulsivity. He also describes that the person with sexual aversion disorder may partake in extreme efforts to avoid sexual contact, including self-mutilation, self-cutting, and gross distortions of bodily image. It is a serious medical and sexual problem that warrants a complex treatment plan that may include medical and psychological intervention.

What is persistent genital arousal syndrome?

Persistent genital arousal syndrome is a novel sexual complaint that has recently been discussed within the sexual medicine scientific literature. Sandra Leiblum, noted sexual healthcare provider and researcher, is perhaps the world's leading authority and expert on this disorder, which is characterized by persistent burning and throbbing sensations in the pelvic area with intense pressure that is unrelieved by orgasm or self-stimulation. Often women with this syndrome enjoy it, live with it, rarely complain, and have adapted to live with the situation. Sex or self-stimulation is often an attempt for release that is not associated with intimacy or pleasure. There are many case studies in the literature of persistent genital arousal syndrome, some being caused by vein malformation, excessive soy intake, or other anatomic changes. Some women complain of persistent pelvic throbbing after stopping anti-depressant[1] medications.

There are many possible treatment options that can help women suffering from persistent genital arousal. Sometimes nerve transmissions can be stabilized with such medications as divalproex (Depakote), citalopram hydrobromide (Celexa), gabapentin (Neurontin), clonazepam (Klonopin), imipramine (Tofranil), fluoxetine (Prozac), paroxetine hydrochloride (Paxil), olanzapine (Zyprexa), or even lorazepam (Ativan). Others have tried topical anesthetics[2], including lidocaine; others have used ice applied to the pelvic area. Other proposed treatments include hormonal normalization including normalizing both estrogen[3], testosterone[4], and progesterone[5]; surgical excision of irritating lesions/tumors; or embolization of arteries if they are thought to be contributing to this distressing condition.

  • [1] The best medication to treat depression and panic attacks. Antidepressants are nonaddictive and may benefit the central nervous system in many ways.
  • [2] Medication applied to the surface of the body, for example, the skin or mucous membrane, to numb the area.
  • [3] A steroid hormone produced mainly in the ovaries; the primary female sexual hormone.
  • [4] A sexual hormone that is produced in the ovaries and adrenal glands that is important in normal sexual functioning. It has been implicated in normal female libido or desire.
  • [5] A hormone that is secreted by the ovary and placenta (during pregnancy); it is necessary for pregnancy and has been implicated in female sexual function.
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