CMAJ • May 10, 2005; 172 (10). doi:10.1503/cmaj.1020174.
© 2005 CMA Media Inc. or its licensors
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Review
Synthèse

Women's sexual dysfunction: revised and expanded definitions

Rosemary Basson

From the Departments of Psychiatry and of Obstetrics and Gynaecology, University of British Columbia and the B.C. Centre for Sexual Medicine, Vancouver General Hospital, Vancouver, BC

Correspondence to: Dr. Rosemary Basson, B.C. Centre for Sexual Medicine, Vancouver General Hospital, 855 W 12th Ave., Vancouver BC V5Z 1M9; fax 604 875-8249; sexmed{at}interchange.ubc.ca

Abstract

ACCEPTANCE OF AN EVIDENCE-BASED CONCEPTUALIZATION OF WOMEN'S SEXUAL RESPONSE combining interpersonal, contextual, personal psychological and biological factors has led to recently published recommendations for revision of definitions of women's sexual disorders found in the American Psychiatric Association's Diagnostic and Statistical Manual (DSM–IV-TR). DSM-IV definitions have focused on absence of sexual fantasies and sexual desire prior to sexual activity and arousal, even though the frequency of this type of desire is known to vary greatly among women without sexual complaints. DSM-IV definitions also focus on genital swelling and lubrication, entities known to correlate poorly with subjective sexual arousal and pleasure. The revised definitions consider the many reasons women agree to or instigate sexual activity, and reflect the importance of subjective sexual arousal. The underlying conceptualization of a circular sex-response cycle of overlapping phases in a variable order may facilitate not only the assessment but also the management of dysfunction, the principles of which are briefly recounted.




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