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Current thoughts on psychosexual disorders in women

^1. Department of Reproductive Medicine, St Michael's Hospital, Southwell St, Bristol BS2 8AE, UK Email: c.coulson{at}bristol.ac.uk (corresponding author)
^2. Department of Genitourinary Medicine, Bristol Royal Infirmary, Upper Marlborough Street, Bristol BS2 8HW, UK

Key content:

• The importance of responsive desire in women, triggered by physical and mental arousal rather than spontaneous desire, is now acknowledged.
  
• A review of the DSM-IV classification of sexual dysfunction in 1999 led to retention of the categories of desire, arousal, orgasmic and pain disorder and were expanded to include physical, as well as psychological, causes. A new diagnosis of non-coital pain disorder was also suggested.
  
• Historically, pain syndromes are categorised as dyspareunia or vaginismus, but they often overlap.
  
• Management of psychosexual disorders requires an understanding of psychosexual function and an ability to communicate about sexual matters.
  

Learning objectives:

• To gain an understanding of the complexities of the female sexual response and psychosexual problems.
  
• To understand that sexual problems are common in women attending gynaecology clinics.
  
• To be more willing to communicate with patients about sexual matters.
  

Ethical issues:

• The sensitive nature of sexual problems raises the dilemma of how to talk to women about significant events without causing further trauma.
  

Please cite this article as: Coulson C, Crowley T. Current thoughts on psychosexual disorders in women. The Obstetrician & Gynaecologist 2007;9:217–222.

Keywords difficulty with orgasm / female pain syndromes / loss of desire / sexual problems / vaginismus