Table 1

Classification of female sexual dysfunction according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5)18 *

Female sexual interest/arousal disorderLack of, or significantly reduced, sexual interest or arousal as manifested by at least three of the following: (1) Absent or reduced interest in sexual activity; (2) Absent or reduced sexual/erotic thoughts or fantasies; (3) No or reduced initiation of sexual activity and unreceptive to partner's attempts to initiate; (4) Absent or reduced sexual excitement or pleasure during sexual activity in almost all or all (75–100%) sexual encounters; (5) Absent or reduced sexual interest or arousal in response to any internal or external sexual or erotic cues (eg, written, verbal, visual); (6) Absent or reduced genital or non-genital sensations during sexual activity in almost all or all (75–100%) sexual encounters.
Female orgasmic disorderPresence of either of the following symptoms and experienced on almost all or all (75– 100%) occasions of sexual activity (in identified situational contexts or, if generalized, in all contexts): (1) Marked delay in, marked infrequency of, or absence of orgasm; (2) Markedly reduced intensity of orgasmic sensations. In evaluating women reporting concerns achieving orgasm, it is important to inquire about adequacy, variety, and amount of stimulation during sexual activity.
Genito-pelvic pain/penetration disorderPersistent or recurrent difficulties with one or more of the following: (1) Vaginal penetration during intercourse; (2) Marked vulvovaginal or pelvic pain during vaginal intercourse or penetration attempts; (3) Marked fear or anxiety about vulvovaginal or pelvic pain in anticipation of, during, or as a result of vaginal penetration; (4) Marked tensing or tightening of pelvic floor muscles during attempted vaginal penetration.
  • *Symptoms persist for a minimum of 6 months, cause clinically significant distress in the individual, are not better explained by a non-sexual mental disorder or a consequence of severe relationship distress or other significant stressors, and are not attributed to the effects of a substance or medication or other medical conditions.