Sexual Desire Disorders

Sexual Desire Disorders Introduction

Alan Riley, M.Sc., M.B., B.S., M.R.C.S., F.F.P.M. Kathryn May, M.Sc.

Of all sexual symptoms, disorders of sexual desire are probably the most difficult to manage, and yet they are seen more frequently than any other sexual disorder in patients presenting for sex therapy. To a great extent, this difficulty arises from our lack of understanding of the nature and determinants of sexual desire, a situation that is complicated by inconsistency in the terminology used to describe this fundamental component of sexual functioning.

Essentially, sexual desire has three critical dimensions: object, intensity, and frequency. Intensity and frequency are usually considered together as "strength" of sexual desire. In this chapter we focus on disturbances in intensity and frequency of sexual desire, which are termed the sexual desire disorders. Disturbances in the object dimension are known as paraphilias. Although some authors include sexual aversion and sexual anxiety in discussions of sexual desire disorders, we see these as separate disorders with separate diagnostic criteria (American Psychiatric Association 1994) and thus will not consider them here.