Which diagnosis best fits duration, episodicity, and exclusions?
A
Female sexual interest/arousal disorder
Absent/reduced sexual interest/arousal; ≥3 of: absent/reduced interest in sexual activity; absent/reduced sexual/erotic thoughts or fantasies; no/reduced initiation of sexual activity and unreceptive to partner's attempts; absent/reduced sexual excitement/pleasure during sexual activity in ≥75–100% encounters; absent/reduced sexual interest/arousal in response to any internal/external erotic cues; absent/reduced genital or non-genital sensations during sexual activity in ≥75–100% encounters
≥1 of: marked delay in, marked infrequency of, or absence of orgasm; markedly reduced intensity of orgasmic sensations — on almost all occasions (≥75–100%) of sexual activity
AAbsent/reduced sexual interest/arousal; ≥3 of: absent/reduced interest in sexual activity; absent/reduced sexual/erotic thoughts or fantasies; no/reduced initiation of sexual activity and unreceptive to partner's attempts; absent/reduced sexual excitement/pleasure during sexual activity in ≥75–100% encounters; absent/reduced sexual interest/arousal in response to any internal/external erotic cues; absent/reduced genital or non-genital sensations during sexual activity in ≥75–100% encounters
B≥1 of: marked delay in, marked infrequency of, or absence of orgasm; markedly reduced intensity of orgasmic sensations — on almost all occasions (≥75–100%) of sexual activity
Additional criteria
AB. Symptoms persist ≥6 months C. Causes marked distress D. Not better explained by non-sexual mental disorder, substances/medications, relationship factors, or significant stressors; not attributable to another medical condition
BB. Symptoms persist ≥6 months C. Causes marked distress D. Not better explained by non-sexual mental disorder, substances/medications, relationship factors, or significant stressors; not attributable to another medical condition
Key features
AA. Absent/reduced sexual interest/arousal; ≥3 of: absent/reduced interest in sexual activity; absent/reduced sexual/erotic thoughts or fantasies; no/reduced initiation of sexual activity and unreceptive to partner's attempts; absent/reduced sexual excitement/pleasure during sexual activity in ≥75–100% encounters; absent/reduced sexual interest/arousal in response to any internal/external erotic cues; absent/reduced genital or non-genital sensations during sexual activity in ≥75–100% encounters B. Symptoms persist ≥6 months C. Causes marked distress
BA. ≥1 of: marked delay in, marked infrequency of, or absence of orgasm; markedly reduced intensity of orgasmic sensations — on almost all occasions (≥75–100%) of sexual activity B. Symptoms persist ≥6 months C. Causes marked distress
Common specifiers
ALifelong; Acquired; Generalised; Situational
BLifelong; Acquired; Generalised; Situational
Differential flags
AFemale orgasmic disorder (arousal intact but orgasm impaired); Genito-pelvic pain disorder (pain limiting engagement rather than absent desire); Major depressive disorder (generalised anhedonia vs specific sexual domain)
BSSRI/medication-induced (temporal relationship to medication initiation); Female sexual interest/arousal disorder (insufficient arousal preceding orgasmic difficulty); Genito-pelvic pain (pain interfering with sexual response)