Desire and Arousal Disorders

Male hypoactive sexual desire

This condition is characterized by a persistent decrease or absence of thoughts, erotic fantasies and desire for sexual activity.

The clinician must eva luate multiple factors, such as age and sociocultural context, to determine if this reduction constitutes a clinical problem.

Often, external stressors, such as financial or work-related problems, can temporarily "shut down" the desire system.

It is critical to differentiate whether the lack of initiative is due to a real low libido or a discrepancy in desire with a partner.

If the patient reports a lack of interest even in self-stimulation and this creates discomfort, we are dealing with a possible desire disorder that requires investigation of both hormonal status and the emotional health of the relationship.

Female sexual arousal/interest disorder

In women, desire and arousal difficulties often overlap in a unified diagnosis.

It manifests as a lack of interest in initiating sexual activity and an absence of response to erotic cues, both mental (fantasies) and physical (lubrication).

To diagnose it, it is eva luated if there is a significant reduction in arousal to stimuli that were previously effective.

It is vital to inquire whether the patient maintains the fantasies but lacks the will to act (which could indicate a relational or situational block), or whether the mental "spark" has completely disappeared.

Diagnosis requires that these symptoms be persistent and not best explained by another mental disorder or severe life stress.

Erectile Disorder and Performance Anxiety

Formerly known as impotence, this disorder involves the recurrent inability to obtain or maintain an erection rigid enough for satisfactory sexual activity.

Although it may have vascular causes, the psychological component of "performance anxiety" is central to many acquired or situational cases.

If a man experiences a one-time erectile failure (perhaps from alcohol or fatigue) and begins to obsess about the possibility of failing again, he enters a cycle of anxious self-observation.

This preoccupation with "compliance" diverts attention from pleasurable sensations, which paradoxically inhibits the physical response he is trying to force.

In cases of infidelity,