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A New Model of Female Sexual Desire

E-Newsletter No. 52

The traditional model of female sexual desire is linear and comprises relatively discreet phases: desire -> arousal -> orgasm -> resolution. However, accumulating evidence supports the need for revision of this model.

In regard to desire (thinking, fantasizing, wanting sex per se), women in established relationships rarely initiate or agree to sex because of desire. For these women, desire is usually secondary to other motivators such as the resulting increased emotional closeness and increased sense of well being. In addition, desire has a broad normative range across sexually content women.

The genital congestion (lubrication, swelling) component of the arousal response is a major focus of the linear model. However, psychophysiological studies suggest that women do not focus on genital congestion when they consider their sexual arousal. Subjective ratings of arousal among women with and without dysfunction did not correlate with objective measurement of increases in genital congestion.

In order to conceptualize women’s sexual response in a less discrete and compartmentalized manner, a new more circular model has been proposed. Here, the cycle includes motivation to engage in sexual activity, willingness to attend to sexual stimuli, subjective arousal, responsive desire, and satisfaction. Sexual satisfaction may or may not include orgasm. Within this cycle, it is important to note that subjective arousal may be influenced by many biological and psychological factors. In addition, although spontaneous desire is rare in many women, especially in long term relationships, its presence can augment the cycle.

Based on this new model, the revised definition of sexual interest/ desire disorder is “absent or diminished feelings of sexual interest or desire, absent sexual thoughts or fantasies, and a lack of responsive desire” [italics added].1 Importantly, this lack of sexual interest is beyond the normal lessening with life cycle and relationship duration. This definition has two major implications: 1) the inability to be subjectively aroused and access desire during the experience designates disorder, but 2) the lack of initial desire by itself does not.

1. Basson et al. J Psychosom Obstet Gynaecol. 2003;24(4):221-9

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