Introduction
Sexuality is a complex interplay of multiple facets, including
anatomical, physiological, psychological, developmental, cultural,
socialization and relational factors (Sadock & Sadock, 2003). All of
these contribute to an individual’s sexuality to varying degrees at any
point in time and it is dynamic hence changing throughout the life
cycle. By nature, the sexual response cycle of every human being comes
in four systematic levels, the excitement, plateau, orgasm, and
resolution (Masters & Johnson, 1966). However, the timing of these
experiences differs; and the duration that each phase lasts varies.
Kaplan (1979) asserts that, the individual must have a desire to engage
in intimacy before responding to the phases of the sexual cycle, and in
the absence of this desire, there may be problems with intimacy. These
problems may include pain, lack of orgasm, sexual dissatisfaction, among
others.
According to the Diagnostic and Statistical Manual of Mental Disorders
(DSM V, 2013), Female Sexual Interest/Arousal Disorder (FSIAD) involves
the fear of sexual intercourse and an intense desire to avoid sexual
situations completely. It includes extreme anxiety and/or disgust at the
anticipation of/or attempt to have any sexual activity (American
Foundation for Urologic Disease, 1996). It can also be explained as the
strong negative feelings associated with sexual interaction with a
partner which produces sufficient fear or anxiety and sexual activity is
avoided (International Classification of Mental Disorders, ICD-10).
Kaplan (1979) explains that the desire for intimacy drives one into the
act. Thus, until an individual is ready and has fully prepared his/her
mind, it becomes difficult enjoying sex and getting satisfaction. With
FSIAD, the individual lacks or has lost interest in sexual activity and
may not even respond when partner initiates. There is also the absence
or reduced erotic thoughts or fantasies and this causes clinically
significant distress to the individual. Some studies have identified
age, level of education, psychological problems such as stress and mood
disorders, and a history of sexual abuse as possible risk factors that
may lead to sexual aversion disorder (Leiblum & Nathan, 2001).
Some studies have emphasized that anxiety plays an important role in
sexual intimacy and it is a possible risk factor of FSIAD (Nobre &
Pinto-Gouveia, 2009; Oliveira & Nobre, 2013). That is, sexual worries
and fears seem to mar sexual arousal, and that affects one’s response to
any sexual activity. Extreme fear or worry results in tensed muscles
which affect our daily functioning and may influence our desire for sex.
Katz, Gipson and Turner (1992) highlight that one vital feature of FSIAD
is recurrent fear and avoidance of genital sexual contact in a person
who otherwise desires sexual activity. This is in the sense that, FSIAD
can be thought of as a fear of sex that may be as a result of fear
associated with contracting a sexually transmitted disease, flashbacks
of past sexual trauma, or feelings of personal non-readiness and
inadequacy.