This includes lack of sexual enjoyment and failure of genital failure of genital response. In lack of sexual enjoyment genital response (orgasm) occurs during sexual stimulation, but is not accompanied by pleasurable sensations or feelings of pleasant excitement. There is no fear or anxiety during sexual activity. Failure of genital response in females is experienced as failure of vaginal lubrication, together with inadequate erection of the labia.
Disorders of arousal are not limited to diminished vaginal lubrication, but also include decreased clitoral and labial enjoyment and lack of vaginal smooth muscle relaxation. If disorder of both desire and arousal are present a diagnosis of both HSDD and FSAD should be made. Vascular insufficiency, neurogenic causes, systemic illnesses, peri or postmenopausal phase, all contribute to lack of arousal in women. Inadequate stimulation or inappropriate method of stimulation may also lead to this problem.