Table 1.

Description of common sexual difficulties and sexual dsyfunctions

Sexual difficulty/dysfunction	Clinical characteristics
Inhibited (hypoactive) sexual desire	Verbal report of being generally uninterested in and unmotivated for sex. Few or no initiations of sex with partner and/or avoidance or refusal’s when partner initiates sexual contact (e.g. body touching, intercourse). Patient rarely has sexual thoughts or fantasies.
Sexual aversion	Extreme aversion or avoidance of genital contact (touching) by partner or self. May be accompanied by feelings of extreme anxiety, nervousness or strong negative feelings such as disgust or repulsion.
Inhibited sexual excitement (or arousal disorder)	Few or complete absence of feelings of sexual pleasure or excitement during sexual activity. A woman may feel as if she cannot be aroused. Disruption of physiologic responding, such as vaginal lubrication and genital vasocongestion.
Orgasmic dysfunction	Delayed or absent orgasm (i.e. rhymic vaginal and or pelvic contractions) despite adequate stimulation. Difficulties can be complete or situational, such as inorgasmia during intercourse.
Disrupted resolution response	Following orgasm and/or intense sexual activity, the patient reports either neutral or negative mood or feelings, such as disappointment. May be accompanied by residual sexual tension and an absence of relaxation or feelings of release.
Vaginismus	Recurrent or persistent spasm of the vaginal musculature sufficient to interfere with sexual activity; usually pain occurs with the spasm. Rather than muscular spasm, the vagina or vaginal opening may be constricted due to cancer treatments, such as surgery or radiotherapy.
Dyspareunia	Verbal report of coital pain. If severe, pain often persists following intercourse and is disruptive to resolution.