Female Sexual Arousal Disorder: Is it a Thing?

By Bill Lovett, MD

As the Medical Director here, I see patients daily for a variety of reasons, including female sexual dysfunction. This can often be diagnosed as “Female Sexual Arousal Disorder” or “FSAD.”

I want to help women recognize the symptoms of FSAD and what life events may have played a role with where they are today and what treatment options are available. In the end, I hope this plays a part, however small, in helping to regain their sexual well-being.

Starting the Conversation

Women may tend to avoid conversations with their primary care physicians regarding sexual dysfunction concerns. These concerns are extremely common. However, the topic may seem somewhat taboo or uncomfortable.

These conversations or lack of conversation typically lead them here to our office where we specialize in sexual health. We’ll start by talking about hormone replacement therapy. This typically becomes a segue into sexual dysfunction. It’s for this exact reason we make sure to include sexual dysfunction-related questions on our medical history evaluation. In addition, this brings to light issues women may not have been aware of. This allows us to see their health, including sexual health, in its entirety.  

It’s common for both halves of a couple to come in and sit down during consultations with us together. We’ve covered some male sexual dysfunction issues in our previous blogs, one of which you can check out here. However, today I really want to focus on the female body.

What is “Female Sexual Arousal Disorder?”

In medical “textbook” terms, female sexual dysfunction is a decrease or absence in sexual desire of about 75% over a period of six months. However, we believe women shouldn’t be bound by that definition. We don’t care if it’s 50% over six months or if it’s just generally decreasing. We want to treat the patient’s symptoms, not their numbers.

Some symptoms to look out for:

  • Painful Intercourse
  • Lack-of or decreased sensation (stemming from little or no lubrication)
  • Vaginal Laxity
  • Inability to achieve an orgasm
  • Lack of libido

Why does our sexual arousal decrease?

There are many reasons women naturally experience decreased sexual arousal:

  1. Sexual arousal research rarely discusses low testosterone being a cause. However, we believe testosterone to be a significant female hormone and therefore deficiency can be a major cause of decreased arousal. This is based on our day-to-day observations and patient feedback.
  2. The literature talks about other factors such as medications, especially antidepressant medications that may be referred to as SSRIs, being shown to affect libido. In addition, other research shows that postmenopausal women experience a significant decrease in libido.
  3. One cause not discussed in a lot of the medical literature is stress. Stress has the ability to kill libido in both men and women. Under extreme stress, the ability to perform any sexual activity is significantly decreased. Where that stress comes from is hard to pinpoint, but by looking at a patient’s symptoms we can oftentimes identify contributing factors.

What treatment options are out there?

Traditional medicine today suggests to use hormone based creams to increase vaginal lubrication. This can help to alleviate symptoms of painful intercourse, including feeling tight or dry.

Along with creams, there are several other treatment options available for female sexual arousal disorder:


  • This is one of our favorite treatments. It’s a Hybrid Fractional Laser (HFL) that uses two wavelengths to resurface the tissue and stimulate new collagen growth.
  • The diVa procedure can alleviate a patient’s sexual dysfunction symptoms up to 90%.
  • Learn more about this treatment here.


  • Estrogen in the form of estradiol should be a primary tool that we should use for estrogen replacement either by pellet form, topical cream, or by mouth.
  • Check out our blog on the importance of Estradiol here.

Testosterone Cream

  • This can specifically be used to help improve sensation (along with lubrication). The testosterone cream would be applied on the clitoris and may be used in conjunction with a growth factor treatment (see below).

The O-Shot with Growth Factors (Plasma rich with the body’s platelets)

  • Uses your own blood-derived growth factors to rejuvenate the vagina.
  • We’ll draw blood from your arm, spin it down in a centrifuge to extract the growth factors, then inject it behind the clitoris and vaginal wall to increase blood flow.
  • Learn about the O-Shot and growth factors in greater detail here.

    • Click here to watch a real patient testimonial from our office.

Hormone Replacement Therapy (HRT)

  • HRT is the use of bioidentical hormones like estrogen, progesterone, and/or testosterone to treat imbalances and deficiencies (which can lead to sexual dysfunction issues).
  • We’ve already mentioned estradiol and testosterone cream, both of which play a part in our hormone replacement program.
  • The most common way you would receive the appropriate hormones would be through a pellet insertion. These are small pellets inserted into the fatty part of the buttocks and they dissolve over a period of 3-4 months.
  • Again, learn more about our hormone replacement program right here.

Don’t Suffer in Silence- We Can Help

Please understand that if you are one of the numerous women out there suffering with any sort of sexual dysfunction, there are options for you. There are ways we can help. You do not have to suffer in silence anymore; you just have to be brave enough to take that first step in revitalizing your sexual health.

If anything above hits home with you, fill out our initial consultation form or give us a call at (513)-791-9474 to sit down with one of our providers. We’ll listen to your concerns and craft an individualized treatment plan to get your sexual health back to where it should be.

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