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.