Approximately 40–50% of women will experience concerns pertaining to sexual health during their lifetime. DSM-5 updated the classification of female sexual dysfunction, combining hypoactive sexual desire disorder (HSDD) and sexual arousal disorder into a larger category termed “female sexual interest or arousal disorder.” Despite this reclassification, some groups recommend maintaining the two as separate clinical entities due to disparate pathophysiology and specific evidence supporting treatments for HSDD. Additional conditions that may impact female sexual health include female orgasmic disorder and genitopelvic pain or penetration disorder. When diagnosing any sexual health disorder, symptoms must be present for 6 months, be personally distressing to the patient, and meet at least three of six specific criteria related to symptoms and frequency (outlined in DSM-5) to ensure an accurate diagnosis. Duration criteria may limit overdiagnosis as transient factors commonly impact sexual function, such as relationship conflict or other life events.
Although female sexual disorders are common, only about one-third of women seek help from their clinicians. Thus, it is important for health care providers to invite women to discuss their sexual concerns by routinely initiating dialogue about sexual health during office visits. Patients who express concerns can be asked a more complete history that includes the onset, duration, and severity of symptoms as well as associated distress.