User:Peter Wukitsch/sandbox

Criticism

One problem with the current definition in the DSM-IV is that subjective arousal is not included. There is often no correlation between women's subjective and physiological arousal. With this in mind, recently, FSAD has been divided up into sub-types:

• Genital Arousal Disorder
• Subjective Sexual Arousal Disorder
• Combined Genital and Subjective Arousal Disorder

The third sub-type is the most common in clinical settings

One of the largest criticisms for female sexual arousal disorder is whether it is an actual disorder or an idea put forth by pharmaceutical companies in order to step into a potentially billion dollar industry. There is also concern that this ignores those women who have experienced a significant loss of libido following hysterectomy.

The only mention of female sexual arousal disorder in a peer-reviewed medical journal indicated that 43% of women suffer from FSD, however the survey turned out to not be a rigorous study. Of the handful of questions, if any respondent answered yes at any time, they were classified as having FSD. Here are the questions asked that respondents could only choose a response of Yes or No:

• Lacked interest in having sex
• Were unable to come to climax
• Came to climax too quickly
• Experienced physical pain during intercourse
• Did not find sex pleasurable even if sex was not painful
• Felt anxious just before having sex
• Had trouble lubricating

Furthermore, the author Edward O. Laumann turned out to have financial ties to Pfizer, creator of Viagra.

Another criticism, for example, is that "the meaningful benefits of experimental drugs for women's sexual difficulties are questionable, and the financial conflicts of interest of experts who endorse the notion of a highly prevalent medical condition are extensive".

Professor of bioethics and sociology Jennifer R. Fishman argues that the categorization of female sexual dysfunction as a treatable disease has only been made possible through the input of academic clinical researchers. Through ethnographic research, she believes she has shown how academic clinical researchers have provided the scientific research needed by pharmaceutical companies to biomedicalize female sexual dysfunction and consequently identify a market of consumers for it. She questions the professional ethics of this exchange network between researchers and pharmaceutical companies, as the clinical research trials are funded by pharmaceutical companies and researchers are given considerable financial rewards for their work. She argues that the conferences where definition of the disease and diagnostic criteria are defined and research is presented to clinicians are also ethically ambiguous, as they are also funded by pharmaceutical companies.

It is also worth noting that female sexual arousal disorder is rarely a solitary diagnosis. Due to its high rates of comorbidity with hypoactive sexual desire disorder (see hypoactive sexual desire disorder), a new disorder is being proposed for the DSM-V: Sexual Interest/Arousal Disorder (see Sexual Interest/Arousal Disorder). The diagnostic criterion "persistent or recurrent" symptoms is also problematic in that it is vague and could lead to too much reliance on clinical judgment.

Heather Hartely of Portland State University, Oregon is critical of the shift from female sexual dysfunction being framed as an arousal problem to a desire problem. In her article, “The ‘Pinking’ of Viagra Culture,” she states that the change from female sexual arousal disorder to hypoactive sexual desire disorder is indicative of ‘disease mongering’ tactics by the drug industry through an effort to match up a drug to some subcomponent of the DSM classification.

Additionally, Leonore Tiefer of NYU School of Medicine voiced concerns that the success of Viagra, in combination with feminist rhetoric, were being used as a means of fast-tracking public acceptance of pharmaceutical treatment of female sexual arousal disorder. The justification behind this, she says, is that "the branding of Viagra has succeeded so thoroughly in rationalizing the idea of sexual correction and enhancement through pills that it seems inevitable and only fair that such a product be made available for women", giving a dangerous appeal to "nonapproved drugs though off-label prescribing."

Natural variation could be overlooked because there are no specific duration or severity criteria for diagnosis. Therefore, the duration criterion of symptoms lasting at least 6 months and the severity criterion of symptoms during 75% or more of sexual encounters have been proposed.

Diagnosis based on insufficient vaginal lubrication/swelling is problematic because women’s genital arousal may be an "automatic response" that they are unaware of. Furthermore, there is little evidence that women with sexual arousal disorder have a poor lubrication/swelling response.