Inability to Become Physically Aroused or Excited During Sexual Activity

Arousal disorders are characterized by the inability to become or stay sexually aroused. This happens to many people within their lifetime and usually isn’t a cause for concern. However, if the inability to get sexually aroused has been persistent for over six months and is causing significant distress, it may be time to consult sexual health professional.

Key takeaways:
  • arrow-right
    Arousal disorders are disorders where the body does not respond to sexual stimuli. They occur in all genders and are highly prevalent, with erectile disorder affecting around 50% of 60-year-old men.
  • arrow-right
    There are many causes of arousal disorders, including depression, stress, anxiety about sexual performance, relationship problems, cardiovascular diseases, diabetes, injury, substance abuse, and certain medications such as antidepressants.
  • arrow-right
    Treatment is individualized to treat the underlying issues and combines psychotherapy, sexual stimulants, and treatment of medical issues and lifestyle factors.

Common arousal disorders include erectile disorder and female sexual arousal disorder; both are relatively common and are treated through psychotherapy and medical treatments.

Erectile disorder

Erectile disorder is the inability to gain or maintain an erection during sexual activity. Erectile disorder is highly prevalent within society, and its prevalence increases with age. For men under 35, the prevalence of erectile disorder is approximately 10%, increasing to around 50% by age 60. For men over 70, between 50% and 100% report experiencing erectile disorder. Many men first report experiencing erectile disorder in their 40s or 50s, which increases in severity until their 60s.

Experiencing this disorder can be highly distressing and impact a man’s self-esteem, relationships, and overall well-being. While the introduction of medication, such as Viagra, has been known to help some, it is often prescribed as a quick fix and fails to address the psychological causes of the disorder.


There are many causes of erectile disorder, and these causes can be present simultaneously. These include:

Mental health: Stress, depression, anxiety, trauma, low self-esteem, poor body image, shame and guilt surrounding sex, and anxiety about sexual performance.

Relationship problems: Lack of trust or communication with a partner.

Injury: Damage to the brain, spine, or pelvic area.

Illness: Cardiovascular diseases such as hypertension and hypercholesterolemia, Alzheimer's disease, Parkinson's disease, diabetes, and lower urinary tract issues.

Other medical treatments: Antidepressants and medical procedures to treat prostate, colon, or bladder cancer.

Lifestyle factors: Abuse of drugs and alcohol, smoking, obesity, and the absence of exercise.

Diagnostic criteria

To meet the diagnostic criteria for erectile disorder, a person must experience one of the following criteria on almost all occasions of sexual activity for a period of over six months. These symptoms must cause the person to experience significant distress to be diagnosed and can not be explained by another disease or disorder.

  • Difficulty getting an erection during sexual activity.
  • Difficulty in keeping an erection during sexual activity.
  • A noticeable decrease in the hardness of the erection.

Erectile disorder can be either lifelong or acquired. For people with lifelong erectile disorder, the inability to get or keep an erection has been present since they became sexually active.

For people with acquired erectile disorder, the inability to get or keep an erection during sex develops after a period of normal erectile functioning. Additionally, erectile disorder can be either generalized or situational. People who experience a generalized erectile disorder experience it in all contexts and with sexual partners. In contrast, people who experience situational erectile disorder experience it in specific situations or with certain partners.


The treatment of erectile disorder is individualized to cater to the exact needs of the man and their partner. Treatment will often include a physical exam and an in-depth medical history to determine any medical causes. This is best combined with psychotherapy to address the individual’s psychological factors, relationship dynamics, sexual knowledge, and other factors that may cause stress, such as culture or religion. Devices to enhance penile stimulation, such as penis pumps and vacuums, may also be prescribed.

It is important to find a health provider to assess the medical and psychological causes of erectile disorder for effective treatment.

Female sexual interest/ arousal disorder

Female sexual interest/ arousal disorder is a sexual dysfunction characterized by a lack of arousal and desire. Previously, desire disorder and arousal disorder were classified separately. However, researchers have found many similarities between the two disorders, meaning that a person may experience one or both disorders simultaneously.

What are the symptoms of low arousal?

Symptoms of low arousal in women include a lack of sexual pleasure and genital arousal during partnered sex or masturbation or lack of arousal from sexual cues such as reading an erotic book or watching a sex scene on TV.

Some women may also experience no desire to have sex. For other women, the desire is present, but the body doesn't respond to sexual cues or activity.

What causes low or no arousal?

There are many causes of low arousal in women, including stress, anxiety, depression, guilt, shame, trauma, hormonal changes from the menstrual cycle, pregnancy, breastfeeding, birth control, and menopause. As well as relationship problems, inadequate stimulation, medications such as antidepressants, medical treatments, diabetes, and vaginal, bladder, and urinary infections.

How can it be treated?

Treatment is individualized to target the underlying cause. This is often a combination of psychotherapy, treatment of medical issues, healthy communication practices (including more foreplay), and devices to increase stimulation, such as lubrication and sex toys.

Arousal disorders are highly prevalent and can be caused by several factors, including mental illness, lifestyle factors, relationship problems, stress, medication, and other medical treatments. Treatment for arousal disorders is individualized as healthcare professionals will assess and treat these factors. It is important to address both the physical and psychological causes for effective treatment.


Leave a comment

Your email address will not be published. Required fields are marked