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Logic would suggest that women with low sexual desire do not acquire sexually transmitted infections. However, this may not be the case. Until recently, it has been considered that sexual activity in women is initiated by desire, which produces arousal. This leads to orgasm and resolution.1, 2 In practice, sexual desire and arousal are not isolated psychological and physiological states but interdigitate and feed back on each other. In a new relationship a woman's sexual desire is often spontaneous.3 In effect this means that thoughts of her partner or seeing him are sufficient to produce an urge to want sexual relations to take place. This produces both mental excitement and bodily arousal (for example, vaginal lubrication, uterine “tenting,” breast enlargement). These sensations (arousal) feed back to produce a greater desire for intercourse. However, it is also well recognised that women are less attentive to genital sensations than men, and indeed may lubricate and vasocongest in the vulva and vagina in the absence of mental sexual excitement.
The DSM IV definition of low sexual desire, or to be more precise, hypoactive sexual desire disorder is “persistently or recurrently deficient (or absent) sexual fantasies and desire for sexual activity. …