How is sexual dysfunction diagnosed?

The majority of the time, medical evaluation and lab tests will not reveal a physical cause. However, testosterone is the hormone most responsible for creating sexual desire in both men and women. It may be useful to check testosterone levels, particularly in men who have ISD. Blood for such lab tests in men should be drawn before 10:00 a.m., when male hormone levels are at their highest. Interviews with a specialist in sex therapy are more likely to reveal possible causes.

The diagnostic criteria (DSM-IV-TR) for female sexual arousal disorders are: persistent or recurrent inability to attain, or to maintain until completion of the sexual activity, an adequate lubrication-swelling response of sexual excitement; the dysfunction causes marked distress or interpersonal difficulty; and the sexual dysfunction is not caused by another primary disorder (except another sexual dysfunction) and is not due exclusively to the direct effects of a substance (such a drug of abuse, a medication) or a general medical condition on the body.

Diagnostic criteria for premature ejaculation DSM-IV-TR (American Psychiatric Association) are: persistent or recurrent ejaculation with minimal sexual stimulation before, upon, or shortly after penetration and occurring before the person wishes it. Factors that affect duration of the excitement phase, such as age, novelty of the sexual partner or situation, and recent frequency of sexual activity, are taken into consideration; the disturbance causes distress or interpersonal difficulty; and the premature ejaculation is not due exclusively to the direct effects of a substance (such as withdrawal from opioids).

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