Some patients have sexual encounters fairly often to please their partners and may have no difficulty with performance but continue to have sexual apathy. A thorough history must be obtained, because the problem may be secondary to marital difficulties, which may include sexual satiation outside of the marriage. If the patient also has sexual dysfunction, the clinician must determine which came first, because sexual dysfunction can lead to loss of desire and vice versa. Changing drugs and, in the occasional case of androgen deficiency, administering IM testosterone may be required. Sexual aversion disorder occurs occasionally in males and much more often in females.
Patients report anxiety, fear, or disgust in sexual situations.
Even after the dyspareunia disappeared, painful memories may persist. Situational sexual aversion may occur in persons who attempt to or are expected to have sexual relations incongruent with their sexual orientation. Treatment Treatment is aimed at removing the underlying cause when possible. The choice of behavioral or psychodynamic psychotherapy depends on the diagnostic understanding. Marital therapy is indicated if the cause is interpersonal.