🧠 Let’s Get Real: “Doc, I Just Don’t Feel Like It Anymore…”
It was a quiet Tuesday.
Sana (name changed), a 32-year-old school teacher, sat across from me.
Tears welled up in her eyes.
“I love my husband. He’s supportive. He’s kind. But for the last year… I just don’t feel any desire. It’s like something in me has shut off.”
She wasn’t alone.
And she wasn’t broken.
She was experiencing something very real — Female Sexual Interest/Arousal Disorder (FSIAD).
🔍 So, What Exactly Is FSIAD?
It’s more than “not being in the mood.”
It’s a persistent lack of sexual thoughts, fantasies, or interest — and when attempts at intimacy do happen, the body doesn’t respond the way it used to.
Core Symptoms:
(To be considered a disorder, these symptoms must cause distress and last at least 6 months)
- Little or no sexual interest in any sexual activity
- Rare or absent sexual or erotic thoughts and fantasies
- Reduced initiation or receptivity to partner’s sexual advances
- Minimal excitement or pleasure during sexual activity
- Few or absent genital or non-genital sensations during sexual intimacy
- Personal distress about lack of interest or arousal
It’s not about not wanting sex sometimes. That’s normal.
It’s when it keeps happening, it’s unwanted, and it starts affecting your life or relationship.
🧬 Etiology: What Causes It?
There’s no single reason. It’s like a cocktail of biological, psychological, and social influences.
🔹 Biological Factors
- Hormonal imbalances (like low estrogen or testosterone, especially after menopause)
- Medical conditions (diabetes, thyroid issues, chronic pain)
- Medication side-effects (SSRIs, antipsychotics, birth control)
- Fatigue or sleep issues
🔹 Psychological Factors
- Depression and anxiety
- Low self-esteem or body image issues
- History of trauma or sexual abuse
- Relationship conflict or communication issues
🔹 Sociocultural Factors
- Cultural taboos around female sexuality
- Guilt or shame related to sex
- Gender role expectations
- Lack of sex education
🧪 Epidemiology
- Globally, about 25-40% of women report low sexual desire at some point.
- In India, it’s likely underreported due to stigma and lack of awareness.
- FSIAD is most common in women aged 35-55, especially after childbirth or menopause.
- Roughly 10% of women experience clinical levels of distress due to sexual dysfunction.
📜 A Brief History: Why This Took So Long to Be Taken Seriously
For decades, female sexual dysfunction wasn’t taken seriously.
Women were told “it’s all in your head” or “just relax, it’s normal.”
It wasn’t until 2013, in the DSM-5, that Female Sexual Interest/Arousal Disorder was formally recognized — combining both desire and arousal issues into one diagnosis.
Before that, women’s sexual health was an afterthought in mainstream medicine.
Even now, many doctors hesitate to ask about it. And many women feel too ashamed to speak up.
But things are changing — slowly, but surely.
🧠 Pathogenesis: What’s Going on in the Brain?
In women with FSIAD, the brain’s reward systems and emotional processing regions (like the amygdala, hypothalamus, and prefrontal cortex) may function differently.
Stress, trauma, or negative sexual experiences can shape neural pathways that suppress desire.
Low dopamine, serotonin imbalance, or a disconnect between physical response and emotional readiness also play a role.
Put simply:
It’s not about not loving your partner.
It’s about your brain, body, and history not syncing up in the moment.
🧍♀️ A Patient’s Perspective: Sana’s Journey
Sana had been silently blaming herself for months.
She thought she was “less of a woman.”
Her mother told her it was just stress.
Her gynaecologist never asked about sex.
When she finally walked into my clinic, she whispered her symptoms like secrets.
But once we put a name to it — FSIAD — she sighed with relief.
We worked on:
- Therapy (including sex therapy and CBT)
- Rule out physical causes (with hormone & thyroid tests)
- Mindfulness and body-focused techniques
- Couple counseling with her husband
And slowly, the spark started to return.
Not like flipping a switch.
But like lighting a candle, one breath at a time.
🧭 If You Relate to This…
You don’t have to suffer in silence.
It’s not your fault.
It’s not “just in your head.”
And you can feel connected again — with your partner and with yourself.
📞 Call to Reach
Mind & Mood Clinic, Nagpur (India)
Dr. Rameez Shaikh, MD (Psychiatrist & Sexologist)
📱 +91-8208823738
🌐 www.hellomind.in
We help women reconnect with their mental and emotional health — in a safe, respectful, and confidential space.
DISCLAIMER:
Names and patient details mentioned in this blog have been changed for confidentiality and privacy. This post is for educational and awareness purposes only. If you’re struggling with any of the issues discussed here, seek help from a qualified mental health professional.
Dr. Rameez Shaikh (MBBS, MD, MIPS) is a consultant Psychiatrist, Sexologist & Psychotherapist in Nagpur and works at Mind & Mood Clinic. He believes that science-based treatment, encompassing spiritual, physical, and mental health, will provide you with the long-lasting knowledge and tool to find happiness and wholeness again.
Dr. Rameez Shaikh, a dedicated psychiatrist , is a beacon of compassion and understanding in the realm of mental health. With a genuine passion for helping others, he combines his extensive knowledge and empathetic approach to create a supportive space for his patients.
