The Evolution of the Female Sexual Disorder/Dysfunction Definitions, Nomenclature, and Classifications: A Review of DSM, ICSM, ISSWSH, and ICD

Sharon J. Parish, Sara Cottler-Casanova, Anita H. Clayton, Marita P. McCabe, Eli Coleman, Geoffrey M. Reed

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

Introduction: The 2 most well-known classification systems that include sexual medicine diagnoses are the International Classification of Diseases and Statistics (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM). Sexual medicine experts from international societies representing an array of disciplines have revised and redefined female sexual dysfunctions (FSDs) to reflect current scientific evidence and the state of the art. Aim: To summarize the evidence and interactive and chronological process by which sexual medicine societies’ consensus groups developed the current nomenclature, classifications, and definitions for FSDs. Methods: We review the contributions and collaborations of the Fourth International Consultation in Sexual Medicine (ICSM), the International Society for the Study of Women's Sexual Health (ISSWSH), and the World Association of Sexual Health in conjunction with the World Health Organization. Main Outcome Measures: The ICSM and ISSWSH diagnostic systems are contrasted with the DSM classification. We discuss innovations and strengths; relevant evidence regarding epidemiology, etiology, and risk factors; and key differences. We describe how sexual medicine expertise informed FSD codes in the ICD-11 classification. Results: ICSM and ISSWSH published evidence-based guidelines on the definitions, nomenclature, and diagnostic criteria for FSD that diverge from the DSM psychiatric compendia. These definitions and nomenclature recommend the separation of female sexual desire and arousal disorders, elaborate on subtypes of arousal problems, broaden the scope of sexual pain definitions, and provide a greater understanding of etiologies and risk factors for FSDs. Conclusions: These collaborations among sexual medicine experts and their role in the ICD-11 development process provide confidence that the ICD-11 Sexual Dysfunction codes are based on current scientific evidence for diagnosing and coding FSDs in clinical settings worldwide, can serve as endpoints in clinical trials, and will provide specificity for treatment outcomes for FSD therapies. Parish SJ, Cottler-Casanova S, Clayton AH, et al. The Evolution of the Female Sexual Disorder/Dysfunction Definitions, Nomenclature, and Classifications: A Review of DSM, ICSM, ISSWSH, and ICD. Sex Med 2021;9:36–56.

Original languageEnglish (US)
Pages (from-to)36-56
Number of pages21
JournalSexual Medicine Reviews
Volume9
Issue number1
DOIs
StatePublished - Jan 2021

Bibliographical note

Funding Information:
The authors would like to acknowledge all members of the Fourth International Consultation in Sexual Medicine Committee One; the International Society for the Study of Women's Sexual Health Nomenclature I, II, and III consensus panels; and the experts from the sexual medicine societies who served on the consultation group convened to provide feedback to World Health Organization (WHO) on the proposed classification of sexual dysfunctions. S.C.-C. and G.M.R. were members of the WHO Secretariat. The positions expressed in this article are those of the authors and, except as specifically noted, do not reflect the official policies and positions of the WHO.

Publisher Copyright:
© 2020 International Society for Sexual Medicine

Keywords

  • DSM 5 Sexual Disorder
  • Female Sexual Arousal Disorder
  • Female Sexual Dysfunctions
  • Hypoactive Sexual Desire Disorder
  • ICD-11
  • Nomenclature

PubMed: MeSH publication types

  • Journal Article
  • Review

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