Sexual arousal though they are generally considered secondary in role to the other three. Erotic stimuli which can result in sexual arousal can include conversation, reading, films or images, or a smell or setting, any of which can generate erotic thoughts and memories in a person. Given the right context, these may lead to the person desiring physical contact, including kissing, cuddling, and petting of an erogenous zone. This may in turn make the person desire direct sexual stimulation of the breasts, nipples, buttocks and/or genitals, and further sexual activity. Erotic stimuli may originate from a source unrelated to the object of
Hypoactive sexual desire disorder rather a weaker positive association than women without HSDD. In the DSM-5, male hypoactive sexual desire disorder is characterized by "persistently or recurrently deficient (or absent) sexual/erotic thoughts or fantasies and desire for sexual activity", as judged by a clinician with consideration for the patient's age and cultural context. Female sexual interest/arousal disorder is defined as a "lack of, or significantly reduced, sexual interest/arousal", manifesting as at least three of the following symptoms: no or little interest in sexual activity, no or few sexual thoughts, no or few attempts to initiate sexual activity or respond to partner's initiation, no or