Female Sexual Interest/Arousal Disorder 435
5) medical factors relevant to pr ognosis, course, or treatment. Note that each of these factors
may contribute differently to the presenting sy mptoms of different women with this disorder.
Prevalence 
The prevalence of female sexual interest/arousal disorder, as defined in this manual, is
unknown. The prevalence of low sexual desire and of problems with sexual arousal (with
and without associated distress), as defined by DSM-IV or ICD-10, may vary markedly in
relation to age, cultural setting, duration of symptoms, and presence of distress. Regard-
ing duration of symptoms, there are striking  differences in prevalence estimates between
short-term and persistent problems related to lack of sexual intere st. When distress about
sexual functioning is requir ed, prevalence estimates are markedly lower. Some older
women report less distress ab out low sexual desire than y ounger women, although sexual
desire may decrease with age. 
Development and Course 
By definition, lifelong female sexual interest /arousal disorder suggests that the lack of
sexual interest or arousal has been present fo r the woman’s entire sexual life. For Criteria
A3, A4, and A6, which assess functioning duri ng sexual activity, a subtype of lifelong
would mean presence of symptoms since the in dividual’s first sexual experiences. The ac-
quired subtype would be assigned if the difficu lties with sexual interest or arousal de-
veloped after a period of nonproblematic se xual functioning. Adaptive and normative
changes in sexual functioning may result from  partner-related, interpersonal, or personal
events and may be transient in nature. Howe ver, persistence of symptoms for approxi-
mately 6 months or more would constitute a sexual dysfunction.
There are normative changes in  sexual interest and arousal across the life span. Fur-