Definition

Sexual aversion disorder is a condition where a person feels an extreme reluctance to engage in sexual contact with their partner. This reluctance is often accompanied by the avoidance of any physical intimacy, including holding hands, due to a fear of triggering sexual interaction. This disorder is usually diagnosed during the second decade of life when people start to become sexually active.

This disorder is considered to be the most severe form of sexual arousal disorder because it involves a fear of intimate relationships and a strong desire to avoid sexual situations. In men, this disorder is often related to an aversion towards a woman's vagina, which could be due to the shape or smell of the vagina.

There are two types of sexual aversion disorder:

• Persistent type: This type of disorder is present in a person no matter who they are in a relationship with and what kind of relationship they have.
• Acquired type: This type of disorder only occurs when a person is in a particular relationship or with specific individuals. The symptoms disappear once the person is no longer in the relationship.

Causes

The most common cause of sexual aversion disorder is a history of sexual trauma, such as rape, incest, molestation, forced intimate relations, and other forms of sexual violence. This is especially important if it occurs when the brain forms an understanding of sexuality, namely during childhood and adolescence. If sexual trauma occurs during this time, the brain can associate sexual arousal or sexual touch with threat, danger, anxiety, or something painful.

This disorder is considered the most severe form of sexual arousal disorder. It is characterized by the fear of intimate relationships and an intense desire to avoid sexual situations. In men, this disorder is often linked to aversion towards a woman's vagina, which can be due to the shape or smell of the vagina.

Sexual aversion disorder can be caused by multiple factors, such as fear of AIDS, other sexually transmitted diseases, pregnancy, and fear of blood. This disorder is often associated with a decrease in sex hormones like estrogen and adrenal androgens. A high stress level can also lead to a decrease in these hormones.

Risk factor

Several factors that can increase a person's risk of developing sexual aversion disorder are:

• In the presence of anxiety and panic disorders, many people with sexual aversion disorder also have anxiety disorders or panic disorders, as well as other phobias
• The presence of PTSD or post-traumatic stress disorder
• Been in an unhealthy relationship
• Women more often feel insecure, worry about what their partners think about their sexual organs, and are more afraid of intimate relationships, especially if they have never had sex before. Some women also experience vaginismus, where there is difficulty in penetrating the vagina even though the woman wants to. This will make women anxious when thinking about penetration.
• In men, this aversion disorder can occur due to concerns about not being able to satisfy their sexual partner.
• There are unresolved sexual identity issues.

Symptoms

Individuals who suffer from sexual aversion disorder usually exhibit an extreme aversion to sexual contact with their partner. This reluctance can manifest as anxiety, fear, and even disgust. In severe cases, individuals may experience panic attacks marked by sensations such as floating, nausea, fainting, palpitations, and shortness of breath. It's worth mentioning that these reactions can even occur when the individual simply thinks about engaging in sexual activity.

Different things can cause sexual aversion, ranging from specific triggers like bodily fluids to general ones like kissing, touching, and hugging. Sexual stimuli that trigger aversion can vary from specific things like bodily fluids to general things like kissing, touching, and hugging.

There are other groupings of types of sexual aversion disorder, namely:

• The total aversion type is an aversion to all erotic sensations, feelings and thoughts
• The situational aversion type is limited to specific aspects of sex, such as genitals, penetration, fantasy, orgasm, oral sex, etc. Some people have specific fears about an aspect of sexual intercourse, for example, vaginal fluids or ejaculation. In cases like this, the person will, as much as possible, avoid things that can make them come into contact with bodily fluids so that fear or panic attacks do not arise. This type can still enjoy many other aspects of sexual activity as long as specific stimuli can be avoided; for example, they can still masturbate to reach orgasm.

Individuals with sexual aversion disorder often experience symptoms that are typically associated with severe anxiety and depression. They may also exhibit avoidant behavior in other areas of their life. To avoid sexual activity, they may utilize various strategies such as going to bed early, traveling, neglecting their appearance, abusing drugs, and keeping themselves busy with work, school, or other activities.

The level of reluctance to engage in sexual activity varies greatly; some can overcome the reluctance and, when carrying out the activity, ultimately experience pleasure. However, some are completely unable to feel erotic sensations, and some even have panic attacks.

Diagnosis

Sexual aversion disorder is diagnosed if there is persistent and recurrent extreme aversion. This reluctance is also accompanied by an attitude of avoiding sexual contact with sexual partners, which significantly disrupts life and interpersonal relationships.

Sexual aversion disorder is different from sexual phobia and sexual arousal disorder in that in aversion disorder, what occurs is a feeling of disgust at the idea of sex. In contrast, sexual phobia is a fear of sex. Meanwhile, in sexual arousal disorders, problems are caused by a lack of passion or desire for sexual activity, not fear or anxiety.

Management

Therapy for sexual aversion disorder is almost the same as treatment for serious anxiety disorders such as:

• In systematic desensitization or exposure therapy, patients write a list of sexual activities; then, they are exposed to activities that trigger anxiety while being trained to relax. Therapy is carried out until there are no longer feelings of intense anxiety. When the patient has been exposed to all activities and relaxation therapy is successful, the person will do what they have been trained to do to their partner.
• Psychotherapy
• Integrative therapy combines therapy from doctors, psychologists, sex therapists and physical therapists.
• Medications are usually used for disorders accompanied by panic attacks that are so severe that they cause real distress.
• Marriage counseling is carried out if the disorder causes problems for the couple.

Complications

If left untreated, sexual aversion disorder can cause marital problems, divorce, and chronic unhappiness in a relationship or marriage. In addition, severe disorders can be accompanied by panic attacks.

Prevention

There is no way to cure sexual rejection disorder, but addressing underlying issues such as post-traumatic stress disorder may reduce the likelihood of it developing into an aversion disorder.

When to see a doctor?

Are you finding yourself recoiling at the mere thought of sexual contact? Do you frequently find yourself dodging or limiting sexual interactions? Does the idea of both sexual and non-sexual intimate touch, like cuddling or kissing, evoke feelings of repulsion? If these sentiments disrupt your life, seeking guidance from a healthcare professional is essential. You deserve to derive happiness from your sexual experiences. While it may be challenging, opening up about these feelings to your partner or doctor can pave the way for a tailored therapy plan, facilitating a fulfilling and enjoyable sexual life with your partner.