Sexual aversion disorder (SAD)

Sexual Aversion Disorder (SAD) is one of two Sexual Desire Disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and is defined as a “persistent or recurrent extreme aversion to, and avoidance of, all or almost all, genital sexual contact with a sexual partner” which causes distress or interpersonal difficulty.

Much has also been written about the overlap between SAD and panic states, and the more obvious similarities between SAD and anxiety as opposed to sexual desire.  SAD is identified as a Sexual Dysfunction however there are researchers and health professionals who argue that it might more appropriately be placed within the Specific Phobia grouping as an Anxiety Disorder.

Adapted from:  Archives of Sexual Behavior: Lori A. Brotto; Volume 39, (2010)

To put it simply; Sexual Aversion Disorder (SAD) is phobic aversion to, and avoidance of sexual contact with a sexual partner, which can cause personal distress.

This is the most severe form of sexual desire disorder. It involves a fear of sexual intercourse and an intense desire to avoid sexual situations completely.

SAD is often related to an aversion to a person’s genitals. The sufferer may be repulsed by the outward looks or the smell of the person’s genitals.

A person’s reaction to their partner’s body and sexuality can greatly impact the quality of their relationship.

Contributing Factors of Sexual Aversion Disorder (SAD):

  • Sexual abuse
  • Rape
  • Incest
  • Parental sexual attitudes
  • Anxieties about a person’s sexual performance
  • Unresolved sexual identity issues
  • Relationship problems
  • Fear of blood on the penis after penetration
  • Fear of transmission of sexually transmitted infections
  • Fear of pregnancy

Consequences of Sexual Aversion Disorder (SAD)

Common experiences of people with Sexual Aversion Disorder, when faced with the possibility of a sexual encounter:

  • Anxiety
  • Fearfulness
  • Physical symptoms, such as:
    • rapid heart rate
    • sweating
    • dizziness
    • nausea
    • trembling
  • diarrhea

Treatment of Sexual Eversion Disorder (SAD)

In order to treat Sexual Aversion Disorder sex therapy /counselling is recommended.  Dave Wells combines individual therapy and couple therapy to address SADS.  Where a partner is involved, a co-operative couple will benefit more from treatment.

Sex therapy/counselling for Sexual Aversion Disorder may include some of the following:

  • Anxiety reduction/desensitization
  • Cognitive restructuring techniques
  • Sexual myths/psychosexual education
  • Enhancing communication
  • Promoting sexual intimacy
  • Behavioural assignments/homework exercises

Other sexual desire disorders differ from the SAD as the condition does not only include a lack of interest, it also comprises of the feeling of disgust and fear (just like a phobia) for any type of sexual activity.

Different patients have different types of aversions such as:

  • Some might not like to see the genitals of their partner
  • Some do not like the smell of the ejaculations or genital organs
  • Some do not like kissing, hugging, cuddling, or mutual masturbation
  • And for some, the fear grows to a complete hatred for intercourse as a whole

A person may become so obsessed with the fear/phobia for sexual activity, that he/she may take every gesture from the partner as demand for sex and may avoid all intimacy or communication between the partners. In long term, aversion for sex might jeopardize the success of the sufferers relationships.

What causes the SAD and are there any noticeable symptoms included?

Clearly, the Sexual Aversion Disorder is a psychological disorder with a few physiological causes that might be an underlying reason. But the greatest factor which becomes the reason for a person developing an aversion such as this is due to some traumatic past experiences or perhaps issues with the partner itself.

If the cause is interpersonal with the partner, it is likely that the patient is capable of sexual fantasies and imagery. This person avoidance may be situational.

In case of an abusive past, such as physical violence, rape, molestation even verbal abuse or bad parenting, the patient will need an extensive therapy as well as the emotional support of the partner.

However, it is important to remember that no person can be branded as suffering from SAD unless he/she has been evaluated or any other causes have been ruled by an expert sexologist.

Also, SAD can be treated very well, with extensive psychotherapy, marital counseling and cognitive behavioural therapy. The results are very promising. The couple should really be motivated to work on their issues.

Adapted from: