WHO Guide to Mental and Neurological Health in Primary Care
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Differential diagnosis and co-existing conditions

When the sexual dysfunction can be better accounted for by another axis 1 disorder, or is due to the direct physiological effects of a substance/medication, or a general medical condition; that is:

  • If low or sad mood is prominent, see Depression - F32#.  Depression may cause low desire, or may result from sexual and relationship problems.
  • Relationship problems. If persistent discord in the relationship is the primary problem, relationship counselling should precede specific psychosexual treatment of the sexual dysfunction.
  • Gynaecological disorders (vulval pain disorders [eg vulval vestibulitis], vaginal infections, pelvic infections [salpingitis] and other pelvic lesions [eg tumours or cysts]), although vaginismus rarely has a physical cause.
  • Side-effects of medication, alcohol or drugs (eg SSRI antidepressants, oral contraceptives and beta-blockers). 
  • Physical illnesses that affect the sexual physiology - vascular, neurological or endocrine systems - might contribute (eg atherosclerosis, multiple sclerosis, diabetes).
  • Note that more than one sexual dysfunction can co-exist.

Last edited: 2/2/2004

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