Arousal is the state of being awake and focused on a certain stimulus. In this article, we’re specifically talking about sexual arousal, which is about being sexually excited or turned on. For individuals who have a vagina, this involves a number of physiological changes in the body.

The words arousal and desire are often used interchangeably, but they’re slightly different.

Desire usually refers to emotionally wanting to have sex, while arousal refers to the physiological changes in your body that happen when you’re sexually excited.

According to the Cleveland Clinic, desire disorders involve a lack of sexual desire or interest in sex, while arousal disorders involve wanting sex but struggling to get your body in the mood.

It’s important to remember there’s a difference between wanting to have sex and being physically aroused. It’s possible to feel physically aroused without wanting to act on that feeling.

Just because someone shows signs of sexual arousal doesn’t mean they want to have sex — nor does it mean they consent to having sex.

Always practice enthusiastic consent: If you’re not sure whether your partner is into it, always ask!

According to the United Kingdom’s National Health Services (NHS), researchers have identified four stages of sexual response — that is, the stages your body and mind goes through before, during, and after sex.

Arousal falls into the first stage of the sexual response cycle.

Excitement

The sexual excitement stage — also known as the arousal stage — involves a range of physiological changes in the body. Most of these functions prepare the body for vaginal intercourse.

For example, your vagina becomes more wet because the glands produce lubricating fluids. Your clitoris and vulva swell up as your blood vessels dilate. Your nipples might become more sensitive to touch, too.

Plateau

The plateau stage is the period before orgasm. In this stage, the changes you feel in the excitement phase intensify. Your breathing may quicken, and you may start moaning or vocalizing involuntarily. Your vagina might tighten and produce more lubrication.

Orgasm

The orgasm stage is often considered the end goal of sex, but it doesn’t have to be! It’s totally possible to have pleasurable sex without reaching orgasm.

Orgasms can include muscular convulsions, especially in the lower back and pelvic area. At this stage, your vagina might tighten and it might become more lubricated.

It’s associated with a sense of euphoria and pleasure.

Resolution

After orgasm, your muscles relax and your blood pressure drops. Your clitoris might feel particularly sensitive or even painful to touch.

You might experience a refractory period, during which you won’t be able to orgasm again.

Some people experience multiple orgasms, but that’s not necessary for you to have a pleasurable sexual experience. The most important thing is for you to listen to your body and be comfortable.

Some of the physical responses to arousal include:

  • Your pulse and heartbeat quicken, and your blood pressure rises.
  • Your blood vessels dilate, including blood vessels to the genitals.
  • Your vagina and vulva might become wet to help lubricate the genitals.
  • Parts of your vulva, such as the labia (lips) and clitoris, become swollen due to the increased blood supply.
  • Your vaginal canal might expand.
  • Your breasts become fuller, and your nipples may become erect.

You might struggle to concentrate on anything else — even if you’re not actually having sex!

That’s because sexual stimuli activates certain changes in your brain, inducing certain sex-focused brain activity.

However, there’s still a lot we don’t know about how the brain works, including how the brain works during sex.

Your physical response to arousal will depend on your genitals, of course. But there are a few similarities in how most people experience arousal.

No matter what your genitals look like, blood would usually flow to them due to the dilation of the blood vessels.

If you have a vagina, that might result in the swelling of the clitoris and labia. If you have a penis, this blood flow causes an erection.

This blood flow could also cause your cheeks and chest to flush.

A lot of mainstream media focuses on the differences between men’s brains and women’s brains, including when it comes to sex. But brain-wise, men and women actually aren’t that different.

One 2012 study involved viewing the brain through an fMRI machine while subjects watched erotic videos. The fMRI machine helped the researchers see how the brain was affected during arousal.

It found that, while sexual stimuli activated the amygdalas and thalami more in men, it generally had a similar effect on all subjects.

It’s worth noting that these studies often don’t include intersex and transgender participants.

To increase sexual excitement, you can prolong foreplay.

This means that before sexual intercourse or masturbation, you take time to arouse yourself by experimenting with different erogenous zones, using different toys, or trying different kinds of sensual touch.

For example, you might feel turned on when you touch your nipples, kiss your partner for a long while, or use a sex toy.

It might be helpful to attend couple’s counseling or sex therapy to help you and your partner communicate better and practice healthy forms of intimacy.

In 2015, the Food and Drug Administration approved the use of flibanserin (Addyi), a prescription drug that treats female sexual interest/arousal disorder. This is a Viagra-like drug.

The research on this drug is mixed. While it’s been shown to be effective for some, others don’t find it helpful.

There’s also some controversy around the number of side effects this medication has, which include:

  • dizziness
  • difficulty falling asleep or remaining asleep
  • nausea
  • dry mouth
  • tiredness
  • hypotension, or low blood pressure
  • fainting or loss of consciousness

The drug shouldn’t be combined with alcohol. It can interact with many other medications and supplements. It can even interact with grapefruit juice.

If you want to try out this medication, speak to your doctor. Be sure to tell them your medical history, including any supplements you’re taking. Ask for a referral to a sex therapist, too, in order to explore any vulnerable factors that may be impeding you from wanting sexual activity.

A sex therapist will help you to identify mental health or relational factors that may be negatively affecting you and teach you more about your sexual health.

Adhere to their advice, and don’t take any more supplements or medications — even over-the-counter (OTC) medications — without their prior approval.

If you want to have sex but don’t seem to experience sexual arousal, this can be difficult to deal with. You might have a sexual dysfunction disorder.

Usually, sexual dysfunction relating to arousal is called female sexual interest/arousal disorder.

It’s also OK if you experience little or no desire to have sex. Many people identify as asexual, which means they feel little or no sexual urges.

Asexuality isn’t a disorder or condition, but an identity — much like any sexual orientation.

It’s more of a spectrum than one single experience, and every asexual person experiences asexuality differently.

Asexual people may or may not experience arousal, and while some asexual people do have sex, others don’t.

If you think you’re asexual, it might be helpful to do a little research on the subject and connect with the asexual community. The Asexual Visibility & Education Network is a good place to start!

Female sexual interest/arousal disorder is a sexual dysfunction that causes low sex drive. It used to be known as hypoactive sexual desire disorder (HSDD).

Signs

If you have female sexual interest/arousal disorder, you could experience the following symptoms:

  • little interest in sex and masturbation
  • little interest in sexual fantasies
  • difficulty enjoying sex
  • difficulty feeling pleasure when your genitals are stimulated

Diagnosis

There’s no specific test for female sexual interest/arousal disorder.

To diagnose this condition, a doctor might ask you about your symptoms. They might also try to find an underlying cause.

This could include physical reasons (health conditions or medication, for example) or emotional reasons (such as a history of sexual abuse, a mental health condition that affects arousal, negative body image, or relational stressors).

Your healthcare provider might do blood tests or perform a pelvic exam to figure out the underlying cause. Sometimes, there’s no apparent cause of female sexual interest/arousal disorder.

Treatment

The treatment of female sexual interest/arousal disorder will depend on the cause.

For example, if it’s caused by a certain medication, your doctor might prescribe a lower dosage or a different medication altogether.

Female sexual interest/arousal disorder could also be caused by low estrogen levels. This is common for people who are experiencing menopause or perimenopause. In this case, your doctor might prescribe hormone therapy.

If the cause is emotional, it might be best to see a therapist who specializes in sexual health. They can help you take care of your mental health and address any past trauma.

According to a 2011 article on arousal disorders, emotional health has a huge impact on arousal, and therapy such as cognitive behavioral therapy can be a very effective treatment for arousal disorders.

A counselor that specializes in sex and relationships can also help you figure out new techniques for communicating, scheduling sex, and finding sexual activities that work for you.

You can also try flibanserin (Addyi), the prescription medication mentioned above. However, it’s important to discuss this with your doctor, as there are many side effects and it can interact with current medications or worsen certain conditions.

Before you consider taking medication, it’s best for you to understand the risks and benefits so that you can make an informed decision.

A number of other conditions can cause arousal disorder or affect your libido negatively.

Hormonal shifts

Menopause, pregnancy, miscarriage, birth, and breastfeeding all cause huge hormonal shifts that can affect your ability to feel aroused.

In the case of pregnancy, miscarriage, birth, and breastfeeding, your sexual desire and ability to become aroused usually return over time.

If it’s a persistent problem or if it’s causing you distress, speak to a doctor or a therapist.

If menopause is causing you to feel little or no sexual desire, your doctor might prescribe estrogen therapy.

Thyroid disorders

Since your thyroid gland can affect your sex hormones, thyroid disorders can affect your ability to become aroused.

A 2013 study that looked at 104 women with thyroid conditions, including hyperthyroidism, hypothyroidism, Hashimoto’s disease, and nodular goiters.

The researchers compared them to women without thyroid conditions.

They found that female sexual dysfunction was more prevalent in women with thyroid conditions (46.1 percent) than women without thyroid disease (20.7 percent).

A study conducted in 2015 looked at the link between sexual dysfunction and depression. It found that hypothyroidism and thyroid autoimmunity could cause both depression and sexual dysfunction.

Managing your thyroid disease by taking your prescribed medication and implementing lifestyle changes can help improve your sexual function.

Mental health disorders

Mood disorders like depression can cause low libido as well as sexual arousal and desire disorders.

According to a 2009 article published in the Journal of Clinical Psychiatry, about 40 percent of women who have a sexual dysfunction also experience depression. The researchers also estimated that 3.7 percent of women have both depression and difficulties with sexual desire.

Many mental health conditions can arise because of trauma, which can also cause sexual dysfunction.

One 2015 study that looked at both men and women found that PTSD and sexual dysfunction are linked, and that PTSD treatments should take the individual’s sexual function into account.

Diabetes

Diabetes could cause different kinds of female sexual dysfunction.

A 2013 review of studies found that women with diabetes were more likely to experience sexual dysfunction than those without diabetes. However, the review noted that the link between the two is still poorly understood.

If you think you’re experiencing any sort of sexual dysfunction, it’s a good idea to talk to a doctor or therapist — especially if it’s affecting your well-being and your relationships.

Remember that, while sexual dysfunction can be difficult and frustrating, it’s treatable.