Dysfunction can occur at any of these stages. In addition, both men and women can experience pain during the sexual act. Both ICD-10 and DSM-IV-TR use these stages to classify sexual dysfunction. Hypoactive sexual desire disorder (HSDD) is a spectrum of diseases that cause personal distress due to persistent or recurring deficiency (or absence) of sexual thoughts and a lack of receptivity to sexual activity. Sexual arousal disorder is a persistent inability to attain or maintain efficient sexual excitement, which leads to personal distress. Sexual arousal disorder may be experienced as decrease of subjective excitement, somatic responses, or genital lubrication/swelling. Inefficient labial and clitoral sensation and engorgement and lack of vaginal smooth muscle relaxation can also lead to sexual arousal disorder. Primary orgasmic disorder is usually due to emotional trauma or sexual abuse. Hormonal deficiency, surgical trauma, or medications are the common causes for secondary orgasmic disorder. The mechanism of apparition of a female orgasm disorder has two important aspects: the hyper-attention and the hyper-intention.