Hypoactive Sexual Desire Disorder (HSDD)

Hypoactive Sexual Desire Disorder Overview, Cause, Symptoms, Treatment, medication

A persistently reduced sexual drive or libido, not attributable to depression where there is reduced desire, sexual activity and reduced sexual fantasy.

Hypoactive sexual desire disorder may be lifelong or acquired, generalized (global) or situational (partner-specific). It occurs in 20% of women and in 10% of men.

HSDD is characterized by a combination of factors including persistently diminished or absent sexual fantasies or desire for sexual activity, and can affect both men and women; a person diagnosed with HSDD can still function sexually.

Diagnostic criteria for Hypoactive Sexual Desire Disorder

1. Persistently or recurrently deficient (or absent) sexual fantasies and desire for sexual activity. The judgment of deficiency or absence is made by the clinician, taking into account factors that affect sexual functioning, such as age and the context of the person's life.
2. The disturbance causes marked distress or interpersonal difficulty.
3. The sexual dysfunction is not better accounted for by another mental disorder (except another sexual dysfunction) and is not due exclusively to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

Diagnosis of Hypoactive Sexual Desire Disorder

A thorough history must be obtained, because the problem may be secondary to marital difficulties, which may include sexual satiation outside of the marriage. The disorder is not diagnosed when the symptoms are better accounted for by another psychiatric disorder (eg, depression) or a physical disorder (eg, terminal illness, endocrinopathies). If the patient also has sexual dysfunction, the clinician must determine which came first, because sexual dysfunction can lead to loss of desire and vice versa.

Treatment of Hypoactive Sexual Desire Disorder

The majority of the time, medical evaluation and lab tests will not reveal a physical cause. However, testosterone is the hormone responsible for creating sexual desire in both men and women. It may be useful to check testosterone levels.

Some couples will need to be taught skills in conflict resolution and be helped to work through differences in nonsexual areas.

Treatment is directed at removing or alleviating the underlying cause eg, marital conflict, depression, other sexual dysfunction (especially arousal or orgasm difficulties). Changing drugs and, in the occasional case of androgen deficiency, administering IM testosterone may be required. The antidepressants Prozac, Zoloft and Paxil cause loss of libido in as many as 60 percent of patients. If that is not an option, ask your doctor if it is possible to at least lower your dosages.

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Site last updated: March 4, 2008

Women with Hypoactive Sexual Desire Disorder and Dysfunctions