An Overview of Hypoactive Sexual Desire Disorder

It can cause personal distress and added stress in a relationship

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Hypoactive sexual desire disorder (HSDD) is a type of sexual dysfunction that can prevent someone from experiencing sexual satisfaction. In the case of HSDD specifically, it results in the absence or lack of sexual desire. Some people experience lifelong HSDD and for others it may happen later in life, even if they previously had a healthy and fulfilling sex life. Though it can happen to anyone, HSDD is especially common in females, occurring up to one-third of adult women in the United States.

female sexual dysfunction
 Verywell / Brianna Gilmartin

Symptoms

 HSDD is an extremely common disorder but is infrequently diagnosed. Some of the symptoms of HSDD include:

  • Wanting to have sex much less than your partner does to a point it causes distress in the relationship
  • Having no interest in any type of sexual activity with your partner
  • Having no interest in sexual activity with yourself, such as masturbation
  • Never or rarely having sexual thoughts or fantasies
  • Being concerned about your lack of sex drive or sexual thoughts and fantasies

It's rare to want to have sex all the time, and depending on what’s going on in your life at any given moment can certainly play a part in your libido and sexual desires. But being actively bothered by your sexual absence and having this lack of desire cause issues or distance in your relationship is the biggest symptom that you may be suffering from HSDD.

While many men and women may have a low libido, what classifies the condition as HSDD is the absence of sexual thoughts or fantasies and lack of sexual desire that then causes distress in a relationship or with someone’s partner.

A low libido that’s void of conflict in a relationship or with a sexual partner can be just that without a diagnosis of HSDD.

Causes

There are many physical and mental hurdles that can impact sex drive, over time resulting in HSDD. A study published in the Journal of the American Medical Association found that sexual dysfunction resulting in HSDD is more prevalent in both women and men who are in poor physical and mental health.

Hormonal Changes

There are also a number of hormonal shifts that can cause HSDD for women down the line, such as menopause. One study found that low sexual desire ranged from 26.7% in premenopausal women to 52.4% of naturally menopausal women, making the disorder twice as prevalent in women once they go through menopause. Other hormonal issues such as pregnancy and breastfeeding may also cause diminished sexual desire which can lead to HSDD.

Certain Medical Conditions

A number of medical conditions can also cause HSDD as a side effect, including:

Recently having or recovering from surgery, particularly any procedure related to your breasts or genital area can affect your sexual function and desire for sex. This is especially true if you are dealing with body image issues from the procedure.

Lifestyle

Your lifestyle may also be a factor in HSDD, particularly if you find yourself extremely fatigued at night after a busy day at work or caring for others like your children or aging parents. And while it’s enjoyable to have a glass of wine at the end of the day, too much alcohol at night can impact your sex drive, as well as smoking which can decrease blood flow and cause you not to feel as aroused.

Even certain prescription medications – such as selective serotonin reuptake inhibitors – can lower your sex drive which may eventually lead to HSDD.

Last, your overall mental health and the health of your relationship can be a cause of HSDD. Anxiety, depression, body image issues, as well as previous sexual abuse or poor sexual experiences all play a part in your sex drive.

Communication issues or a disconnect with your partner can also cause your libido to wane, and if these issues aren’t being actively worked on together through therapy or other measures, over time HSDD can evolve from them.

Diagnosis

The most important part of diagnosing HSDD is that you have to mention your lack of sexual desire to your doctor. There are no external signs of HSDD, and your doctor may or may not ask you about your sex drive at your annual physical exam, so it’s important to speak up if your decreased libido is causing you distress.

Once you’ve mentioned this, there are a number of tests your doctor can do to help pinpoint the problem behind your lack of sexual desire. This includes a questionnaire about your sexual desire (often referred to as a Decreased Sexual Desire Screener) and running blood tests to check your hormone levels to see if there’s a medical condition causing HSDD such as a thyroid disorder, diabetes, or high cholesterol.

If you’re a woman, they will also recommend you make an appointment with your gynecologist, who will perform a physical exam to check for vaginal dryness, tissue thinning, or anything that may be causing vaginal pain resulting in a low sexual desire.

For the mental or emotional causes linked to HSDD, your doctor may refer you to a sex therapist who will be able to evaluate both you and possibly your partner in order to help treat the relationship or personal triggers that are causing HSDD and sexual distress.

Treatment

Once the cause of your HSDD is found, there are a number of ways to treat and manage it. The type of treatment you receive will depend on what other external factors have triggered and caused your HSDD. It may also be recommended that you receive multiple forms of treatment, such as counseling and medication.

The most popular forms of treatment include:

  • Medication: Your doctor will review the medicines you are currently taking (both prescription and over-the-counter) and make adjustments as needed. If you’re not taking any medication or your current prescriptions aren’t causing your HSDD, your doctor may also prescribe you medication to boost your libido. Vyleesi (bremelanotide injection) is one such example.
  • Hormone therapy: If your HSDD is a result of vaginal dryness or pain, your doctor may recommend estrogen in order to be more comfortable having sex which in turn could reverse symptoms of HSDD.
  • Lifestyle changes: Your doctor will likely recommend a number of lifestyle changes to make in addition to other treatment options in order to help boost your libido long-term. This can include establishing a consistent exercise routine, providing you tools to help cope with stress, quitting smoking and drinking less alcohol, as well as communicating and setting aside intimate time to spend with your partner.

Coping

Dealing with HSDD can be very lonely for both you and your partner. It may cause you to feel frustrated that you don’t feel as aroused as you once used to. Your partner may also feel rejected or undesirable in the relationship.

It’s important to keep in mind that HSDD is common and can be diagnosed as long as you’re willing to be candid about your sexual desire and relationship with your doctor in order to get the help and treatment you need.

HSDD is also consistent with age. Previous research found that 67% of women in the United States ages 20 to 29 were distressed about their low sexual desire, while only 37% of 60 to 70-year-old women were distressed. This means that you may have experienced HSDD in the past, and as you get older see another dip on your libido and not feel distressed by it. Both of these scenarios are normal and, in the case of HSDD, there are a number of ways to manage it to help you have a fulfilling and healthy sex life. 

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Article Sources

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