Hypoactive
Sexual Desire Disorder
Hypoactive Sexual
Desire Disorder (HSDD) is a deficiency or absence of sexual fantasies
and desire for sexual activity. This is considered a disorder if it
causes distress for the patient or problems in the patient's relationships.
It must be determined that this is not the result of another psychological
disorder which is the primary problem. If the sexual partner of a
patient with suspected hypoactive sexual desire disorder feels that
this is a problem within the relationship, that concern should be
sufficient for the individual to seek psychological consultation.
Desire for and fantasy about sexual activity are chronically or recurrently
deficient or absent. The clinician judges this on the basis of the
patient's age and other life circumstances that may affect sexual
functioning.
This behavior causes marked distress or interpersonal problems.
Except for another Sexual
Dysfunction.
It is not directly caused by substance use (medication or drug of
abuse) or by a general medical condition.
Associated
Features:
Physical illnesses when they produce fatigue, pain .
Hormone deficiencies may occasionally be implicated.
Stress.
Insomnia
or inadequate amounts of sleep, resulting in fatigue.
Pain with intercourse, for women.
Erection problems.
Retarded Ejaculation.
Differential
Diagnosis
Some disorders have similar or even the same symptoms. The clinician,
therefore, in his/her diagnostic attempt, has to differentiate against
the following disorders which need to be ruled out to establish a
precise diagnosis.
Depression
Cause:
This
disorder can be present in adolescents and can persist throughout
a person's life. Many times, however, the lowered sexual desire occurs
during adulthood, often times following a period of stress.
Interestingly, patients with a general dislike of sexual activity
(hypoactive desire or aversion), at least with their current partner,
can effectively use an injury to justify avoidance of sexual contact.
Treatment:
Treatment of HSDD will depend in some part on the duration of the
problem and its causes. If it is the result of attitudes and experiences
of a long-standing nature, changing how patients think and feel about
the problem and their sexuality is crutial.
Sex therapy may
not be the best referral in some circumstances, especially if the
relationship between the sufferer and partner has frequent have angry
disagreements. Some couples just aren’t sexually attracted to
each other, leading to HSDD in one or both. They find it difficult
to tell each other about the lack of attraction. In all of these cases,
referral to a psychotherapist for couples counseling is the treatment
of choice. Treatment must be individualized to the factors that may
be inhibiting sexual interest. Often, there may be several such factors.
Some couples will need relationship enhancement work or marital therapy
prior to focusing directly on enhancing sexual activity. Declining
sex is sometimes one of the few areas where someone who feels dominated
in most other areas of a marriage may still exert control. Many couples
will need direct focus on the sexual relationship wherein through
education and couple assignments they expand the variety and time
devoted to sexual activity. Some couples will also need to focus on
how they may sexually approach their partner in more interesting and
desirable ways, and in how to more gently and tactfully decline a
sexual invitation. When problems with sexual arousal or performance
are factors in decreasing libido, these sexual dysfunctions will need
to be directly addressed.
Pharmacotherapy
[ See Psychopharmacology
Section ] :
Testosterone supplementation for men.
|
|
