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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.
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.



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 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.

Counseling and Psychotherapy [ See Therapy Section ]:

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.


DSM Code

302.71 Hypoactive Sexual Desire Disorder

F52.0 Hypoactive Sexual Desire Disorder

Disorder Sheets

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Recommended Book

The Sexual Desire Disorders: Dysfunctional Regulation of Sexual Motivation - Click Here to View


Hypoactive Sexual Desire Disorder

Misc Information


Sexual Dysfunctions