HSDD Hypoactive sexual desire disorder (HSDD) refers to a woman’s chronic or ongoing lack of interest in sex, to the point that it may cause personal distress or problems in relationships.
It’s normal for women to lose interest in sex from time to time. A woman’s libido can fluctuate throughout her life. It might be high when she’s feeling good about her relationship or if she’s excited about a new one. It might decrease when she’s under emotional stress or dealing with hormonal changes from pregnancy or menopause.
If a woman does not feel concerned about her sex drive, then she may not have HSDD.
According to the Society for Women’s Health Research, HSDD is the most common female sexual dysfunction and affects about 1 in 10 women. It can happen at any age. The Mayo Clinic notes that as many as 40% of women have HSDD at some point in their lives, according to some studies. 5% to 15% of women have the problem continuously.
HSDD can be frustrating for a woman and her partner but it’s a treatable condition. Even though it might take some time to discover what’s causing it, a woman with HSDD can return to a satisfying sex life.
HSDD is a complicated disorder with a number of possible causes. Sometimes, several underlying conditions contribute to HSDD all at once. There can be physical causes, such as hormonal fluctuations or surgery that changes a woman’s body image. There can also be psychological and emotional causes. Many women associate a positive emotional connection with their partner with pleasurable sex, so negative changes in a relationship can trigger a lack of interest.
Many illnesses, such as diabetes, cancer, arthritis, and coronary artery disease, can weaken a woman’s sex drive. Similarly, many medications, like those taken for depression and high blood pressure, can decrease her libido. Even fatigue can take its toll. A woman may just be too exhausted to want sex.
Women may experience lower sex drive during menopause, when levels of estrogen – a hormone that boosts libido – fall substantially. Women can also see testosterone levels drop during menopause. Testosterone is usually associated with a man’s sex drive, but it affects women, too.
Also, hormonal changes during and after pregnancy can make a woman less interested in sex.
Psychological and Emotional Conditions
A number of psychological and emotional factors can affect a woman’s sex drive. She may have anxiety, depression, or poor self-esteem. She might be under a lot of stress. Or, she might be a victim of physical abuse, sexual abuse, or rape.
Problems in her relationship can also be a factor. If her partner has been unfaithful or deceitful, her lack of trust may make her less interested in sex. Low sex drive might result if she and her partner don’t communicate well or haven’t resolved a fight. She and her partner might not have satisfactory sex to begin with because they don’t talk about their needs or what they like in the bed.room They might not know how to talk about it or are too embarrassed to do so. That can fuel low libido, too.
The main symptom of HSDD is a lack of interest in sex. But because every woman is different, there is no official threshold or diagnostic test that tells whether a woman has HSDD or not. Rather, diagnosis depends on how distressed she is about her low sex drive and whether it’s causing any problems for her.
However, if a woman does express concerns about low libido, doctors will usually try to pinpoint any underlying causes. Often started by looking for related physical causes and do a complete medical workup, including a medical history, screening tests, and pelvic/clitoris exam.
Doctors might also refer women to a counselor or sex therapist to see whether there are emotional or relationship issues that need attention.
There are many ways to treat HSDD. Just as a combination of factors can cause the disorder, a combination of treatments can be beneficial.
Treatments for the physical causes depend on the individual. For example, changes in medication or diabetes control may be in order. A woman might need to make some lifestyle changes to combat stress and fatigue.
Some women may also benefit from counseling or sex therapy. Specialists can help them cope with any past sexual trauma. They can help women improve their self-esteem and understand their relationships with their partners. Women can learn how to talk about sex with confidence and express their needs and concerns to their partners. They might also introduce ways to make intimacy a bigger priority – and more interesting.
Some women find estrogen therapy helpful. Estrogen is sex hormone that affects libido, among other functions. It can be administered with a pill or through the skin with a patch or gel. This type of therapy, called systemic estrogen therapy, helps the brain make its needed chemical connections to increase desire. Local estrogen therapy can be applied through a vaginal cream or ring. This increases blood flow to the vagina and stimulates arousal.
In some cases, doctors prescribe a combination of estrogen and progesterone to women with HSDD.
Testosterone is another hormone that affects the sex drives of both men and women. However, testosterone therapy is currently not FDA approved for women in the United States. Studies have shown that side effects like extra hair growth or hair loss, acne, liver problems, and enlargement of the clitoris are possible.
Did you know that hypoactive sexual desire disorder (HSDD) affects about 1 in 10 women?
It’s the most common of female sexual dysfunctions, but it’s underdiagnosed and undertreated. Many practitioners aren’t sure of how to approach it with their patients. Some clinicians feel uncomfortable discussing sex. Others feel that they don’t have the expertise to handle HSDD complaints or that discussing sexual health will take up too much time during the office visit.
However, sexual health is important to overall general health.
Unfortunately, female patients are often just as – or even more – reluctant to bring up the subject. Many women are brought up to believe that “nice girls” aren’t supposed to want to have sex or that their sexual needs aren’t important. Some believe, or fear, that it’s all in their heads.
Also, many women simply don’t know about HSDD and that it’s a treatable condition. A recent survey conducted by the Society for Women’s Health Research showed that women were 7 times more familiar with erectile dysfunction in men (ED) than with HSDD. 66% of the women surveyed knew about ED, but only 9% knew about HSDD.
Treatment options are available.
At DOSH, We are here for you when you’re ready for us.
Department of Sexual Health