Hypoactive Sexual Desire Disorder in Women: Physiology, Assessment, Diagnosis, and Treatment
- PMID: 34510696
- PMCID: PMC8673442
- DOI: 10.1111/jmwh.13283
Hypoactive Sexual Desire Disorder in Women: Physiology, Assessment, Diagnosis, and Treatment
Abstract
Nearly half of women in the United States report problems with sexual function. Many health care providers do not ask about sexual concerns during routine clinical encounters because of personal discomfort, lack of familiarity with treatment, or the belief that they lack adequate time to address this complex issue. This may be especially true for hypoactive sexual desire disorder (HSDD), the most commonly identified sexual problem among women. HSDD is characterized by a deficiency of sexual thoughts, feelings, or receptiveness to sexual stimulation that has been present for at least 6 months, causes personal distress, and is not due to another medical condition. This is an up-to-date overview of HSDD for clinicians, discussing its physiology, assessment, diagnosis, and treatment strategies. Although a definitive physiology of HSDD is still unknown, multiple hormones and neurotransmitters likely participate in a dual-control model to balance excitation and inhibition of sexual desire. For assessment and diagnosis, validated screening tools are discussed, and the importance of a biopsychosocial assessment is emphasized, with guidance on how this can be implemented in clinical encounters. The 2 recently approved medications for HSDD, flibanserin and bremelanotide, are reviewed as well as off-label treatments. Overall, HSDD represents a common yet likely underrecognized disorder that midwives and other health care providers who care for women across the life span are in a unique position to address.
Keywords: hypoactive sexual desire disorder; libido; sexual desire; sexual dysfunction; women's health.
© 2021 by the American College of Nurse-Midwives.
Conflict of interest statement
Conflict of Interest: The authors have no relevant conflicts of interests to disclose.
Figures
Similar articles
-
Female Hypoactive Sexual Desire Disorder: A Practical Guide to Causes, Clinical Diagnosis, and Treatment.J Womens Health (Larchmt). 2020 Aug;29(8):1101-1112. doi: 10.1089/jwh.2019.7865. Epub 2020 May 27. J Womens Health (Larchmt). 2020. PMID: 32460605
-
The International Society for the Study of Women's Sexual Health Process of Care for Management of Hypoactive Sexual Desire Disorder in Women.Mayo Clin Proc. 2018 Apr;93(4):467-487. doi: 10.1016/j.mayocp.2017.11.002. Epub 2018 Mar 12. Mayo Clin Proc. 2018. PMID: 29545008 Review.
-
Hypoactive Sexual Desire Disorder: A Review of Epidemiology, Biopsychology, Diagnosis, and Treatment.Sex Med Rev. 2016 Apr;4(2):103-120. doi: 10.1016/j.sxmr.2015.11.009. Epub 2016 Feb 6. Sex Med Rev. 2016. PMID: 27872021 Review.
-
Hypoactive Sexual Desire Disorder: International Society for the Study of Women's Sexual Health (ISSWSH) Expert Consensus Panel Review.Mayo Clin Proc. 2017 Jan;92(1):114-128. doi: 10.1016/j.mayocp.2016.09.018. Epub 2016 Dec 1. Mayo Clin Proc. 2017. PMID: 27916394 Review.
-
Pharmacotherapy of Hypoactive Sexual Desire Disorder in Premenopausal Women.Ann Pharmacother. 2024 May 20:10600280241253273. doi: 10.1177/10600280241253273. Online ahead of print. Ann Pharmacother. 2024. PMID: 38767282 Review.
Cited by
-
Self-Perception of Sexual Dysfunction of Adult Brazilian Women of Reproductive Age: A Cross-Sectional Study.J Multidiscip Healthc. 2024 May 7;17:2165-2173. doi: 10.2147/JMDH.S442074. eCollection 2024. J Multidiscip Healthc. 2024. PMID: 38736543 Free PMC article.
-
Understanding Hypoactive Sexual Desire Disorder (HSDD) in Women: Etiology, Diagnosis, and Treatment.Cureus. 2023 Nov 30;15(11):e49690. doi: 10.7759/cureus.49690. eCollection 2023 Nov. Cureus. 2023. PMID: 38161863 Free PMC article. Review.
References
-
- Bitzer J, Giraldi A, Pfaus J. A standardized diagnostic interview for hypoactive sexual desire disorder in women: standard operating procedure (SOP Part 2). J Sex Med. 2013;10(1):50–57. - PubMed
-
- Shifren JL, Monz BU, Russo PA, Segreti A, Johannes CB. Sexual problems and distress in United States women: prevalence and correlates. Obstet Gynecol. 2008;112(5):970–978. - PubMed
-
- Hayes RD, Bennett CM, Fairley CK, Dennerstein L. What can Prevalence Studies Tell Us about Female Sexual Difficulty and Dysfunction? The Journal of Sexual Medicine. 2006;3(4):589–595. - PubMed
-
- Clayton AH, Goldstein I, Kim NN, et al. The International Society for the Study of Women’s Sexual Health Process of Care for Management of Hypoactive Sexual Desire Disorder in Women. Mayo Clinic Proceedings. 2018;93(4):467–487. - PubMed
-
- Hayes RD, Dennerstein L, Bennett CM, Koochaki PE, Leiblum SR, Graziottin A. Relationship between hypoactive sexual desire disorder and aging. Fertility and Sterility. 2007;87(1):107–112. - PubMed
Publication types
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Medical