FREQUENTLY ASKED QUESTIONS
The most frequently asked questions healthcare professionals have about hypoactive sexual desire disorder (HSDD)
HSDD is the persistent or recurrent deficiency or absence of spontaneous desire (including sexual thoughts, fantasies, stimulation) and desire to initiate or participate in sexual activity. Clinically significant personal distress is also central to the diagnosis of HSDD.1,2
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First introduced in the DSM in 1980, HSDD has been a recognized medical condition for almost 4 decades. Approximately 1 in 10 premenopausal women in the United States are living with HSDD.3-5
Learn more about the impactHSDD is prevalent among women at all reproductive stages, whether premenopausal, menopausal, or postmenopausal. This suggests that it’s not about reproductive hormones, it’s about neurotransmitters and other hormones.4,6,7
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HSDD can be classified based on context—when HSDD is situational, the problem is limited to certain types of stimulation, situations, or partners.8
Learn more about HSDD classificationHSDD is not caused by hormonal differences. Women with HSDD have normal hormone levels and menstrual cycles with elevations in estrogen and testosterone at ovulation.4,9
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There are different types of female sexual dysfunction (FSD), including hypoactive sexual desire disorder (HSDD), diminished sexual arousal, orgasmic difficulties, and dyspareunia. The inclusion of low sexual desire and clinically significant personal distress as part of the diagnostic criteria differentiates HSDD from other FSD.2,4,5
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Talking to your patients about their low sexual desire and associated distress may take less time than you realize. Ask her open-ended questions about her desire, and invite her to tell you more.10,11
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References
References: 1. McCabe MP, Sharlip ID, Atalla E, et al. Definitions of sexual dysfunctions in women and men: a consensus statement from the Fourth International Consultation on Sexual Medicine 2015. J Sex Med. 2016;13(2):135-143. 2. Parish SJ, Goldstein AT, Goldstein SW, et al. Toward a more evidence‐based nosology and nomenclature for female sexual dysfunctions—part II. J Sex Med. 2016;13(12):1888-1906. 3. Brotto LA. The DSM diagnostic criteria for hypoactive sexual desire disorder in women. Arch Sex Behav. 2010;39(2):221-239. 4. Goldstein I, Kim NN, Clayton AH, et al. Hypoactive sexual desire disorder: International Society for the Study of Women’s Sexual Health (ISSWSH) expert consensus panel review. Mayo Clin Proc. 2017;92(1):114-128. 5. 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. 6. Leiblum SR, Koochaki PE, Rodenberg CA, Barton IP, Rosen RC. Hypoactive sexual desire disorder in postmenopausal women: US results from the Women’s International Study of Health and Sexuality (WISHeS). Menopause. 2006;13(1):46-56. 7. Clayton AH, Hamilton DV. Female sexual dysfunction. Obstet Gynecol Clin North Am. 2009;36(4):861-876. 8. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994;494. 9. Pfaus JG, Jones SL, Flanagan-Cato LM, Blaustein JD. Female sexual behavior. In: Plant T, Zeleznik A, eds. Knobil and Neill’s Physiology of Reproduction. 4th ed. New York, NY: Elsevier; 2015:2287-2370. 10. Clayton AH, Goldfischer ER, Goldstein I, DeRogatis L, Lewis-D’Agostino DJ, Pyke R. Validation of the decreased sexual desire screener (DSDS): a brief diagnostic instrument for generalized acquired female hypoactive sexual desire disorder (HSDD). J Sex Med. 2009;6(3):730-738. 11. Parish SJ, Hahn SR. Hypoactive sexual desire disorder: A review of epidemiology, biopsychology, diagnosis, and treatment. Sex Med Rev. 2016;4(2):103-120.