If you have little interest in sex, and it’s causing distress in your life, you may have hypoactive sexual desire disorder. Learn about treatment options for this sex disorder.
Medically Reviewed by Pat F. Bass III, MD, MPH
Just because you aren’t interested in sex doesn’t mean you are sexually dysfunctional. However, if your disinterest is causing distress in your life, then you may be diagnosed with hypoactive sexual desire disorder (HSDD).
An estimated 30 to 39 percent of women in any given population will report little or no interest in sex at any given time in their lives. This may not cause personal problems or constitute a sex disorder, especially if the woman is single and not actively engaged with a partner.
When a lingering lack of desire, however, is coupled with distress, which is believed to be the case in about 12 percent of women and a roughly estimated 5 percent of men — and if other issues, such as an abusive partner are ruled out — then HSDD may be diagnosed.
Although “lack of sexual fantasy” used to be included in the official HSDD definitions, this is no longer universally used as a determinant of healthy sexuality; not all sexually healthy adults fantasize.
“Some people don’t want to have sex. If it’s not causing distress, it’s not dysfunction,” says sexual dysfunction expert Raymond C. Rosen, PhD, chief scientist at the New England Research Institutes in Watertown, Mass., formerly chief psychologist and associate faculty dean at Robert Wood Johnson Medical School and Rutgers University in New Jersey. “The most important clinical determinant for HSDD in women is when the woman is unreceptive. She has a good relationship. She likes her partner. But she’s not able to respond to overtures. She says, ‘I feel nothing. I feel numb. I feel empty.’”
Because of the personal nature of sexual desire, HSDD can be difficult to track, quantify, and treat. Studies do consistently show that HSDD can affect both women and men. Prevalence within the male population is less studied, but some researchers believe women may be at least twice as likely to have HSDD, which is why much of the research is pointed at women.
Why Do More Women Have Hypoactive Sexual Desire Disorder?
Some researchers believe the greater number of female HSDD cases may be related to the way most women approach sexuality: hypoactive sexual desire disorder can be psychologically, as well as physically, based. A woman’s desire for sex is often predicted by a greater number of factors in both realms working together — including relationship satisfaction and health, personal and partner well-being, and physical and emotional responses to lovemaking.
The same researchers speculate that sexual disinterest among some women may be related to sexual inhibition, conditioned in women by longstanding cultural tradition. In addition, they suggest that a lack of sexual desire in some women may not constitute a disorder at all, but rather may be a natural protective mechanism against having too many children, which has evolved over time. The theory is that if conditions are not favorable to have a child, the woman would be uninterested in sex.
Risk Factors for Hypoactive Sexual Desire Disorder
Besides being female, other risk factors for HSDD include:
- Hormones. Hormone and other changes during menopause can make HSDD more prevalent for middle-aged, post-menopausal women than for younger, pre-menopausal women. Men can also experience hormonal changes, specifically low testosterone levels that can interfere with sexual desire
- Being in an active relationship. Most people living with HSDD who seek help are in a relationship. Sometimes a man or woman will seek help at the request of his or her partner. Nine out of 10 women who seek help do so because their partner is in distress.
- Emotional or mental health issues. This can include partner dissatisfaction, sexual communication and sexual performance issues, general life stress, and such potentially complicated psychological problems as body image issues and depression.
- Physical health conditions. These can include diabetes, arthritis, heart disease, hypothyroidism, and menopause.
- Medications. Certain pharmaceuticals can interfere with sexual function, including morphine, codeine, chemotherapy drugs, and some psychoactive drugs.
Treatment Options for Hypoactive Sexual Desire Disorder
Sometimes just having a frank conversation with your partner can solve your HSDD. You also may choose to talk with your doctor, who may ask you about your relationship history and about past psychological issues related to your sexuality. Your doctor may also look for underlying medical conditions. You may ultimately be helped by:
- Individual or couples sex therapy.
- Treatment of an underlying medical condition.
- Hormone therapy. Hormone balancing therapy for women and testosteronesupplementation for some men with low testosterone levels can increase sexual desire.
- Adding or changing medication. Sometimes the problem of HSDD can be solved simply by changing medications, from an older psychoactive drug that interferes with sexual desire, for example, to one of the newer drugs with fewer side effects. The addition of some drugs for underlying conditions — such as Levodopa used to treat Parkinson’s disease — has been found to help with male sexual desire, for example, by increasing production of the neurostransmitter dopamine.
Additionally, researchers are studying the safety and efficacy of a number of medical treatment options. These include a testosterone patch for women, which has proven particularly helpful after menopause or the surgical removal of ovaries — where much of a woman’s testosterone is produced. Two antidepressants, flibanserin and bupropion, are among the drugs being studied in the treatment of pre-menopausal women.
Whichever treatment option you choose, whether you choose to enter couples counseling, or whether you are holding out hope for new therapies on the horizon, you do not have to suffer silently with a sex disorder. Ask your doctor for help, or have a frank discussion with your partner today.
Learn more in the Everyday Health Sexual Health Center.