When it comes to sex, there's no such thing as "normal." There's only what's normal for you. Sometimes, a person can experience such low sexual drive that it interferes with their ability to enjoy life. In that case, that person might have a condition called HSDD, or hypoactive sexual desire disorder.
What Is HSDD?
HSDD is a type of sexual dysfunction. It's characterized by a lack of sexual desire and receptivity to sexual activity. Now, some people aren't interested in sex much or at all and are perfectly content with that. HSDD differs from low libido because it causes distress to the affected person. The resulting distress happens most often in the form of relationship difficulties. Men and women can both be affected by HSDD, but it is seen most often in women.
Symptoms of HSDD
- Little or no interest in sexual activity
- Little or no erotic thoughts or fantasies
- No response to sexual stimulation
- Loss of interest in initiating sex
- Loss of interest in masturbation
- Concern over one's own lack of interest in sex
What Causes HSDD?
The direct cause of HSDD is currently unknown. However, researchers have identified factors that can contribute to a low libido, which is the main symptom of HSDD. Psychological problems and hormone imbalances can cause low sexual desire in both men and women. Also, certain conditions like cancer, diabetes, or incontinence can result in low sexual desire. In these cases, the patient's low libido is likely a symptom of their pre-existing condition rather than true HSDD.
How Is HSDD Diagnosed?
HSDD can affect both men and women. In the updated DSM-5, HSDD was further split into male HSDD and female HSDD, as studies have shown variations in the condition based on the patient's gender.
Most doctors will assess a patient's level of sexual desire by administering the Decreased Sexual Desire Screener (DSDS). The DSDS is a diagnostic questionnaire that assesses whether or not a person has HSDD. The questionnaire consists of four questions covering the patient's sexual health. Patients must answer "yes" to all questions to receive an HSDD diagnosis. If they are suspected of having HSDD, they may also have to identify their stress level, life changes, or any physical conditions to help the doctor find the right diagnosis.
How Is HSDD Treated?
After diagnosis, doctors will use data from the DSDS to determine the severity of the patient's case. Any accompanying physical conditions, such as depression or incontinence, will be addressed and treated. Then, the patient may consider one of the following two options:
Therapy can help people with the psychological or sexual aspect of having HSDD. Sex therapy can educate the patient on having realistic perceptions of sex. Psychological counseling can include stress management, learning communication skills, and more, depending on the patient's needs. Because HSDD often results in relationship problems, couple's therapy may help as well.
Flibanserin, which is marketed under the brand name Addyi, is the first drug approved by the FDA to treat HSDD in pre-menopausal women. Presently, Addyi is also the only treatment for HSDD that is non-hormonal and comes in pill form. This pill is typically taken once a day and works by rebalancing the hormones in the brain responsible for sexual motivation. Addyi can also be prescribed to pre-menopausal women experiencing low libido as a side effect of antidepressants.
HSDD occurs in one out of ten women. It also happens to be the most under-diagnosed conditions among women. Luckily, it's treatable, and solutions exist for both men and women. If you find that your life is significantly less enjoyable because of your low libido, you should know that there's help available. Make an appointment with a certified professional to see what treatment options are available to you.