Understanding hypoactive sexual desire disorder

Laura Dean-Osgood

Hyposexual desire disorder is an often misunderstood condition. We're myth-busting inhibited sexual desire. 

What is hyposexual desire disorder?

Hyposexual desire disorder

Hypoactive Sexual Desire Disorder (HSDD) is a condition that’s marked by a lack of sexual desire, interest or fantasy over a length of time. For a person with HSDD, an absence of sexual desires or fantasy will cause significant distress, and for this reason it is distinct from a low sex drive alone.

Symptoms can include a reduced or absent desire for sex, few or no sexual thoughts, no interest in initiating sexual contact or reduced pleasure of sexual intimacy.

For a doctor to diagnose HSDD, symptoms will have been present for at least six months, not explained by another medical condition. HSDD affects both sexes, though it is more common in women and can impact on quality of life, relationships and self-esteem.

HSDD is also known as inhibited sexual desire (ISD).


Why does it happen?

There’s no clear cause of HSDD, and it’s more likely that causes are individual to the person. They can be psychological, hormonal, environmental and social.

HSDD has been linked to lowered levels of testosterone, which can reduce sex drive in men and women, as well reduce the perception of pleasure, reduce sexual motivation and increase fatigue.

Low levels of estrogen have also been linked, which correlates with levels of HSDD in women around their menopause, when levels of this hormone fall. 

Medications can also affect sexual desire.

Some drugs, for example certain antidepressants, can also lower not only sexual desire, but an ability to orgasm. Other causes could be relationship problems, significant life events and sexual abuse.


How can it be treated?

Sex therapy

Because of the various factors at play in HSDD it can be difficult to assess and therefore to treat. Assessment should take into account factors including health, sexual context, relationship issues and messages from family or religious upbringings.

Where a hormonal imbalance is identified, there are some drug treatments available. Where no hormone deficiency is found the primary goal is to address psychological causes and the choice of therapy will be dependent on this.

Psychological treatments include sex therapy, which can look at personal types of sexual desire, levels of anxiety related to sex and looking at relationships. Cognitive therapies and counseling may also be appropriate.


How can I support someone who has HSDD?

Patience, understanding and support are essential when it comes to supporting someone with HSDD.

It is important to remember that the person who has HSDD is distressed and that they would like to get better. 


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