Sexual Desire Disorder

Hypoactive sexual desire disorder is marked by a substantial lack of interest in maintaining or engaging in sexual relationships or activities. Not all cases of hypoactive sexual desires are problematic, but in some cases extremely low libido can affect the quality of life and integrity of relationships.It is imperative to keep in mind that sexual desire disorders are usually ignored or overlooked by individuals. According to a study reported by Gingell and associates, the prevalence of sexual desire disorders is fairly high in females (i.e. up to 43%). The prevalence in males is about 13% to 28% (1).

Here are some interesting facts about the hypoactive sexual desire disorder in females:

• It is estimated that approximately 40% females develop a dislike towards sex at some point in their lives. It does not always lead to personal issues and sexual disorder in single females.
• Almost 12 females and 5% males require medical or psychological help to address the hypoactive sexual desire disorders.
• Females in menopausal age group are twice as likely to experience hypoactive sexual desires (possibly due to hormonal influence).

The clue lies in the way females approach sexuality. HSDD can be psychological or physical. The spectrum of sexual desire in females is always an end product of these two entities; such as physical health and quality of the relationship. The same approach dictates that sometimes cultural norms and traditions can also lead to sexual dormancy in females. Additionally, female sexual desires are more responsive to the changes in the serum level of hormones and for obvious reasons, hormonal fluctuations are more common in women.

Risk Factors for Hypoactive Sexual Desire Disorder

Some common risk factors that are usually associated with hypoactive sexual desire disorders are:

• Serum Level of Sexual Hormones: Menopausal, middle aged female population is more prone to develop HSDD. Likewise, males with lower testosterone levels also admits to poor sexual drive.
• Being in an Active Relationship: Most patients of HSDD who reports to the clinical setting for management or treatment are in active relationships and demand help mainly because their partner is in trouble.
• Emotional or Mental Health Issues: The umbrella term include all mental health issues that may compromise libido or sexual desires. This include; generalized stress disorder, panic disorder, sexual miscommunication, sense of low-esteem, poor image of self, confusion regarding sexuality or sexual orientation and clinical depression.
• Physical Health Issues: Chronic, disabling and debilitating diseases affects the mood, stamina and energy levels and can aggravates the risk of sexual desire disorders. These include uncontrolled diabetes, heart disease, arthritis and hypothyroidism.
• Medications: A number of pharmacological prescription medications can affect sexual vigor of an individual; such as chemotherapy, anti-depressants, anti-hypertensive medications, insulin and hypoglycemic, codeine etc.

Treatment Options for Hypoactive Sexual Desire Disorder

It is strongly advised to discuss your concerns and issues with your partner at first. In certain cases, where marital discord or poor communication is the cause of hypoactive sexual desires, an honest conversation can work wonders for troubled couples. Additionally, you can always consult a professional therapist or counsellor to learn more about the therapeutic options. A physician may also be consulted to rule out underlying medical condition.Most popular treatment modalities are:

• Professional couple counselling for sex.
• Addressing underlying medical condition.
• Hormone replacement therapy: Hormone augmentation along with low-dose testosterone balancing therapy for women and testosterone enhancement in males is one of the most reliable methods of enhancing the sex drive.
• Medication: Dose adjustment or switching medications that are causing sexual dysfunction also helps a great deal in addressing this issue. Moreover, pharmacological agents for the management of medical conditions like Parkinson’s is known to improve the sex desire. Levodopa, an anti-Parkinson drug, improves sexual synergy by increasing the levels of Dopamine neurotransmitter.
• Women with menopause or surgical excision of ovaries are very responsive to testosterone (administered via dermal patch). Although their efficacy and safety is questionable if used over a long period of time, but according to a new study reported in the Archives of Internal Medicine (4) lose dose testosterone (or 300-μg/d) is safe and effective in post-menopausal women. Besides, testosterone is also known to improve bone health and manage osteoporosis in high risk group.
• Two new anti-depressants agents – fibanserin and bupropion(5) are being tested for FDA approval as a therapeutic option for HSDD in pre-menopausal population.

Regardless of the treatment modality, individuals should be encouraged to seek professional assistance for the early resolution of their symptoms.References:

1. West, S. L., D’Aloisio, A. A., Agans, R. P., Kalsbeek, W. D., Borisov, N. N., & Thorp, J. M. (2008). Prevalence of low sexual desire and hypoactive sexual desire disorder in a nationally representative sample of US women. Archives of Internal Medicine, 168(13), 1441-1449.
2. Shifren, J. L., Monz, B. U., Russo, P. A., Segreti, A., & Johannes, C. B. (2008). Sexual problems and distress in United States women: prevalence and correlates. Obstetrics & Gynecology, 112(5), 970-978.
3. Beck, J. G. (1995). Hypoactive sexual desire disorder: an overview. Journal of consulting and clinical psychology, 63(6), 919.
4. Braunstein, G. D., Sundwall, D. A., Katz, M., Shifren, J. L., Buster, J. E., Simon, J. A., ... & Watts, N. B. (2005). Safety and efficacy of a testosterone patch for the treatment of hypoactive sexual desire disorder in surgically menopausal women: a randomized, placebo-controlled trial. Archives of Internal Medicine, 165(14), 1582-1589.
5. Segraves, R. T., Clayton, A., Croft, H., Wolf, A., & Warnock, J. (2004). Bupropion sustained release for the treatment of hypoactive sexual desire disorder in premenopausal women. Journal of clinical psychopharmacology, 24(3), 339-342.