HSDD Has Many Common Causes

Hypoactive Sexual Desire Disorder is a medical term that describes when a person stops thinking about and loses interest in sexual activity for six months or longer and feels distress over their situation. Although the acronym HSDD is most commonly associated with female sexual dysfunction in news stories and medical research studies, the term can actually apply to females or males who have lost sexual desire. Confusion exists because the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders breaks the disorder into two confusing gender-focused terms: Female Sexual Arousal Disorder and Male Hypoactive Sexual Desire Disorder. Many doctors use only HSDD when discussing this disorder with patients because the terms and the current descriptions fail to adequately address symptom discrepancies, imply that FSAD is only about arousal and reflect gender bias. HSDD is sometimes also referred to as Inhibited Sexual Desire because of a previous DSM designation.

Causes of HSDD

HSDD occurs for a wide range of mental and physical reasons. Anyone might have low sexual desire and/or difficulty feeling aroused for a lengthy period of time because they're overwhelmed by home and work responsibilities or relationship trust issues and difficulties. 

Certain types of local, national and international news and emergencies, such as a man-made or natural catastrophes, major life events and sudden financial difficulties, can cause a person to dwell on their fears and worries so much that they're unable to feel or think about anything else. 

People who have low self-esteem, depression or anxiety often lack a libido. If a person takes antidepressants, they're at an increased risk of having HSDD. In fact, one of the major side effects of certain types of medications and surgeries is sexual inhibition. Sexual abuse and assault victims often experience HSDD. Fear of accidental pregnancy can cause the symptoms of this disorder as well.

Physical pain can cause HSDD symptoms. For example, a woman with a tilted uterus or a partner who fails to prepare them enough for intimacy might become disinterested in intercourse. HSDD can also be a problem for people who experience extreme or recurrent fatigue and/or pain caused by an acute illness or a chronic condition like arthritis or fibromyalgia. Certain circulation disorder conditions, such as diabetes and coronary artery disease, reduce sexual interest by adversely affecting blood flow to the brain, genitals and other organs involved in the sexual act. 

Some people experience HSDD after their hormone levels become imbalanced, as seen with a thyroid problem or reduction of certain hormones like estrogen in women as they age. Women also often experience HSDD because of a hormonal shift after a hysterectomy or pregnancy. Nutritional deficiencies can impact the body in a similar fashion. Other causes of HSDD include infections, tumors, cancer and over-consumption of alcohol.

Symptoms of HSDD

HSDD patients have little interest in sexual acvity or no interest whatsoever. They might state that they have failed to experience sexual thoughts and/or physical stimulation for a long time or explain that they no longer feel pleasure when performing sexual acts. HSDD patients usually have difficulties with performance since they don't desire sexual activity. HSDD sufferers are very unlikely to initiate intimacy. Someone with HSDD might feel distress because they previously had desire and then it started to taper off. Conversely, they might actually feel okay about their mental and physical state overall, but experience distress because they're unable to sexually please their partner any longer or their partner has started to feel distress as the result of their disinterest. Doctors can have difficulty determining if a patient has HSDD because some people naturally have no sexual desire. Many doctors refuse to diagnose a patient with HSDD unless the patient experiences distress. Of course, doctors make certain to confirm whether a non-distressed patient has an underlying condition that might have altered their mood and ability to care.

Treatment of HSDD

HSDD treatment involves targeting the root cause or causes of the disorder. A family physician might recommend singular or couples counseling to a patient. A counselor might recommend stress reduction strategies and offer advice about how to cope with stress. They might also advise an HSDD patient to practice avoidance strategies: For example, they might tell a patient to stop watching sad or horrifying news or stay away from people who make them feel emotionally worn out. A relationship counselor might advise a couple to talk more or try new things. If there's a current abusive component, a counselor usually does whatever they can to help the patient move away from their abuser. 

With treatable physical causes, a doctor might prescribe therapies related to a specific condition, such as hormone and nutritional therapies. They might transition the patient to a different medication that doesn't have HSDD as a side effect. Lastly, they might talk to a patient about lifestyle changes to improve mood and energy, such as maintaining regular sleep and exercise schedules.

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