Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 10/03/2020
While it’s normal to have moments in which you just don’t feel “in the mood,” a persistently low sex drive is often a sign that your body isn’t working the way it should.
Hypoactive sexual desire disorder (HSDD), also widely known as female sexual interest/arousal disorder, is a type of sexual dysfunction that causes a low or absent sex drive in women.
It’s a fairly common dysfunction, affecting about one in every 10 women. It’s also a dysfunction that’s easy to pass off as a normal effect of feeling tired and stressed, or simply as a side effect of the aging process.
The reality is that HSDD is a real, clinically recognized sexual dysfunction. It’s a dysfunction that can have serious effects on your life, affecting everything from your ability to maintain a normal, healthy sexual relationship to your overall well being.
Luckily, HSDD is treatable. Below, we’ve covered everything you need to know about hypoactive sexual desire disorder, from the most common symptoms to causes, as well as the most popular and effective treatments available for restoring your sex drive.
Hypoactive sexual desire disorder, or HSDD, is a persistent lack of sexual interest, that causes distress or interpersonal difficulty and is not related to medication use, or a medical or mental health condition. While it’s far from abnormal to have days (or even weeks) in which you have little to no interest in sex, HSDD is defined as a lack of sexual desire that lasts for longer than six month, with accompanying distress.
Unlike simply not feeling in the mood, HSDD involves a very low or completely absent sex drive that doesn’t go away on its own. Because of this, HSDD can have major effects on your ability to maintain a relationship, feel self-confident and enjoy a fulfilling sex life.
There are several main symptoms of HSDD. The first is a total lack of interest, or very limited level of interest, in sex. The second is an absence of sexual thoughts and dreams, from quick, drifting sex-related thoughts to more detailed sexual dreams and fantasies.
If you have HSDD, you might not completely avoid sexual activity. If your partner initiates sex, you might take part. However, people with HSDD usually experience some level of difficulty in enjoying sexual activity as much as they normally would.
Sometimes, HSDD involves all of the above symptoms. In other cases, it only involves one or two. The severity of HSDD can vary massively from one person to another — while one person might have no sex drive at all, you might only experience a mild interest in sexual activity.
HSDD can be caused by a physical factor, such as diabetes or a drop in your body’s production of specific hormones. It can also be the result of an emotional event or disorder, such as anxiety or depression.
Anxiety and depression are associated with an increased likelihood of sexual dysfunction. You can also begin to lose sexual interest due to a traumatic or difficult event with your partner, such as a violation of your trust.
It’s also possible for past sexual abuse or trauma to affect your level of sexual interest. HSDD is often caused by a combination of emotional factors, with each factor affecting your sex drive in its own way.
Often, the medications used to treat anxiety, depression and other psychological disorders can cause or worsen HSDD.
HSDD can also be caused by physical factors. The most likely physical factors that can cause you to develop HSDD include:
Diabetes. Studies show that people with diabetes are more likely to develop HSDD than their peers, with up to 71 percent of women diagnosed with diabetes also reporting some level of sexual dysfunction.
Heart disease. Coronary artery disease and sexual dysfunction are linked in men and women, with heart disease potentially affecting sexual desire, performance and general sexual wellbeing.
Hormonal health. Changes in your body’s production of testosterone and estrogen can affect your sex drive. Androgen and estrogen hormones are both used off-label to treat HSDD in women, often in response to lower-than-normal production by your body.
Medication. Certain medications can affect your level of sexual interest, as well as the level of enjoyment you feel from sexual activity.
Fatigue. Extreme tiredness, fatigue and exhaustion, whether from your professional or personal life, can affect your sex drive.
Healthcare providers diagnose HSDD using several methods, ranging from discussing your symptoms and making a decision to blood testing to rule out medical causes. Some providers may use a sexual health symptom questionnaire to better assess and determine a diagnosis.
If your healthcare provider thinks your HSDD could be linked to a hormone imbalance, they might ask you to take a blood test. Modern blood testing can help healthcare professionals identify hormone imbalances, making it easier to treat your HSDD and restore your sex drive.
If your healthcare provider thinks your HSDD is linked to an emotional or psychological condition, they might refer you to a psychiatrist or other specialist health professional.
If you currently take a medication that’s linked to HSDD, your healthcare provider might recommend using an alternative medication, or adjusting your dosage to alleviate your symptoms.
Because there’s no one method for diagnosing HSDD, your healthcare provider’s approach could differ from the examples provided above.
HSDD can be caused by a variety of factors, meaning there’s no one-size-fits-all treatment that can guarantee results. Instead, treatment for HSDD is focused on identifying and improving the key, underlying problem that’s causing your symptoms.
Treating for HSDD usually begins with your healthcare provider identifying potential causes. You’ll need to let your healthcare provider know about any over-the-counter or prescription medications you currently use, as it’s possible that they could affect your sex drive.
It’s also important to let your healthcare provider know about any habits that could affect your general health and sexual wellbeing, such as smoking, excessive alcohol consumption or drug use.
Your body’s production of estrogen and testosterone, two essential hormones for normal sexual function, can vary over time. Many women experience a decline in estrogen production as they age, resulting in a reduced level of sexual interest and desire.
Healthcare providers treat HSDD caused by hormonal issues using several approaches. First, your healthcare provider will check your hormone levels using a blood test. After identifying any hormonal imbalances, they might recommend a form of medication to bring your hormones to healthy levels.
HSDD can also be caused by specific health issues, such as high blood pressure, heart disease or diabetes.
If your HSDD is the result of an underlying health condition, your healthcare provider will most likely focus on improving the underlying problem. Health factors such as obesity, activity level and stress can affect your sex drive and, in some cases, contribute to HSDD.
If your HSDD is the result of an emotional or mental health issue, your healthcare provider might recommend counseling. Many counselors can help you to identify and solve the root problems that prevent you from enjoying a fulfilling sex life, either by yourself or with your partner.
In addition to medication, your healthcare provider might recommend making changes to your lifestyle, such as increasing the amount of time you spend exercising, changing your eating habits or reducing your consumption of alcohol and tobacco.
Many widely used medications, such as antidepressants, can have significant effects on your sex drive.
If you regularly use medication that’s linked to a reduced level of sexual interest, your healthcare provider might recommend switching to an alternative medication, adjusting your medication dosage or making other changes to your medication usage.
Follow your healthcare provider’s instructions regarding medication usage. Do not stop taking medications — particularly antidepressants — without first discussing the matter with your healthcare provider.
If all else fails, there are medications available to treat HSDD. The most popular and effective is a medication called flibanserin.
Flibanserin works by stimulating the receptors in your body responsible for sexual interest. It’s an effective, safe medication, but it can potentially require some changes to your lifestyle to be completely effective.
While using flibanserin, it’s important to abstain from alcohol. Flibanserin can cause a significant drop in blood pressure when combined with alcohol, making this an essential lifestyle change if you plan to use this medication to treat HSDD.
Our guide to flibanserin goes into more detail about the effects of flibanserin on your body, from its positive effects as a treatment for HSDD to its potential side effects.
As frustrating as HSDD can be, it’s important to remember that it doesn’t need to be something you’ll face forever. With counselling, lifestyle changes and medication, many women are able to restore their sex drive and enjoy a fulfilling, satisfying sexual life once again.
Interested in learning more about treating HSDD? Our guide to flibanserin covers all you need to know about HSDD medication.
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