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Female Hypoactive Sexual Desire Disorder

Last updated May 26, 2018

Check out this great explanation picked by DoveMed. Dr. Jeffrey Albaugh, Director of the William D. and Pamela Hutul Ross Clinic for Sexual Health discusses the causes of desire disorder and treatment with testosterone.


What are the other Names for this Condition? (Also known as/Synonyms)

  • Diminished Sex Drive in Women due to HSDD
  • Female Sexual Interest/Arousal Disorder (FSIAD)
  • Hypoactive Sexual Desire Disorder in Women

What is Female Hypoactive Sexual Desire Disorder? (Definition/Background Information)

  • Female Hypoactive Sexual Desire Disorder (HSDD) is defined as a lack of desire for sex that leads to distress and interpersonal difficulties. HSDD is the most prevalent sexual disorder in women of all ages
  • "Surgically post-menopausal women" at 20-49 years of age are at a greater risk of being diagnosed with HSDD, compared to those who are naturally post-menopausal, pre-menopausal, and surgically post-menopausal of advanced age

Note: The term ‘surgical menopause’ refers to the condition (before normal menopause) when both the ovaries and/or the uterus are removed from a woman, due to various health reasons.

  • HSDD could be caused by a multitude of factors including fatigue, lack of connection with the partner, hormonal changes due to pregnancy, childbirth, or menopause, illness, psychological issues, etc.
  • The signs and symptoms of Female Hypoactive Sexual Desire Disorder include a lack of sexual desires and sexual fantasies, and distress for such shortcomings
  • A diagnosis of Diminished Sex Drive in Women due to HSDD may involve physical, hormonal and psychological evaluations
  • The treatment is usually geared toward individual needs, because HSDD could potentially have many causative factors
  • A majority of women benefit from treatment of the underlying causes for Hypoactive Sexual Desire Disorder

Who gets Female Hypoactive Sexual Desire Disorder? (Age and Sex Distribution)

  • Female Hypoactive Sexual Desire Disorder is prevalent among women of all ages and health statuses
  • Surgically, post-menopausal women of 20-49 years of age are the most likely to be diagnosed with HSDD. Surgically, post-menopausal women on serotonin-reuptake inhibitors (anti-depressants) are reported to show a positive correlation with HSDD
  • Among pre-menopausal women of any race or ethnicity, relationship problems and depression are the known causes of HSDD

What are the Risk Factors for Female Hypoactive Sexual Desire Disorder? (Predisposing Factors)

Female Hypoactive Sexual Desire Disorder is a condition with numerous causative factors. The following are generally considered risk factors for HSDD in Women:

  • Post-menopausal status owing to surgery: Women between the age of 20-49 years who are surgically post-menopausal (when both the ovaries and/or the uterus are removed prior to normal menopause) are at greatest risk of developing HSDD
  • Surgery: Having recently had a surgery could pose a risk to having a satisfactory sex life
  • Life-changing events such as cancer diagnosis or treatment
  • Depression

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Female Hypoactive Sexual Desire Disorder? (Etiology)

Sexual desire in a woman is a complex interplay of a variety of factors. Hence, the lack of sexual desire in Hypoactive Sexual Desire Disorder (HSDD) could be the result of a variety of reasons, which could include:

  • A lack of information or education on sexuality during childhood or adolescence
  • Pre-existing sexual dysfunction
  • Diseases and disorders such as diabetes, cancer (breast), etc.
  • Depression and anxiety
  • Use of medications for depression
  • Surgery
  • Pregnancy and childbirth
  • Exhaustion and fatigue
  • Advancing age and waning hormones such as associated with menopause
  • Stress
  • Low self-esteem
  • Being unable to emotionally connect with the partner
  • Previous psychological trauma such as emotional/sexual abuse

What are the Signs and Symptoms of Female Hypoactive Sexual Desire Disorder?

The major signs and symptoms for diagnosing Female Hypoactive Sexual Desire Disorder are:

  • Low sex drive
  • Lack of sexual fantasies or thoughts
  • Distress owing to low sex drive and an adverse effect on interpersonal relationships

How is Female Hypoactive Sexual Desire Disorder Diagnosed?

A physician may employ one or more of the following methods to diagnose Female Hypoactive Sexual Desire Disorder, since a number of reasons could exist for HSDD in Women:

  • Learn the complete medical history of a patient
  • Do a pelvic exam to check for lubrication or its lack thereof, tender spots (if pain is experienced during intercourse), thinning of genital tissues, and other factors
  • Check hormonal levels
  • Check or recommend tests for diseases and conditions such as diabetes, liver abnormalities, overactive or underactive thyroid glands, and many other conditions
  • Assess for emotional or psychological issues such as depression, anxiety, and stress

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Female Hypoactive Sexual Desire Disorder?

Female Hypoactive Sexual Desire Disorder could potentially cause the following complications:

  • A feeling of discontent with sex life
  • Deterioration and breakdown of relationship with the partner
  • Stress and anxiety
  • Depression
  • If hormone therapy is used to improve sexual desire, it could lead to undesirable side effects (such as mood changes)

How is Female Hypoactive Sexual Desire Disorder Treated?

A physician may recommend one or more kinds of treatment methods depending on the underlying causes for Female Hypoactive Sexual Desire Disorder. The most common approaches to treatment are:

  • Medication: If an anti-depressant medication is producing adverse sexual side effects, a physician may recommend a new class of medication
  • Counseling: If a couple is experiencing relationship problems, therapy could be recommended for both. Additionally, therapists may help a woman explore and understand her sexuality by offering educational materials
  • Systemic hormone therapy: Estrogen therapy could improve mood and increase sexual desire. However, this kind of treatment poses associated health risks
  • Local hormone therapy: Topical ointments containing a combination of estrogen and progesterone may be recommended for increasing blood flow to the vagina and improve one’s sexual drive

Newer medication to alter the brain’s chemicals, which may decrease the signs and symptoms of Female Hypoactive Sexual Desire Disorder, are currently in the developmental stage. Proposals submitted by the drug manufacturing companies are being reviewed by the U.S. Food and Drug Administration (FDA).

How can Female Hypoactive Sexual Desire Disorder be Prevented?

If the underlying causes of Hypoactive Sexual Desire Disorder in Women are stress and emotional issues, the following may help improve one’s sexual desire:

  • Physical activity: Regular exercise is known to reduce stress and likely to contribute to better self-image and self-esteem
  • Better communication: Communicating with the partner is recommended, as this could result in a woman feeling more connected
  • Increasing intimacy: Giving importance to the partner and scheduling specific times to interact with the partner
  • Experimenting with the partner to improve one’s sex life
  • Avoiding alcohol overindulgence
  • Ceasing drug habits, smoking, etc.

What is the Prognosis of Female Hypoactive Sexual Desire Disorder? (Outcomes/Resolutions)

With proper diagnosis of Female Hypoactive Sexual Desire Disorder and suitable treatment, a majority of women show improvement in sexual desire.

Additional and Relevant Useful Information for Female Hypoactive Sexual Desire Disorder:

  • In 2013, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) changed the term “Female Hypoactive Sexual Desire Disorder” to “Female Sexual Interest/Arousal Disorder (FSIAD)”
  • Alternative and complementary medicine: Some medicines available in health food stores are reported to improve sexual desires in women. Caution must be exercised while using these medications, as these do not undergo rigorous regulatory oversight by the U.S. Food and Drug Administration (FDA) before being marketed

What are some Useful Resources for Additional Information?


References and Information Sources used for the Article:


Helpful Peer-Reviewed Medical Articles:


Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: June 17, 2015
Last updated: May 26, 2018