Hypoactive Sexual Desire Disorder

Hypoactive Sexual Desire Disorder is a condition where there is a deficiency or absence of sexual fantasies and desire for sexual activity.

The diagnostic criteria includes the following symptoms:

• Persistently or recurrently deficient (or absent) sexual fantasies and desire for sexual activity. The judgment of deficiency or absence is made by the clinician, taking into account factors that affect sexual functioning, such as age and the context of the person's life.

• The disturbance causes marked distress or interpersonal difficulty.

• The sexual dysfunction is not better accounted for by another Axis I disorder (except another Sexual Dysfunction) and is not due exclusively to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

Subtypes

Subtypes are provided to indicate the onset, context, and etiological factors associated with the Sexual Dysfunctions.

Lifelong: This subtype applies if the sexual dysfunction has been present since the onset of sexual functioning.

Acquired: This subtype applies if the sexual dysfunction develops only after a period of normal functioning.

Generalized Type: This subtype applies if the sexual dysfunction develops only after a period of normal functioning.

Situational Type: This subtype applies if the sexual dysfunction is limited to certain types of stimulation, situations, or partners.

Due to Psychological Factors: This subtype applies when psychological factors are judged to have the major role in the onset, severity, exacerbation, or maintenance of the Sexual Dysfunction, and general medical conditions and substances play no role in the etiology of the Sexual Dysfunction.

Due to Combined Factors:

This subtype applies when 1) psychological factors are judged to have a role in the onset, severity, exacerbation, or maintenance of the Sexual Dysfunction; and 2) a general medical condition or substance use is also judged to be contributory but is not sufficient to account for the Sexual Dysfunction.

If sexual dysfunction is attributed solely to substance abuse or a medical cause, Sexual Dysfunction Due to a General Medical and/or Substance-Induced Sexual Dysfunction is diagnosed.

Course

The age at onset of Hypoactive Sexual Desire Disorder is puberty. More frequently, the disorder develops in adulthood, after a period of adequate sexual interest, in association with psychological distress, stressful life events, or interpersonal difficulties.

The loss of sexual desire may be continuous or episodic, depending on psychosocial or relationship factors. An episodic pattern of loss of sexual desire occurs in some individuals in relation to problems with intimacy and commitment.

Diagnostic criteria summarized from:

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.