Hypoactive Sexual Desire Disorder

Hypoactive sexual desire disorder is also known as sexual aversion disorder and is seen in both men and women[1]. It is defined as “an absence or lack of any sexual desire and sexual fantasies”. Usually it can be mild, but when it becomes severe, it can cause severe distress in the patient and also cause problems with the relationship.

Hypoactive sexual desire disorder (HSDD) is listed in the DSM-IV under “Sexual and Gender Identity Disorders” category. The disorder has to be unrelated to any other mental illness, or drug abuse for it to be recognized as a sexual disorder. The disorder has many subtypes but it is mostly a lack of sexual desire for their partner. It can originate even after normal sexual function at anytime in a person’s life and can become life-long.


The exact cause of the disorder is unknown; it can be a combination of social, physiological and psychological elements that can cause it. Simply having low sexual desire is not enough for the disorder to be diagnosed; rather it should be severe enough to cause marked depression and distress to the patient. The following are a few causes of Hypoactive Sexual Desire Disorder:

Physical Causes

A low sex drive can start with a change in medication or illnesses. Physically the person may not feel up to indulging in sexual intercourse. The following are some physical causes of HSDD:

Sexual Problems

Sexual problems such as experiencing pain during intercourse or not being able to experience orgasm can hamper sexual desire


Medical conditions such as arthritis, diabetes, cancer, high blood pressure, neurological conditions and coronary artery diseases can also affect sexual desire.


Prescription medicines which include anti-seizure medicines and antidepressants also cause a drop in sexual desire.

Alcohol and Drugs

Over indulging in alcohol and illicit drug use can kill sex drive in people. Too much alcohol use can decrease sex drive markedly.


Surgery which is related to genitals or breasts in women (such as surgery for cancer) can also hamper sexual desire due to low self esteem and body image issues.


Constantly caring for young children or aging parents can tire out a person leaving no mood for sexual intercourse.

Psychological Causes

Psychological causes of low sex drive are many and include depression and anxiety as the main causes. The following are a few psychological causes of a low sex drive in men and women:

  • Depression
  • Anxiety
  • Stress especially work stress or financial stress
  • Body image issues
  • Low self esteem
  • Physical abuse or sexual abuse in the past

Relationship Issues

If a relationship suffers, sex drive may also suffer. For many people, especially women, closeness in the relationship is necessary for sexual intimacy. If the relationship has problems, a low sex drive can develop[3]. If there are any unresolved conflicts, lack of communication, constant fights, infidelity and breach of trust and miscommunication between partners, a low sex drive may develop in one of the partners.

Hormone Changes

Women going through hormonal changes experience altered sexual desire. These changes are most prominent during the following:


When a woman is going through menopause her Estrogen levels tend to drop during the period of transition[4]. This can cause vaginal dryness and a decrease in sex interest. Due to vaginal dryness, painful intercourse also results. The male hormone testosterone also drops, which although is much lower in women, is also important to boost sex drive. Some women are able to have a satisfactory sex life during menopause and even after it, but many women also experience mood swings and depression during the period which also contribute to low sexual desire.

Pregnancy and Lactation (Breast Feeding)

Sometime hormonal changes that occur during pregnancy and during the period after birth can dampen a woman’s sex drive. Fatigue and body image issues also contribute to the overall lowering of sexual desire. This can also work in the opposite manner, when the male partner can feel sexual aversion due to pregnancy and lactation (breast feeding) in their partner.

Specific Causes of Hypoactive Sexual Desire Disorder in Men

Usually men are diagnosed with one of the following three subtypes, even if more exist these can be:

Life-Long or Generalized: in this men feel no sexual stimulation or desire for sex. This type is rare as the male may feel no desire with a partner or even on his own, and never has before.

Situational or Acquired: in this disorder a man who was previously sexually active is now not active anymore. The sexual desire has been lost for their present partner but not lost overall. That is, sexual stimulation still exists with a partner other than their present one.

Acquired Generalized: in this disorder a man who was previously sexually interested in their present partner has lost all sexual interest altogether. This includes a loss of sexual desire with another partner or even sexual stimulation on his own.


The disorder can be treated with the help of medication and counseling at times, but most of the time the root cause has to be diagnosed for successful treatment to begin. Thorough tests and examinations need to be conducted followed by a detailed interview in which the psychological causes are also assessed if a person is feeling a low sexual desire.


Current medicines taken by the patient are reviewed by the doctor and if the current medicines are interfering with sex drive, they can be switched to other medicines that don’t cause this side effect. Hormone therapy can also help if a lowered hormone level is the cause.


Usually a sex therapist or a skilled counselor can help a person understand their own loss of sexual desire. Therapy includes sexual response education and other practice exercises for couples.


Bhasin S, Basson R. Sexual dysfunction in men and women.

DSM-IV The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition



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