The DSM diagnostic criteria for Hypoactive Sexual Desire Disorder in men

J Sex Med. 2010 Jun;7(6):2015-2030. doi: 10.1111/j.1743-6109.2010.01860.x.


Introduction: Hypoactive Sexual Desire Disorder (HSDD) is one of two sexual desire disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and is defined by two criteria: A-"persistently or recurrently deficient (or absent) sexual fantasies and desire for sexual activity" and B-"marked distress or interpersonal difficulty."

Aim: This paper reviews the prevalence and correlates of low desire in men and qualitative and quantitative research on the experience of sexual desire in men and women.

Methods: A literature search of Medline, PudMed, and PsychInfo was used to identify any publication on low desire in men.

Main outcome measure: The strength of empirical findings was used as a basis for making proposed revisions to the diagnostic criteria for HSDD in men.

Results: The dilemma of whether desire and arousal can be reliably differentiated in men is discussed, and parallels to the literature in women are drawn. Finally, I consider three options for the diagnosis of low desire in men for DSM-5. Option 1 proposes that the DSM-IV-TR name and criteria are preserved for men in DSM-5. Option 2 proposes that the recently proposed criteria for Sexual Interest/Arousal Disorder in women are also adopted for men, which would result in one gender-neutral category. Option 3 proposes that the criteria for Sexual Interest/Arousal Disorder also be applied to men, with a minor modification to one criterion (i.e., that absent or reduced genital and/or nongenital physical changes not be included as a criterion); this diagnosis would then be applied only to men.

Conclusions: The evidence supporting each of these proposals is presented and critiqued. It is concluded that the proposal for DSM-5 should be made on the basis of field testing of new criteria.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Arousal / physiology
  • Cross-Sectional Studies
  • Diagnostic and Statistical Manual of Mental Disorders
  • Erectile Dysfunction / diagnosis
  • Erectile Dysfunction / epidemiology
  • Erectile Dysfunction / etiology
  • Female
  • Health Surveys
  • Humans
  • Libido / physiology
  • Male
  • Middle Aged
  • Risk Factors
  • Sex Factors
  • Sexual Dysfunctions, Psychological / classification
  • Sexual Dysfunctions, Psychological / diagnosis*
  • Sexual Dysfunctions, Psychological / epidemiology
  • Sexual Dysfunctions, Psychological / etiology
  • Sexual Dysfunctions, Psychological / therapy
  • Testosterone / blood
  • Young Adult


  • Testosterone