Hypoactive sexual desire in women

Menopause. 2013 Dec;20(12):1284-300. doi: 10.1097/GME.0000000000000131.

Abstract

Objective: This review aims to describe low sexual desire (1) as a construct within theoretical models of female sexual response, (2) as a sexual disorder with evolving or competing nosology between the DSM-IV-TR and the DSM 5, and (3) as a clinical condition that healthcare providers need to manage, and the current status of treatment options.

Methods: We conducted a literature review of the epidemiology, diagnosis, and treatment of low sexual desire/hypoactive sexual desire disorder (HSDD).

Results: The prevalence rate of low sexual desire is high, reaching 43%, whereas that of HSDD comes close to 10%. The DSM 5 categories of female sexual disorders include female sexual interest/arousal disorder, which is a combination of the DSM-IV-TR disorders HSDD and female sexual arousal disorder. Treatment paradigms vary and are individualized based on the biopsychosocial components of desire that are compromised in a woman. The two primary approaches to treating HSDD are psychotherapy/sex therapy (individual or couples) and pharmacotherapy. To date, there are no Food and Drug Administration-approved pharmacologic treatments. However, four investigational drugs are in mid- to late-stage clinical trial development.

Conclusions: Low sexual desire is the most prevalent sexual problem in women and should be assessed and treated by healthcare professionals. Currently, there are only modest evidence-based nonpharmacologic treatment options and no approved pharmacologic options. Despite these treatment limitations, healthcare providers can address many of the sexual health concerns of women.

Publication types

  • Review

MeSH terms

  • Behavior Therapy / methods*
  • Diagnostic and Statistical Manual of Mental Disorders
  • Female
  • Humans
  • Libido*
  • Perimenopause
  • Sex Education / methods*
  • Sexual Behavior / statistics & numerical data*
  • Sexual Dysfunction, Physiological / epidemiology
  • Sexual Dysfunction, Physiological / therapy*
  • Sexual Dysfunctions, Psychological / epidemiology
  • Sexual Dysfunctions, Psychological / therapy*
  • Women's Health