Hypoactive Sexual Desire Disorder (HSDD): Causes, Symptoms & Treatment for Low Libido

Menopause. Low libido treatment options.

Hypoactive Sexual Desire Disorder (HSDD): What You Need to Know

If your libido has disappeared, there are steps you can take to regain sexual desire. It’s completely normal to go through phases of being less interested in sex, especially during menopause when tiredness, stress, and physical changes like weight gain, night sweats, and joint pain can impact intimacy.

What is HSDD?

There’s a difference between occasionally saying “not tonight” and permanently feeling disinterested in sex. Hypoactive Sexual Desire Disorder (HSDD) is a persistent lack of sexual interest that lasts for more than six months and negatively affects self-esteem and relationships.

Signs of HSDD include:

• No interest in any type of sexual activity

• No sexual thoughts or fantasies

• No interest in initiating sex

• Difficulty deriving pleasure from sexual activities, including masturbation

Who Gets HSDD?

HSDD is the most common female sexual dysfunction. A review found it affects:

• 8.9% of women aged 18-44

• 12.3% of women aged 45-64

• 7.4% of women aged 65+ [1]

This suggests HSDD peaks during menopause, but it doesn’t have to be an inevitable part of aging.

How is HSDD Diagnosed?

There is no single test for HSDD, but the International Society for the Study of Women’s Sexual Health (ISSWSH) has established diagnostic guidelines [2]. A healthcare professional may ask:

1. Was your past sexual desire level satisfying for you?

2. Has your sexual interest significantly decreased?

3. Are you distressed by this decrease?

4. Would you like to regain your sexual interest?

5. What factors do you think contribute to this decrease?

   • Medical conditions, medications, hormonal changes?

   • Stress, fatigue, relationship dissatisfaction?

   • Other sexual concerns (e.g., pain, lack of arousal)?

How is HSDD Treated?

Treatment depends on the cause and individual preferences, but it often involves a holistic approach, including:

✅ Lifestyle Adjustments:

• Exercise to improve self-esteem and energy

• Prioritizing relaxation and intimacy time

• Experimenting with new ways to enhance sexual connection

✅ Counselling & Therapy:

• Individual or couples therapy can help address emotional and psychological aspects of low desire.

✅ Medical Considerations:

• Reducing or changing medications that may lower libido

• Addressing discomfort with vaginal oestrogen to relieve dryness

• Systemic testosterone therapy (gel or cream) is recommended for women with HSDD who do not have other contributing issues, such as untreated mental health conditions or unresolved relationship concerns.

Final Thoughts

If your sexual desire has changed and it’s affecting your well-being, there are solutions available. Speaking to a menopause specialist can help determine the best treatment plan for you.

Time for Fireworks? Low libido Treatments do exist!

References

1. Parish, S. J., Hahn, S. R. (2016), ‘Hypoactive sexual desire disorder: A review of epidemiology, biopsychology, diagnosis, and treatment’, Sex Medicine Reviews, 4 (2) pp. 103–20. doi: 10.1016/j.sxmr.2015.11.009

2. ISSWSH Process of Care for Management of Hypoactive Sexual Desire Disorder in Women

💡 WA Menopause Clinic is here to help. If you’re experiencing changes in sexual desire, book a consultation today for expert support and guidance!