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Hypoactive sexual desire in women

Kingsberg, Sheryl A. PhD1; Rezaee, Roya L. MD2

doi: 10.1097/GME.0000000000000131
Clinical Corner: Invited Review

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.

From the 1University Hospitals Case Medical Center, MacDonald Women’s Hospital, Cleveland, OH; and 2Case Western Reserve University School of Medicine, Cleveland, OH.

Received July 7, 2013; revised and accepted September 16, 2013.

Funding/support: None.

Financial disclosure/conflicts of interest: S.A.K. is a paid consultant for Apricus, Palatin, Sprout, Shionogi, Emotional Brain, Pfizer, NorvoNordisk (consultancy but without financial compensation), Viveve, and Trimel.

Address correspondence to: Sheryl A. Kingsberg, PhD, MacDonald Women’s Hospital, Mailstop 5034, 11100 Euclid Avenue, Cleveland, OH 44106. E-mail:

© 2013 by The North American Menopause Society.