Hypoactive sexual desire disorder (HSDD)

Loss of sex drive, a condition known as hypoactive sexual desire disorder (HSDD), in women is a persistent lack of desire or absence of sexual fantasies.


  • Psychological causes such as communication problems, marital problems, power struggles
  • Lifestyle factors also influence the desire for sex. A single working mom who is overwhelmed by family needs may feel too exhausted to relax, kick back and fantasize about sex?let alone engage in it.
  • Physical problems such as heart disease, or any other disabling disease.
  • Some medications may also lead to low sex drive: antihypertensives, antidepressants and birth control pills, interfere with sex drive, arousal and orgasm by affecting the balance of sexual hormones and the transmission of chemical messengers.
  • Menopause: Reduced estrogen to postmenopausal levels can lead to dryness of the vagina making sex painful which reduces motivation. The gradual decline of the hormones estrogen, progesterone and testosterone together serve to decrease drive.
  • Another cause may be reduced testosterone levels. It has been argued that increasing testosterone levels even in those without low levels may also serve to increase sex drive.
  • Another hormone currently under study is MSH (melanocyte stimulating hormone). It has been proposed to be a cause for the increased sex drive experienced in women at the time of ovulation. A recent study on female rats has just been published and shows favorable results. However, the drug is still in the preclincal testing phase and it will be a long time before we see it on the market (if it ever makes it).

Therapeutic options

If the cause is suspected to be psychological then counseling and therapy for both partners is probably your No. 1 treatment option to overcome HSDD. Lifestyle factors should be identified and treated. Medical conditions should be treated optimally.

The antidepressants Prozac, Zoloft and Paxil, of which women are major consumers, cause loss of libido in as many as 60 percent of patients. These should be switched to one that has less of a sexual side effect, like Celexa, Wellbutrin, BuSpar, Serzone or Effexor.

Testosterone level evaluated and if it is below 20 nanograms per deciliter, consider starting testosterone therapy. Testosterone therapy is one of the most important stimulants for sex drive available.

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