Hypoactive Sexual Desire Disorder - Treatment

Treatment

HSDD, like many sexual dysfunctions, is something that people are treated for in the context of a relationship. Theoretically, one could be diagnosed with, and treated for, HSDD without being in a relationship. However, relationship status is the most predictive factor accounting for distress in women with low desire and distress is required for a diagnosis of HSDD. Therefore, it is common for both partners to be involved in therapy. Typically, the therapist tries to find a psychological or biological cause of the HSDD. Sometimes this is possible and sometimes it is not. If the HSDD is organically caused, the clinician may try to deal with that. If the clinician believes it is rooted in a psychological problem, they may recommend therapy for that. If not, treatment generally focuses more on relationship and communication issues, improved communication (verbal and nonverbal), working on non-sexual intimacy, or education about sexuality may all be possible parts of treatment. Sometimes problems occur because people have unrealistic perceptions about what normal sexuality is and are concerned that they do not compare well to that, and this is one reason why education can be important. If the clinician thinks that part of the problem is a result of stress, techniques may be recommended to more effectively deal with that. Also, it can be important to understand why the low level of sexual desire is a problem for the relationship because the two partners may associate different meaning with sex but not know it.

In the case of men, the therapy may depend on the subtype of HSDD. Increasing the level of sexual desire of a man with lifelong/generalized HSDD is unlikely. Instead the focus may be on helping the couple to adapt. In the case of acquired/generalized, it is likely that there is some biological reason for it and the clinician may attempt to deal with that. In the case of acquired/situational, some form of psychotherapy may be used, possibly with the man alone and possibly together with his partner.

As neurotransmitters and sex hormones have modulatory function on sexual desire, treatment intervention has been evaluated in multiple clinical trials. Intrinsa is a testosterone patch that works by releasing the hormone testosterone through the skin into the bloodstream. It is licensed by Procter & Gamble for the use in post-menopausal women with surgical menopause who are also receiving estrogen replacement therapy. Flibanserin, a 5-HT1A receptor agonist and 5-HT2A receptor antagonist, has been investigated by Boehringer Ingelheim as a novel, non-hormonal treatment for pre-menopausal women with Hypoactive Sexual Desire Disorder (HSDD). Development on this medication has since been discontinued by the company. Preclinical evidence suggested that flibanserin targets these receptors preferentially in selective brain areas and helps to restore a balance between inhibitory and excitatory effects.