Hypoactive Sexual Desire Disorder
About a third of women experience some form of sexual disorder. Hypoactive sexual desire disorder is a particularly common one. It is linked most often to a psychological issue, although it can be medically caused. Using various journal articles and research, the causes and treatments of hypoactive sexual desire disorder are discussed, focusing on women.
Passion, sensuality, amorousness, eroticism, and lust are all terms used for sexual desire. The Webster’s dictionary describes desire as a conscious impulse toward something that promises enjoyment or satisfaction in its attainment. This desire, however, can be lacking in many otherwise healthy relationships. A serious lacking of sexual desire could mean that a person has hypoactive sexual desire disorder (HSDD). According to the Diagnostic Statistical Manual of Mental Disorders (DSM-IV-TR) hypoactive sexual desire disorder is defined as “a persistent or recurrent deficiency or absence of sexual fantasies and desire for sexual activity that causes marked distress or interpersonal difficulty” (American Psychiatric Association, 2000). In other words, a long lasting lack of sexual fantasies and desire for sexual activity that causes personal or relationship issues. This condition is seen in both men and women, although it seems to be more prevalent in women. Data from the National Health and Social Life Survey says that one third of women experience a significant lack of interest in sexual activities. This makes it one of the most common sexual and mental disorders found in women (Laumann, Paik, & Rosen, 1999). Previously known as inhibited sexual desire, hypoactive sexual desire disorder is also linked with sexual aversion and sexual apathy. Even with the DSM-IV-TR definition, it is difficult for physicians to diagnose someone with hypoactive sexual desire disorder as there are so many factors involved. There are no set symptoms, other than the lack of desire, and that can be highly subjective. The first thing that a physician must do is take a thorough history to rule out pharmaceutical or recreational drugs, along with other mental disorders. Helen Kaplan introduced a triphasic model further explaining the intricacies of sexual response. These divisions included desire, excitement and orgasm. She described desire as an appetite that resides in the brain, excitement as the result of vasodilation of the blood vessels in the genitals, and lastly, orgasm as the sensation associated with the involuntary contractions of genital muscles (Kaplan, 1977). Many physicians use this or one of the other various tests designed to assess sexual response, including the Female Sexual Functioning Index (FSFI; Rosen et al., 2000), the Index of Sexual Desire (HISD; Apt &, 1992), and the Sexual Desire Inventory (SDI; Spector, Carey & Steinberg, 1996). There are also different variations of the disorder. It can be defined as lifelong versus acquired and generalized versus situational. In the lifelong form, a person would have felt a lack of sexual desire from the time they entered puberty, while the acquired form occurs after a period of normal sexual functioning, as when a woman loses desire in her marriage. The generalized form refers to a lack of sexual desire regardless of the individual, situation, or stimulation, while the situational form is limited to issues with a certain person, situation or stimulation (American Psychiatric Association, 2000). In the 1990s, Lenore Teifer began to think that the DSM-IV-TR did not comprehensively explain hypoactive sexual desire disorder. She and some of her colleagues came up with a list of causes for female sexual disorders. According to them, female sexual problems may be the result of sociocultural, political or economic factors; partner and relationship influences; psychological factors; and/or medical factors (Teifer, Hall, and Tavris, 2002).
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