Hypoactive Sexual Desire Disorder (HSDD)
Hypoactive Sexual Desire Disorder (HSDD) is an absence of sexual fantasies and desire for sexual activity.
Absent or diminished feelings of sexual interest or desire, absent sexual thoughts or fantasies, and a lack of responsive desire. Motivations for attempting to become sexually aroused are scarce or absent. The lack of interest is considered to be beyond a normative lessening with life cycle and relationship duration.
Causes for Hypoactive Sexual Desire Disorder (HSDD)
Psychological risk factors in the individual can be expressed within the context of sexual intimacy, giving rise to the development of HSDD. These involve:
- Sexual orientation conflicts;
- Negative thinking patterns;
- Inaccurate beliefs about sex;
- Poor body image;
- A tendency to fuse sex and affection;
- Career overload; and
- Related sexual problems.
Fears can also increase the risk of developing HSDD, since emotional and physical intimacies are closely related.
Sexual desire may be hampered by a fear of intimacy, anger, rejection and abandonment, exposure, feelings or dependency.
Physical factors, such as sexual abuse and emotional trauma, can also inhibit desire.
Inter generational risk factors - Family of origin
Many anti-sexual beliefs are learned within the social familial context. For example, when raised in an extremely religious household, an individual may learn that sex is for procreation and not personal enjoyment. This can lead to feelings of guilt and shame, and may then result in HSDD.
Interactional risk factors - The couple’s relationship
The extent to which an individual is satisfied with a marriage or relationship is related to sexual satisfaction. For example, women with HSDD tend to report greater degrees of marital distress and less relational cohesion.
Other relational risk factors can include:
- Contemptuous feelings;
- Power struggles; and
- Toxic communication.
Deficiencies of testosterone or other hormones, and medical conditions that create hormone deficiencies, can have an impact on sexual desire. Chronic medical conditions, physiological changes, and medications can also contribute to HSDD.
- Medications, such as serotonergic antidepressants;
- Chronic debilitating illnesses, such as chronic renal failure;
- Fluctuations in blood sugar with diabetes; and
- Hypo and Hyperthyroid states this is less common.
Arousability may also be negatively affected by:
- Androgen deficiencies;
- Lamic or pituitary disease; and
- Prolonged high-dose steroid use.
Symptoms of Hypoactive Sexual Desire Disorder (HSDD)
- HSDD can be either lifelong or acquired.
- When HSDD is lifelong, the absence of sexual desire is a typical state for the person.
- Acquired HSDD occurs when a change is experienced in sexual appetite.
- An individual with a generalized lack of desire does not have a sexual appetite under any circumstances.
- On the other hand, an individual who experiences selective desire in certain situations or with specific partners is classified as situational type. For example, a person might feel desire toward a partner they have an affair with, but not with their established partner.
- It is important to note that males with inhibited sexual desire appear to use fantasy in a different way to females with this complaint.
- Females with desire phase problems show low levels of fantasy, whereas men with desire phase problems show a high level of sexual fantasy.
- Males may use sexual fantasy to enhance their sexual performance due to response anxiety.
- Response anxiety is experienced when there is widespread pressure to feel sexually aroused, but arousal does not occur.
- Sexual fantasies may be constructed to help generate sexual arousal that is difficult to achieve without the use of fantasy.
Clinical Findings of Hypoactive Sexual Desire Disorder (HSDD)
Clinical assessment of HSDD should take into account a variety of factors related to the individual and the couple, including:
Level of emotional intimacy;
The belief that emotional intimacy is highly relevant to the experience of sexual desire is not new.
Mental and physical health
Assessment and management of overall mental health is vital, as is assessment of well-being at the time of sexual interaction. This includes energy levels, self-esteem, sense of attractiveness, body image, and freedom from stressful distractions and preoccupations.
Depression is strongly associated with reduced sexual function. Antidepressants, especially those that are highly serotonergic, may lessen sexual desire. Various medical conditions can also impact on a person’s level of desire.
A detailed assessment of a couple’s usual sexual context may lead the health professional to recommend changes. Factors that may be assessed include:
- Time of day;
- Time since last sexual activity;
- What happens in the hours preceding sexual opportunities; and
- What needs to be done after sexual activity.
The couple Relationship issues or concerns;
Throughout the assessment process, the health professional will evaluate the couple’s emotional contracts, styles of communication, level of discord, conflict resolution style, and ways of defining problems.
When evaluating emotional contracts, the health professional will look at what is important for the couple to feel good emotionally, i.e. what is needed and what they do to feel happy. Western philosophy and psychology generally agree that happiness is good for people and distress is bad, that people seek happiness, and that it is easier to be happy when others are happy as well. To attain such conditions, it is useful to try to maximise pleasant emotions over the long term. Openness to emotion is also recognised as being important, because it permits emotional information to be recognised and coped with, thereby promoting conditions that foster happiness.
The health professional will also assess both sexual and nonsexual relational factors.
Thoughts during sexual interaction
The health professional may assess the individual’s ability to focus on sexual stimuli to determine if help is needed. Distractions regarding day-to-day stresses are common.
Other distracting feelings include:
- Sense of obligation regarding imposed sexual frequency or type of sexual interaction; and
- Prediction of negative outcome such as unwanted pregnancy, further proof of infertility, or lack of sexual satisfaction.
Messages from families of origin - Intergenerational system
Family of origin factors and intergenerational factors are assessed through the use of a genogram. A genogram examines different aspects of familial functioning. Instances of incest, parentification, triangulation and other dysfunctional patterns of familial relationships that impact intimacy and sexuality will often need to be assessed.
Hypoactive Sexual Desire Disorder (HSDD) Treatment
- Medical therapies
- Sex therapy
- Sex therapy for HSDD may involve a number of treatment strategies.
- Personal type of sexual desire
- Relationship views
- Other issues
- Lowering response anxiety
- Cognitive therapy
- Homework assignments
Whom to contact for HSDD Counseling & Treatment
Dr. Senthil Kumar is well experienced Homeopath & Psychologist who treats many cases such HSDD problems with successful outcomes. Many of the clients get relief after Taking treatment & attending psychological counselling with him. Dr. Senthil Kumar visits Vivekanantha Homeopathy Clinic & Psychological Counseling Center, Velachery, Chennai. To fix an appointment, please call or mail us:
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