Hypoactive Sexual Desire Disorder
Hypoactive Sexual Desire Disorder (HSDD) is a sexual problem characterized by distress related to loss or major decline in sexual interest. Sexual desire is the psychobiological energy that accompanies sexual arousal and tends to result in sexual behavior. Decreases in this energy occur in the form of continuous or repetitive sexual fantasies and little or no desire to engage in sexual activity. Factors affecting sexual functioning such as age and living conditions are important when making this diagnosis. One of the important points here is that biological factors has noting to do with this reduction. Otherwise, the problem is of interest to non-psychiatric physicians.
Hypoactive Disorder occurs in both men and women;
They may not experience a dysfunction when sexual activity begins. However, reduced sexual desire may also be used to cover another sexual dysfunction. Lack of desire can be expressed as a decrease in the frequency of sexual intercourse, not being seen as an attractive partner, or openly reluctant complaints. The patient has little or no sexual thoughts or fantasies, there is little response to sexual stimuli and little interest in initiating sexual experiences.
Nearly 20% of the whole population has decreased sexual desire disorder. This complaint is more common in women. The disorders are common in 32% of American women and 15% of American men. Some studies have shown that the actual rate may be higher.
Aging, pregnancy, menopause can also lead to changes in sexual desire. Menopause has negative effects on sexuality. The most common sexual problem reported by postmenopausal women is hypoactive sexual desire. According to researches 40-50% of postmenopausal women experience decreased sexual desire, whereas this rate is 15-25% in premenopausal women.
Most studies have shown that sexual desire decreases with age in both women and men. Interestingly, however, the degree of complaints of decreased sexual desire decreases with age. Sexual desire also changes according to gender. While men see sexual intercourse as a way of re-establishing and being close to their partner, women perceive sexual intercourse as the result of emotional closeness (at least in long-term relationships).
Lack of desire may also result from chronic stress, anxiety, or depression. Request problems can be an expression of hostility or a sign that the relationship has deteriorated. In a study comparing the group of women with hypoactive sexual desire to a group without sexual dysfunction, 91% of women without dysfunction described their communication with their partner as good, while this rate was 35% in the reduced sexual desire group. However, there are studies showing that sexual dysfunctions (including decreased sexual desire) may occur without a significant problem in marital adjustment.
Culture also affects sexual desire. Extremely rigid, judgmental attitudes towards sexuality can lead to a decrease in sexual desire. There are studies reporting different decreased sexual desire rates in different cultures.
Sexual aversion can affect the frequency of sexual intercourse in both men and women. There is no frequency of sexual intercourse defined as sexual ‘normality.. There are many factors that affect the frequency of sexual intercourse: age, equality, relationship process, pregnancy, time, relationship status, purpose of reproduction and use of birth control methods. Decreased sexual desire in women has been discussed in recent years and is thought to be different from male sexual aversion in many ways. Many women may never have spontaneous sexual desire. However there is no problem during sexual activity. Decreased sexual desire women can continue sexual intercourse due to pressure from the willing partner or avoidance of guilt and blame. Decreased sexual desire men have secondary erectile dysfunction. However, according to many researchers, the desire difference between men and women is greater than the differences between genders.
As a result, decreased sexual desire is a common, dysfunctional sexual dysfunction that can affect men and women of all ages and sociocultural situations. Because it can be caused by a variety of reasons, a detailed assessment is needed before starting sexual therapy. In some cases, urology and obstetrics may also be needed. Couple therapy may also be require sexual therapy in cases where low sexual desire is the result of a poor relationship.