Hypoactive Sexual Desire Disorder (HSDD), is a common condition where in women have sexual dysfunction, which leads to lowered sex drive. Most women with hypoactive sexual desire disorder presume it is due to menopause or aging.

Women have fluctuating sexual desire, however if there is a lack of sexual desire for more than six months, you should seek help from an endocrinologist. Low sexual desire can be distressing, affect relationship and could lead to poor quality of life. However, if a woman is not concerned about having low sexual desire, she does not have hypoactive sexual desire disorder.

What are the symptoms associated with HSDD?

Symptoms of hypoactive sexual desire disorder vary widely. HSDD can manifest in several ways. Either the woman has reduced to no interest in sexual activity (low libido) or disinterest in initiating sex or difficulty getting pleasure from sex.

What are the causes for low sexual desire?

There are several reasons for hypoactive sexual desire disorder. Underlying cause for hypoactive sexual desire disorder may be physical, emotional, hormonal or a combination of these.

Physical causes of hypoactive sexual desire disorder include: 

• Dyspareunia (painful sex)
• Arthritis
• Backache
• Coronary artery disease
• Type 1 and Type 2 diabetes
• Lack of time
• Tiredness
• Medications (Beta blockers, antipsychotics)

Psychological causes for hypoactive sexual desire disorder include:

• Anxiety
• Depression
• Low self-esteem
• Mental health problem
• History of sexual abuse
• Body image dissatisfaction
• Relationship problems

Hormonal Causes for hypoactive sexual desire disorder include:

• Menopause
• Low oestrogen and vaginal dryness
• Low testosterone levels
• Hormonal changes around and during pregnancy
• Underactive thyroid (Hypothyroidism)

However, sometimes there is no specific underlying cause identified for HSDD

How is hypoactive sexual desire disorder diagnosed? 

There is no specific test to diagnose hypoactive sexual desire disorder. After a detailed history of all the problems encountered you may have a physical examination followed by several investigations. Investigations may include blood tests and scans

A gynaecologist opinion may be needed to ensure there is no pelvic or other gynaecological problem.

How do endocrinologist treat hypoactive sexual desire disorder? 

There are various treatment options for hypoactive sexual desire disorder. Right treatment depends on the underlying cause. In some women, just change in medication itself may lead to improvement. For example, a change in type and dose of antidepressants may improve sex drive.

In the first instance lifestyle changes could help improve a woman’s libido. These include regular exercise, balanced meals, reducing alcohol intake, avoiding smoking, improved sleep hygiene and proper time management.

In some women with psychological issues, behaviours therapy or psychologist intervention may help.

After identifying underlying medical or hormonal problem, your endocrinologist will provide appropriate replacement in the form of cream, suppository, tablets of injections.

Dr Chinnadorai Rajeswaran is a consultant Physician specialising in Endocrinology, Diabetes and Obesity. As a private endocrinologist he  has private endocrine, diabetes and weight loss clinics in Harley Street, London, Chennai (India), Claremont Hospital, Sheffield, Nuffield Hospital, Leeds and Simplyweight, Bradford.

He has face to face consultations with people from Barnsley, Rotherham, Chesterfield, Doncaster, Wakefield, Huddersfield, Bradford, Harrogate, Leeds, Sheffield, London and Chennai (India). He also offers video consultations.