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Hypoactive Sexual Desire Disorder

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Cancer and Sexual Health

Part of the book series: Current Clinical Urology ((CCU))

Abstract

Hypoactive Sexual Desire Disorder (HSDD) is diagnosed when an individual indicates persistent or recurrent blunted levels of sexual desire and/or a lack of sexual fantasies that cause marked distress and/or interpersonal difficulties [1]. This diagnosis is intended to include only individuals who experience dissatisfaction with their low levels of sexual desire. Women with this condition will often report that they “want to want” more sex, while women with low levels of sexual desire that do not meet HSDD criteria will indicate no bother or concerns with the frequency of their sexual desire. The subjective experience of distress caused by low desire is a critical component of the diagnosis of HSDD because many individuals are not alarmed by low levels of sexual desire. Indeed, an epidemiological study conducted in Australia demonstrated that 32% of women who are 20–70 years old report low sexual desire, but only 16% report distress caused by the low sexual desire [2].

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References

  1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4, TRth ed. Washington, DC: American Psychiatric Association; 2000.

    Google Scholar 

  2. Hayes RD, Dennerstein L, Bennett CM, Fairley CK. What is the ‘true’ prevalence of female sexual dysfunctions and does the way we assess these conditions have an impact? J Sex Med. 2008;5:777–87.

    Article  PubMed  Google Scholar 

  3. Santtila P, Wager I, Witting K, Harlaar N, Jern P, Johansson A, et al. Discrepancies between sexual desire and sexual activity: gender differences and associations with selationship satisfaction. J Sex Marital Ther. 2008;34:31–4.

    Article  Google Scholar 

  4. Jones JC, Barlow D. Self-reported frequency of sexual urges, fantasies, and masturbatory fantasies in heterosexual males and females. Arch Sex Beh. 1990;19:269–79.

    Article  CAS  Google Scholar 

  5. Basson R, Leiblum S, Brotto L, Derogatis L, Fourcroy J, Fugl-Meyer K, et al. Revised definitions of women’s sexual dysfunction. J Sex Med. 2004;1:40–8.

    Article  PubMed  Google Scholar 

  6. Brezsnyak M, Whisman MS. Sexual desire and relationship functioning: the effects of marital satisfaction and power. J Sex Marit Ther. 2004;30:199–217.

    Article  Google Scholar 

  7. Christophere FS, Sprecher S. Sexuality in marriage, dating, and other relationships: a decade review. J Marriage Fam. 2000;62:999–1017.

    Article  Google Scholar 

  8. Kennedy SH, Rizvi S. Sexual dysfunction, depression, and the impact of antidepressants. J Clin Psychopharm. 2009;29:157–64.

    Article  CAS  Google Scholar 

  9. Masters WH, Johnson VE. Human sexual response. Toronto, New York: Bantam Books; 1966.

    Google Scholar 

  10. Kaplan HS. The new sex therapy. New York: Brunner/Mazel; 1974.

    Google Scholar 

  11. Basson R. Are our definitions of women’s desire, arousal and sexual pain disorders too broad and our definition of orgasmic disorder too narrow? J Sex Marit Ther. 2002;28:289–300.

    Article  Google Scholar 

  12. Levine SB. The nature of sexual desire: a clinician’s perspective. Arch Sex Beh. 2003;32:279–85.

    Article  Google Scholar 

  13. McCall K, Meston CM. Cues resulting in desire for sexual activity in women. J Sex Med. 2006;3:838–52.

    Article  PubMed  Google Scholar 

  14. McCall K, Meston C. Differences between pre- and postmenopausal women in cues for sexual desire. J Sex Med. 2007;4:364–71.

    Article  PubMed  Google Scholar 

  15. Pfaus JG. Of rats and women: preclinical insights into the nature of female sexual desire. Sex Relat Ther. 2006;21:463–76.

    Article  Google Scholar 

  16. Buck RW. Human motivation and emotion. 2nd ed. New York: Wiley; 1988.

    Google Scholar 

  17. Meston CM, Buss DM. Why humans have sex. Arch Sex Behav. 2007;36:477–507.

    Article  PubMed  Google Scholar 

  18. Sand M, Fisher WA. Women’s endorsement of models of female sexual response: The Nurses’ Sexuality Study. J Sex Med. 2007;4(3):708–19.

    Article  PubMed  Google Scholar 

  19. Leiblum S, Symonds T, Moore J, Soni P, Steinberg S, Sisson M. A methodology study to develop and validate a screener for hypoactive sexual desire disorder in postmenopausal women. J Sex Med. 2006;3:455–64.

    Article  PubMed  Google Scholar 

  20. Clayton AH, Goldfischer ER, Goldstein I, Derogatis L, Lewis-D’Agostino DJ, Pyke R. Validation of the decreased sexual desire screener (DSDS): A brief diagnostic instrument for generalized acquired female hypoactive sexual desire disorder (HSDD). J Sex Med. 2009;6:730–8.

    Article  PubMed  Google Scholar 

  21. Giraldi A, Rellini AH, Bitzer J, Pfaus JG, Laan E, Jannini E, et al. Questionnaires for assessment of female sexual dysfunction: A review and proposal for a standardized screener. In preparation.

    Google Scholar 

  22. Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R, et al. The female sexual function index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther. 2000;26:191–208.

    Article  PubMed  CAS  Google Scholar 

  23. Quirk FH, Heiman JR, Rosen RC, Laan E, Smith MD, Boolell M. Development of a sexual function questionnaire for clinical trials of female sexual dysfunction. J W Heakth Gender-Based Med. 2002;11:277–89.

    Article  Google Scholar 

  24. Meston CM, Trapnell PD. Development and validation of a five factor sexual satisfaction and distress scale: the Sexual Satisfaction Scale for Women (SSS-W). J Sex Med. 2005;2:66–81.

    Article  PubMed  Google Scholar 

  25. Leteourneau EJ, Schewe PA, Christopher FB. Preliminary evaluation of sexual problems in combat veterans with PTSD. J Trauma Stress. 1997;10(1):125–32.

    Google Scholar 

  26. Hurlbert DF, Apt CV, White LC. An empirical examination into the sexuality of women with borderline personality disorder. J Sex Marital Ther. 1992;18:231–42.

    PubMed  CAS  Google Scholar 

  27. Rosen R, Lane R, Menza M. Effects of SSRIs on sexual function: a critical review. J Clin Pharmacol. 1999;19:67–85.

    CAS  Google Scholar 

  28. Vulink NC, Denys D, Bus L, Westenberg HG. Sexual pleasure in women with obsessive-compulsive disorder. J Affect Disord. 2006;91:19–25.

    Article  PubMed  Google Scholar 

  29. Prause N, Janssen E, Hetrick WP. Attention and emotional responses to sexual stimuli and their relationship to sexual desire. Arch Sex Behav. 2008;37:934–49.

    Article  PubMed  Google Scholar 

  30. Meston CM, Frohlich PF. The neurobiology of sexual function. Arch Gen Psychi. 2000;57:1012–30.

    Article  CAS  Google Scholar 

  31. Cyranowski JM, Bromberger J, Youk A, Matthews K, Kravitz HM, Powell LH. Lifetime depression history and sexual function in women at midlife. Arch Sex Behav. 2004;33:539–48.

    Article  PubMed  Google Scholar 

  32. Clayton AH, Pradko JF, Croft HA, et al. Prevalence of sexual dysfunction among newer antidepressants. J Clin Psychi. 2002;63:357–66.

    Article  Google Scholar 

  33. Serretti A, Chiesa A. Treatment-emergent sexual dysfunction related to antidepressants: a meta-analysis. J Clin Psychopharmacol. 2009;29:259–66.

    Article  PubMed  CAS  Google Scholar 

  34. Clayton AH, Dennerstein L, Pyke R, Sand M. Flibanserin: a potential treatment for hypoactive sexual desire disorder in premenopausal women. Women’s Health. 2010;6:639–53.

    Google Scholar 

  35. Metz M, McCarthy B. The Good Enough Sex model for men’s and couple’s satisfaction. Sex Relat Ther. 2007;22:351–62.

    Article  Google Scholar 

  36. Shifren JL, Monz BU, Russo PA, Segreti A, Johannes CB. Sexual problems and distress in United States women: prevalence and correlates. Obstet Gyn. 2008;112:970–8.

    Article  Google Scholar 

  37. Dennerstein L, Guthrie JR, Hayes RD, DeRogatis LR, Lehert P. Sexual function, dysfunction, and sexual distress in a prospective, population-based sample of mid-aged Australian-born women. J Sex Med. 2008;5:2291–9.

    Article  PubMed  Google Scholar 

  38. Öberg K, Fugl-Meyer AR, Sjögren Fugl-Meyer K. On categorization and quantification of women’s sexual dysfunction. An epidemiological approach. Int J Imp Res. 2004;16:261–9.

    Article  Google Scholar 

  39. Sievert LL, Morrison LA, Reza AM, Brown DE, Kalua E, Tefft HA. Age-related differences in health complaints: the Hilo Women’s Health Study. Women Health. 2007;45:31–51.

    Article  PubMed  Google Scholar 

  40. Lewis RW, Fugl-Meyer KS, Bosch R, et al. Definitions, classification, and epidemiology of sexual dysfunction. In: Lue TF, Basson R, Rosen R, Giuliano F, Khoury S, Montorsi F, editors. Sexual Medicine: Sexual Dysfunctions in Men and Women. Paris: Health Publications; 2004. p. 39–72.

    Google Scholar 

  41. Kontula O, Haavio-Mannila E. Sexual pleasures- enhancement of sex life in Finland, 1971–1992. The Finnish Academy of Science and Letters Publisher; 1995.

    Google Scholar 

  42. Davis SR, Moreau M, Kroll R, et al. Testosterone for low libido in postmenopausal women not taking estrogen. N Engl J Med. 2008;359:2005–17.

    Article  PubMed  CAS  Google Scholar 

  43. North American Menopause Society. The role of testosterone therapy in postmenopausal women: position statement of the North American Menopause Society. Menopause. 2005;12:497–511.

    Article  Google Scholar 

  44. Heiman JR. Treating low desire – new findings for testosterone in women. N Engl J Med. 2008;359:2047–9.

    Article  PubMed  CAS  Google Scholar 

  45. Davis SR, Tran J. Testosterone influences libido and well being in women. Trends Endocrinol Metab. 2001;12:33–7.

    Article  PubMed  CAS  Google Scholar 

  46. Salmon UJ, Geist SH. Effect of androgens upon libido in women. J Clin Endocrinol Metab. 1943;3:235–8.

    Article  CAS  Google Scholar 

  47. Pfaus JG. Pathways of sexual desire. J Sex Med. 2009;6:1506–33.

    Article  PubMed  CAS  Google Scholar 

  48. Krebs M, Leopold K, Hinzpeter A, Shaefer M. Current schizophrenia drugs: efficacy and side effects. Expert Opin Pharmacother. 2006;7:1005–16.

    Article  PubMed  CAS  Google Scholar 

  49. Derogatis LR, Meyer JK, King KM. Psychopathology in individuals with sexual dysfunction. Am J Psychiatry. 1981;138:757–63.

    PubMed  CAS  Google Scholar 

  50. Maslow AH. A theory of human motivation. Psychol Rev. 1943;50:370–96.

    Article  Google Scholar 

  51. Clayton AH, McGarvey EL, Clavet GJ, Piazza L. Comparison of sexual functioning in clinical and nonclinical populations using the Changes in Sexual Functioning Questionnaire (CSFQ). Psychopharmacol Bull. 1997;33:747–53.

    PubMed  CAS  Google Scholar 

  52. Schreiner-Engel P, Schiavi RC. Lifetime psychopathology in individuals with low sexual desire. J Nerv Ment Disease. 1986;174(11):646–51.

    Article  CAS  Google Scholar 

  53. Basson R, Weijmar WCM, Binik YM, Brotto LA, Eschenbach DA, Laan E, et al. Women’s sexual desire and arousal disorder and sexual pain. In: Lue TF, Basson R, Rosen R, Giuliano F, Khoury S, Montrosi F, editors. Sexual medicine: sexual dysfunction in men and women. Paris: Health Publications; 2004. p. 851–974.

    Google Scholar 

  54. Avis NE, Stellato R, Crawford S, Johannes C, Longcope C. Is there an association between menopause status and sexual functioning? Menopause. 2000;7:297–309.

    Article  PubMed  CAS  Google Scholar 

  55. Dennerstein L, Lehert P, Burger H, Dudley E. Factors affecting functioning of women in the midlife years. Climateric. 1999;2:254–62.

    Article  CAS  Google Scholar 

  56. Fobair P, Spiegel D. Concerns about sexuality after breast cancer. Cancer J. 2009;15(1):19–26.

    Article  PubMed  Google Scholar 

  57. Schover LR. Sexuality and body image in younger women with breast cancer. J Natl Cancer Inst Monogr. 1994;16:177–82.

    PubMed  Google Scholar 

  58. Carter J, Rowland K, Chi D, et al. Gynecologic cancer treatment and the impact of cancer-related infertility. Gynecol Oncol. 2005;97(1):90–5.

    Article  PubMed  Google Scholar 

  59. Amichetti M, Caffo O. Quality of life in patients with early stage breast carcinoma treated with conservation surgery and radiotherapy: an Italian monoinstitutional study. Tumori. 2005;87:78–84.

    Article  Google Scholar 

  60. Amsterdam A, Krychman ML. Sexual dysfunction in patients with gynecologic neoplasms: a retrospective pilot study. J Sex Med. 2005;3:646–9.

    Google Scholar 

  61. Ganz PA, Desmond KA, Belin TR, Meyerowitz BE, Rowland JH. Predictors of sexual health in women after breast cancer diagnosis. J Clin Oncol. 1999;17:2371–80.

    PubMed  CAS  Google Scholar 

  62. Lundberg PO, Hulter B. Sexual disfunction among patients with hypothalamus-pituitary disorders. Exp Clin Endocrinol. 1991;98:81–8.

    Article  PubMed  CAS  Google Scholar 

  63. Miller K, Kissane DW. Counseling in palliative care. In: Bruera E, Higginson IJ, Ripamonti C, von Gunten C, editors. Textbook of palliative medicine. London: Hodder Arnold; 2006. p. 705–17.

    Google Scholar 

  64. Reich M. Depression and cancer: recent data on clinical issues, research challenges and treatment approaches. Curr Opin Oncol. 2008;20:353–9.

    Article  PubMed  Google Scholar 

  65. Schultz WCM, Van de Wiel HBM. Sexuality, intimacy, and gynecological cancer. J Sex Marital Ther. 2003;29 Suppl 1:121–8.

    Article  PubMed  Google Scholar 

  66. Andersen BL, Woods XA, Copeland LJ. Sexual self-schema and sexual morbidity among gynecologic cancer survivors. J Consult Clinic Psychol. 1997;65(2):221–9.

    Article  CAS  Google Scholar 

  67. Carpenter KM, Andersen BL, Fowler JM, Maxwell GL. Sexual self schema as a moderator of sexual and psychological outcomes for gynecologic cancer survivors. Arch Sex Behav. 2009;38:828–41.

    Article  PubMed  Google Scholar 

  68. Yurek D, Farrar W, Andersen BL. Breast cancer surgery: comparing surgical groups and determining individual differences in postoperative sexuality and body change stress. J Consult Clinic Psycho. 2000;68(4):697–709.

    Article  CAS  Google Scholar 

  69. Van de Wiel HBM, Schultz WCMW, Hallensleben A, Thurkow FG, Bouma J. Sexual functioning following treatment of cervical carcinoma. Eur J Gynaec Oncol. 1988;9:275–81.

    Google Scholar 

  70. Kafka M. Paraphilia –related disorders: The evaluation and treatment of Non-paraphilic hypersexuality. In: Lieblum S, editor. Priniciples and practices of sex therapy. 4th ed. N.Y: Guilford; 2007.

    Google Scholar 

  71. Andersen, B.L., & van der Does, J. (1994). Sexual morbidity following gynecologic cancer: An international problem. International Journal of Gynecologic Cancer, 4, 225–240.

    Google Scholar 

  72. Broeckel JA, Thors CL, Jacobsen PB, Small M, Cox CE. Sexual functioning in long-term breast cancer survivors treated with adjuvant chemotherapy. Breast Cancer Res Treat. 2002;75:241–8.

    Google Scholar 

  73. Andersen B, Lachenbrunch P, Anderson B, deProsse C. Sexual dysfunction and signs of gynecological cancer. Cancer. 1986;57:1880–6.

    Article  PubMed  CAS  Google Scholar 

  74. Cull A, Cowie V, Farquharson D, Livingstone J, Smart G, Elton R. Early stage cervical cancer: psychosocial and sexual outcomes and treatment. Br J Cancer. 1993;68:1216–20.

    Article  PubMed  CAS  Google Scholar 

  75. Bartelson K. Sexual dysfunction after treatment of cervical cancer. Danish Med Bull. 1983;30:32–4.

    Google Scholar 

  76. Seibel M, Freeman M, Graves W. Sexual function after surgical and radiation therapy for cervical carcinoma. Southern Med J. 1982;75:1195–7.

    Article  PubMed  CAS  Google Scholar 

  77. Schover L, Fife M, Gershenson D. Sexual dysfunction and treatment for early stage cervical cancer. Cancer. 1989;63:201–12.

    Article  Google Scholar 

  78. Greeneberg D. The measurement of sexual dysfunction in cancer patients. Cancer. 1984;53:2281–5.

    Google Scholar 

  79. Schover LR. The impact of breast cancer on sexuality, body image and intimate relationships. CA Cancer J Clin. 1991;41:112–20.

    Article  PubMed  CAS  Google Scholar 

  80. Beckmann J, Johans L, Richardt C, Blichert-Toft M. Psychological reactions in younger women operated on for breast cancer. Dan Med Bull. 1983;30:10–3.

    PubMed  Google Scholar 

  81. Aaronson NK, Bartelink H, van Dongen JA, Van Dam FSAM. Evaluation of breast-conserving therapy: clinical methodological and psychosocial perspectives. Eur J Surg Oncol. 1988;14:133–40.

    PubMed  CAS  Google Scholar 

  82. Mortimer JE, Boucher L, Baty J, Knapp DL, Ryan E, Rowland JH. Effect of tamoxifen on sexual functioning in patients with breast cancer. J Clin Onc. 1999;17:1488–92.

    CAS  Google Scholar 

  83. Mourits MJ, Bockermann EG, de Vries EG, et al. Tamoxifen effects on subjective and psychosexual well-being, in a randomized trial. Br J Cancer. 2002;86:1546–50.

    Article  PubMed  CAS  Google Scholar 

  84. Dennerstein L, Koochaki P, Barton I, Graziottin A. Hypoactive sexual desire disorder in menopausal women: a survey of Wester European women. J Sex Med. 2006;3:212–22.

    Article  PubMed  Google Scholar 

  85. Graziottin A, Leiblum SR. Biological and psycho-social patophysiology of female sexual dysfunction during the menopausal transition. J Sex Med. 2005;2:133–45.

    Article  PubMed  Google Scholar 

  86. Kingsber SA, Simon JA, Goldstein I. The current outlook for testosterone in the management of hypoactive sexual desire disorder in postmenopausal women. J Sex Med. 2008;5 Suppl 4:182–93.

    Article  Google Scholar 

  87. Husnu C, Bilgin G, Adem Y, Cemile N, Fethi H, Burcin K. The effect of hysterectomy and bilaterally salpingo-oophorectomy on sexual function in post-menopausal women. Maturitas. 2008;61:358–63.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Psychology, University of Vermont, Burlington, VT, USA

    Alessandra H. Rellini

Authors
  1. Alessandra H. Rellini
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  2. Melissa A. Farmer
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  3. Gale H. Golden
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Correspondence to Alessandra H. Rellini .

Editor information

Editors and Affiliations

  1. Sexual Medicine Program, Memorial Sloan-Kettering Cancer Center, East 68th Street 353, New York, 10021, New York, USA

    John P. Mulhall

  2. Daniel den Hoed Cancer Center, Dept. Radiation Oncology, Erasmus Medical Center, Groene Hilledijk 301, Rotterdam, 3075 EA, Netherlands

    Luca Incrocci

  3. Alvarado Hospital, Alvarado Road 6719, San Diego, 92120, California, USA

    Irwin Goldstein

  4. New England Research Institutes, Galen Street 9, Watertown, 02472, Massachusetts, USA

    Ray Rosen

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Rellini, A.H., Farmer, M.A., Golden, G.H. (2011). Hypoactive Sexual Desire Disorder. In: Mulhall, J., Incrocci, L., Goldstein, I., Rosen, R. (eds) Cancer and Sexual Health. Current Clinical Urology. Humana Press. https://doi.org/10.1007/978-1-60761-916-1_9

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  • DOI: https://doi.org/10.1007/978-1-60761-916-1_9

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