Archives of Sexual Behavior

, Volume 39, Issue 2, pp 221–239 | Cite as

The DSM Diagnostic Criteria for Hypoactive Sexual Desire Disorder in Women

  • Lori A. BrottoEmail author
Original Paper


Hypoactive Sexual Desire Disorder (HSDD) is one of two sexual desire disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and is defined by the monosymptomatic criterion “persistently or recurrently deficient (or absent) sexual fantasies and desire for sexual activity” that causes “marked distress or interpersonal difficulty.” This article reviews the diagnosis of HSDD in prior and current (DSM-IV-TR) editions of the DSM, critiques the existing criteria, and proposes criteria for consideration in DSM-V. Problems in coming to a clear operational definition of desire, the fact that sexual activity often occurs in the absence of desire for women, conceptual issues in understanding untriggered versus responsive desire, the relative infrequency of unprovoked sexual fantasies in women, and the significant overlap between desire and arousal are reviewed and highlight the need for revised DSM criteria for HSDD that accurately reflect women’s experiences. The article concludes with the recommendation that desire and arousal be combined into one disorder with polythetic criteria.


Hypoactive sexual desire disorder Sexual interest Sexual desire DSM-V 



The author is a member of the DSM-V Workgroup on Sexual and Gender Identity Disorders. I wish to acknowledge the valuable input I received from members of my Workgroup (Yitzchak Binik, Cynthia Graham, and R. Taylor Segraves) and Kenneth J. Zucker. Feedback from DSM-V Advisors John Bancroft, Rosemary Basson, Ellen Laan, Marta Meana, and Leonore Tiefer is greatly appreciated. Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders V Workgroup Reports (Copyright 2009), American Psychiatric Association.


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Copyright information

© American Psychiatric Association 2009

Authors and Affiliations

  1. 1.Department of Obstetrics and GynaecologyUniversity of British ColumbiaVancouverCanada

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