Treatment of Male Hypoactive Sexual Desire Disorder



Male hypoactive sexual desire disorder (HSDD) is a crucial issue that has been understudied clinically and empirically. Secondary HSDD is much more common and is typically caused by erectile dysfunction. The man has lost confidence in erections, intercourse, and orgasms; as a result, he avoids all types of sensual and sexual touch. When couples stop being sexual after age 50, it is almost always the man’s choice, which he conveys nonverbally. Primary HSDD typically involves a sexual secret, such as a variant arousal pattern, preference for masturbatory sex, or a sexual trauma history.

This chapter advocates for a comprehensive couple biopsychosocial approach to assessment, treatment, and relapse prevention, rather than a biomedical stand-alone approach. The new sexual mantra is desire/pleasure/eroticism/satisfaction with strong, resilient sexual desire as the core dimension. The Good Enough Sex (GES) model replaces the traditional perfect individual erection and intercourse performance model. GES promotes sexual desire and satisfaction for the man and couple.


Biopsychosocial model of assessment and treatment Hypoactive sexual desire disorder Low sexual desire Inhibited sexual desire Primary and secondary HSDD Good enough sex (GES) model Case study 


  1. 1.
    Foley S, Kope SA, Sugrue D. Sex matters for women: a complete guide to taking care of your sexual self. 2nd ed. New York, NY: Guilford; 2012.Google Scholar
  2. 2.
    Zilbergeld B. The new male sexuality. New York, NY: Bantam; 1999.Google Scholar
  3. 3.
    Meana M, Steiner E. Hidden disorder/hidden desire: presentations of low sexual desire in men. In: Binik I, Hall K, editors. Principles and practice of sex therapy. 5th ed. New York, NY: Guilford; 2014. p. 42–60.Google Scholar
  4. 4.
    Metz M, McCarthy B. The good enough sex (GES) model. In: Kleinplatz P, editor. New directions in sex therapy. 2nd ed. New York, NY: Routledge; 2012. p. 213–30.Google Scholar
  5. 5.
    McCarthy B, Wald L. The psychobiosocial model of couple sex therapy. In: Peterson Z, editor. Wiley-Blackwell handbook of sex therapy. New York, NY: Wiley-Blackwell; 2017.Google Scholar
  6. 6.
    McCarthy B. Sex made simple. Eau Clair, WI: PESI Publishing; 2015.Google Scholar
  7. 7.
    Berry M. Historical revolutions in sex therapy. J Sex Marital Ther. 2013;39:21–39.CrossRefPubMedGoogle Scholar
  8. 8.
    Althof S, Leiblum S, Chevret-Measson M, Hartman U, Levine S, McCabe M. Psychological and interpersonal dimensions of sexual function and dysfunction. J Sex Med. 2005;2:793–818.CrossRefPubMedGoogle Scholar
  9. 9.
    McCarthy B, McCarthy E. Rekindling desire. 2nd ed. New York, NY: Routledge; 2014.Google Scholar
  10. 10.
    Hyde J. The gender similarities hypothesis. Am Psychol. 2005;60:581–92.CrossRefPubMedGoogle Scholar
  11. 11.
    Gray J. Men are from mars, women are from venus. New York, NY: Harper-Collins; 1988.Google Scholar
  12. 12.
    Kelly S, Shelton J. African-American couples and sex. In Hall K, Graham C, editors. The cultural context of sexual pleasure and problems. New York, NY: Routledge; 2012. p. 48–83.Google Scholar
  13. 13.
    McCarthy B, Thestrup M. Men, intimacy, and eroticism. J Sex Med. 2009;6:588–94.CrossRefPubMedGoogle Scholar
  14. 14.
    Whisman M, Snyder D, Beach S. Screening for marital and relationship discord. J Fam Psychol. 2009;22:247–54.CrossRefGoogle Scholar
  15. 15.
    Snyder D, Whisman M. Treating difficult couples. New York, NY: Guilford; 2003.Google Scholar
  16. 16.
    Tennov D. Love and limerance. New York, NY: Scarborough; 1988.Google Scholar
  17. 17.
    Perel E. Mating in captivity. New York, NY: Harper-Collins; 2006.Google Scholar
  18. 18.
    Metz M, McCarthy B. Coping with erectile dysfunction. Oakland, CA: New Harbinger; 2004.Google Scholar
  19. 19.
    Bancroft J, Vukadinovic Z. Sexual addiction, sexual compulsivity, or what? J Sex Res. 2004;41:225–34.CrossRefPubMedGoogle Scholar
  20. 20.
    McCarthy B, Metz M. Men’s sexual health. New York, NY: Routledge; 2008.Google Scholar
  21. 21.
    Lindau S, Schumm L, Laumann E, Levinson W, O’Muircheartaigh C, Waite L. A study of sexuality and health among older adults in the United States. N Engl J Med. 2007;357:762–74.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Nagoski E. Come as you are. New York, NY: Simon and Schuster; 2015.Google Scholar
  23. 23.
    Brooks G, Elder W. Sex therapy for men. In: Kleinpatz P, editor. New directions in sex therapy. 2nd ed. New York, NY: Routledge; 2012. p. 37–50.Google Scholar
  24. 24.
    Toates F. An integrative theoretical framework for understanding sexual motivation, arousal, and behavior. J Sex Res. 2009;46:168–93.CrossRefPubMedGoogle Scholar
  25. 25.
    Kafka M. Nonparaphilic hypersexuality disorders. In: Binik I, Hall K, editors. Principles and practice of sex therapy. 5th ed. New York, NY: Guilford; 2014. p. 280–304.Google Scholar
  26. 26.
    Abel G, Becker J, Cunningham-Rathner J, Mittleman M, Rouleau J. Multiple paraphilic diagnoses among sex offenders. Bull Am Acad Psychiatry Law. 1988;16:153–68.PubMedGoogle Scholar
  27. 27.
    Braun-Harvey D, Vigorito M. Treating out of control sexual behavior. New York, NY: Springer; 2015.Google Scholar
  28. 28.
    Maltz W. The sexual healing journey. 3rd ed. New York, NY: William Morrow; 2012.Google Scholar
  29. 29.
    Zoldbrod A. Sexual issues in treating trauma survivors. Curr Sex Health Rep. 2015;7:3–11.CrossRefPubMedGoogle Scholar
  30. 30.
    Herek G, Garnets L. Sexual orientation and mental health. Annu Rev Clin Psychol. 2007;3:353–75.CrossRefPubMedGoogle Scholar
  31. 31.
    Nichols M. Therapy with LGBTQ clients. In: Binik I, Hall K, editors. Principles and practice of sex therapy. 5th ed. New York, NY: Guilford; 2014. p. 309–33.Google Scholar
  32. 32.
    Brotto L, Kudson G, Inskip J, Rhodes K, Erskine Y. Asexuality. Arch Sex Behav. 2010;39:599–618.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.American UniversityWashington, DCUSA
  2. 2.Department of PsychologyAmerican UniversityWashington, DCUSA

Personalised recommendations