In retrospect, sexual disorders have a significant impact on an individual’s quality of life. It is also apparent that these disorders bear immense significance to the clinical practice. Despite their impact, most physicians do not seem to be interested to engage in extensive discussion with patients regarding sexual desire problems. This phenomenon is, probably, attributable to several reasons including time constraints, lack of efficient therapeutic interventions and insufficient knowledge. One of the most debilitating sexual desire disorders is hypoactive sexual desire disorder. HSDD is also known as inhibited sexual desire. HSDD is characterized by decreased or absence of desire for sexual activity and sexual fantasies which causes interpersonal difficulties, as well as personal distress. In some circumstances, the diagnosis of HSDD exhibits co-morbidity to an underlying sexual dysfunction. However, this disorder is not exclusively attributed to the effects of any substance, pathology or another psychiatric disorder. Even though some clinical experts have hypothesized the causes of HSDD to be associated with biological imbalances, the pathophysiology of this disorder remains unknown. As such, efforts to develop a comprehensive treatment and management strategies have not achieved remarkable success. Therefore, this literature review aims at providing an overview of HSDD.
Table of Contents
1. Introduction
2. Epidemiology
3. History of HSDD
4. Etiology of HSDD
4.1 Low Testosterone
4.2 Low Estrogen
4.3 Other Causes of HSDD
5. Risk Factors
6. Diagnosis of HSDD
7. Co-morbidity
8. Interventions/Treatment
8.1 Psychotherapy
8.1.1 Cognitive behavioral therapy (CBT)
8.1.2 Sex Therapy
8.2 Pharmacotherapy
8.2.1 Hormone Therapy
8.2.2 Other Medications
9. Conclusion
Research Objectives and Key Themes
This literature review aims to provide a comprehensive overview of Hypoactive Sexual Desire Disorder (HSDD), examining its prevalence, historical classification, complex multifactorial etiology, and current diagnostic and therapeutic management strategies in clinical practice.
- Epidemiological patterns and gender disparities in HSDD prevalence.
- Evolution of the diagnostic criteria within the DSM framework.
- Physiological and psychological contributors including hormonal imbalances.
- Overview of evidence-based interventions such as psychotherapy and pharmacotherapy.
Excerpt from the Book
Etiology of HSDD
Even though the pathophysiology of HSDD remains a mystery, it etiology is clearly understood. Clayton (2010) reports that the causes of HSDD are multifactorial in which an array of causative and contributing factors exist. Clinical studies suggest interplay among psychological, neurological and hormonal factors which is responsible for the balance of excitatory and inhibitory activities in the brain. Ordinarily, dopamine, testosterone, progesterone, and estrogen are considered as the main excitatory factors which are responsible for sexual desire. On the other hand, prolactin and serotonin are antagonistic to excitatory factors; thus, they enhance inhibitory activity (Clayton, 2010). In general, testosterone and estrogen deficiencies are considered as the principle causes of HSDD.
Summary of Chapters
Introduction: This chapter introduces HSDD, its impact on quality of life, and the general reluctance of physicians to address sexual desire problems due to time constraints and knowledge gaps.
Epidemiology: This section explores the gender-based prevalence of HSDD, highlighting higher rates in women and the influence of aging on sexual desire across different demographic groups.
History of HSDD: This chapter outlines the historical evolution of how sexual dysfunction was categorized and eventually codified in the DSM, noting the shifts from early terms like "frigidity" to specific clinical definitions.
Etiology of HSDD: This section details the biological and multifactorial causes of the disorder, focusing specifically on the roles of testosterone, estrogen, and other medical conditions.
Risk Factors: This chapter examines the external and internal factors that increase susceptibility to HSDD, emphasizing the role of relationship dynamics and physiological changes related to aging.
Diagnosis of HSDD: This chapter explains the current diagnostic approach according to DSM-5 criteria, distinguishing between requirements for men and women.
Co-morbidity: This section discusses the frequent co-occurrence of HSDD with other sexual dysfunctions, which often leads to clinical misdiagnosis.
Interventions/Treatment: This chapter reviews the current management landscape, covering both psychological approaches like CBT and pharmacological treatments including hormone therapy.
Conclusion: The final chapter summarizes the clinical significance of HSDD, the necessity for better diagnostic practices, and the progress made in treatment options like flibanserin.
Keywords
Hypoactive Sexual Desire Disorder, HSDD, Sexual Dysfunction, Inhibited Sexual Desire, DSM-5, Testosterone, Estrogen, Psychotherapy, Cognitive Behavioral Therapy, Sex Therapy, Pharmacotherapy, Flibanserin, Sexual Desire, Hormonal Imbalance, Clinical Diagnosis
Frequently Asked Questions
What is the primary focus of this publication?
This work provides an academic literature review on Hypoactive Sexual Desire Disorder (HSDD), examining its definitions, history, causes, and modern treatment options.
What are the central themes discussed in the book?
The central themes include the epidemiological prevalence of the disorder, the evolution of its diagnostic criteria in the DSM, the role of hormones, and the effectiveness of various therapeutic interventions.
What is the primary objective of this review?
The primary objective is to synthesize existing scientific knowledge to provide a clear, comprehensive overview of HSDD to assist in better clinical understanding and management.
Which scientific methods are utilized?
The author utilizes a comprehensive literature review method, analyzing various clinical studies, prospective research, and established medical diagnostic manuals like the DSM.
What topics are covered in the main body of the work?
The main body covers the history of HSDD, its etiology—specifically hormonal factors like testosterone and estrogen—diagnostic procedures, common risk factors, and available treatments.
Which keywords best characterize this work?
Key terms include HSDD, sexual dysfunction, DSM-5, hormone therapy, psychotherapy, and clinical management.
How has the diagnostic definition of HSDD changed over time?
The definition has evolved from broad terms like "frigidity" in the 1970s to specific clinical criteria in the DSM-III, DSM-IV, and eventually the DSM-5, which now separates female sexual interest/arousal disorder and male hypoactive sexual desire disorder.
Why is HSDD often misdiagnosed?
Misdiagnosis frequently occurs because HSDD often co-occurs with other sexual dysfunctions, such as erectile dysfunction or vaginismus, and can be masked by underlying medical conditions or psychological distress.
What is the significance of flibanserin in HSDD treatment?
Flibanserin is significant as a specifically FDA-approved medication for the treatment of HSDD, though its use remains somewhat controversial due to contraindications like alcohol interaction.
- Quote paper
- Patrick Kimuyu (Author), 2018, Understanding Hypoactive Sexual Desire Disorder, Munich, GRIN Verlag, https://www.grin.com/document/411947
