Desire Disorders: Definition, Causes & Treatment

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  • 0:07 Hypoactive Sexual…
  • 0:56 Diagnosis
  • 4:06 Causes
  • 5:44 Treatment
  • 6:53 Lesson Summary
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Lesson Transcript
Instructor: Natalie Boyd

Natalie is a teacher and holds an MA in English Education and is in progress on her PhD in psychology.

Desire is a normal part of adult relationships. But what happens when someone loses all desire? In this lesson, we'll examine hypoactive sexual desire disorder, its symptoms, causes, and treatment.

Hypoactive Sexual Desire Disorder

Aidan and Caro are in love. They live together and have a great relationship that makes all their friends envious. They get along well, make each other laugh and rarely fight. There's just one problem: Caro isn't interested in sex. It's not just that she doesn't like Aidan; she doesn't have fantasies or sexual interest at all. Her doctor says there's nothing physically wrong with her, but she hasn't had any interest in sex for months, and she's very upset about it.

Caro might be suffering from hypoactive sexual desire disorder, or HSDD for short. HSDD is a psychological disorder that is characterized by a lack of sexual desire for a long period of time. It is more common in women than in men. Let's look closer at how HSDD is diagnosed and treated.


Imagine that you are a psychologist and Caro and Aidan come to see you about her problems. Caro describes her symptoms and tears up when she talks about it. It's obvious that this is a big problem to her, even though Aidan does his best to support her.

In order to diagnose patients, psychologists use a book called the Diagnostic and Statistical Manual of Mental Disorders, or DSM for short. The DSM includes all sorts of mental illnesses, including several disorders that have to do with sexuality.

You think that Caro might have HSDD, but in order to make sure, you open up your DSM and find the page that describes the symptoms of HSDD. You see that in order to be diagnosed with it, there are certain criteria that need to be met first.

  1. Persistently or recurring deficient sexual fantasies and sexual desire. Of course, many things can cause people to lose their desire, including age and stress. But when you talk to Caro, you realize that her loss of desire is not because of age or stress.
  2. The loss of desire causes marked distress or interpersonal difficulty. Obviously, this is causing Caro distress, because she can't even talk about it without crying. And though Aidan is supportive, sometimes HSDD can cause people to break up or not be able to be in a relationship.
  3. The cause is not another mental disorder, drug use or other medical condition. When you talk to Caro, you realize that there's nothing physically or psychologically wrong with her, and she doesn't abuse drugs or alcohol, so you can rule those out as possible causes.

Caro meets all three of these criteria, so you can diagnose her with HSDD. Once you've determined that's what she has, though, you also need to figure out what type she has. There are three categories, and you have to choose one type for each category. Together, the three types make up Caro's unique diagnosis.

The three categories are:

  1. Lifelong vs. acquired. Has Caro always been this way, or is this a relatively new thing? We know that Caro has not had any fantasies or sexual desire for several months, but before that, she had a healthy interest in sex. Because this is not something that's always been a problem for her, we can say that she has the acquired type.
  2. Generalized vs. situational. Does Caro's disinterest in sex have to do with a specific situation, or is it a general issue? For example, some women find that they only lose interest in sex with their one partner, but are still interested in sex with other people. Caro isn't interested in sex with anyone, so we can say that she has the generalized type.
  3. Due to psychological factors vs. due to combined factors. There are many things that can cause HSDD, which we will examine more closely in a moment. If more than one of these causes are present, Caro would be said to have HSDD due to combined factors. But for now, let's say that the only cause of Caro's symptoms is psychological; we could say that she has HSDD due to psychological factors.

So, we can diagnose Caro as having acquired, generalized type HSDD due to psychological factors.


The causes of HSDD are not all known, and they depend on what type of HSDD the person has. For lifelong/generalized type HSDD, there is little known about what causes it. One theory is that it's caused by hormonal imbalances, particularly low levels of testosterone. Another is that it might be caused by rape or sexual abuse early in life, or a family or cultural environment that is stringently against sex.

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