HSDD: I Have No Sexual Desire, What Can I Do About It?

HSDD: I Have No Sexual Desire, What Can I Do About It?

Do you find yourself with a lack of sexual desire, which is bothersome to you? This could be a symptom of HSDD.

HSDD stands for hypoactive sexual desire disorder, which is a sexual dysfunction characterized by a persistent or recurrent lack of sexual desire or interest in sexual activities. A lack of sexual desire is only considered to be HSDD if it is distressing to the individual and there are no easily modifiable factors that can correct the problem.

This sexual dysfunction can be very upsetting for the person experiencing it, and it may cause strain in their sexual relationship(s). It may also negatively impact their overall well-being. While HSDD can occur in both men and women, it is more commonly reported by women.

There can be various biopsychosocial factors contributing to HSDD, including physical, psychological, and relationship factors. Some potential contributors include hormonal imbalances, certain medications, medical conditions (like thyroid disorders), psychological issues (such as depression, anxiety, or past trauma), and lifestyle factors. A diagnosis of HSDD is considered when people have low sexual desire causing distress not related to or caused by any specific, modifiable factors such as relationship factors or genitourinary syndrome of menopause – those other factors should be treated.

If you experience a lack of sexual desire that is distressing to you, here are a few steps you can take:

Consult a Health Care Professional: If you suspect you have HSDD, it is important to talk to your health care practitioner. This professional can conduct a thorough assessment, possibly including blood tests, to determine potential underlying causes and recommend appropriate treatment options.

Psychotherapy: Counseling or therapy can be beneficial for addressing psychological factors that might contribute to HSDD. Cognitive-behavioral therapy (CBT) or sex therapy might help individuals identify and work through underlying emotional or psychological barriers.

Medications: A health care practitioner might prescribe medications for HSDD. Postmenopausal women could consider off label testosterone. In some cases, medications like flibanserin or bremelanotide might be prescribed to address low sexual desire, but their use should be discussed thoroughly with a health care practitioner.

Lifestyle Changes: Making healthy lifestyle choices can have a positive impact on sexual desire. Regular exercise, stress management, a balanced diet, and adequate sleep can contribute to overall well-being, including sexual health.

Communication With Your Partner: If HSDD is affecting your relationship, open and honest communication with your partner is crucial. Couples therapy or relationship counseling can help address any relational issues that might be contributing to or exacerbated by the disorder.

It’s important to remember that there’s no one-size-fits-all approach to treating HSDD. The appropriate treatment strategy will depend on the individual’s specific circumstances, underlying causes, and personal preferences. Make an appointment with your health care practitioner or a sexual medicine specialist to discuss the best course of action if you are struggling with HSDD symptoms.

For more information on this topic, please read these publications from the ISSM Journals: The Journal of Sexual Medicine, Sexual Medicine Reviews, and Sexual Medicine Open Access:

International Society for the Study of Women’s Sexual Health Clinical Practice Guideline for the Use of Systemic Testosterone for Hypoactive Sexual Desire Disorder in Women

Treatments for Hypoactive Sexual Desire Disorder (HSDD) and the Pursuit of Sexual Health for Women Amidst Inglorious Rhetoric


Goldstein, I., Kim, N. N., Clayton, A. H., DeRogatis, L. R., Giraldi, A., Parish, S. J., Pfaus, J., Simon, J. A., Kingsberg, S. A., Meston, C., Stahl, S. M., Wallen, K., & Worsley, R. (2017). Hypoactive Sexual Desire Disorder: International Society for the Study of Women's Sexual Health (ISSWSH) Expert Consensus Panel Review. Mayo Clinic proceedings92(1), 114–128. https://doi.org/10.1016/j.mayocp.2016.09.018

Pachano Pesantez, G.S., & Clayton, A.H. (2021). Treatment of Hypoactive Sexual Desire Disorder Among Women: General Considerations and Pharmacological Options. Focus (American Psychiatric Publishing)19(1), 39–45. https://doi.org/10.1176/appi.focus.20200039

Parish, S.J., Goldstein, A.T., Goldstein, S.W., Goldstein, I., Pfaus, J., Clayton, A.H., Giraldi, A., Simon, J.A., Althof, S.E., Bachmann, G., & Komisaruk, B. (2016). Toward a more evidence-based nosology and nomenclature for female sexual dysfunctions—part II. The Journal of Sexual Medicine13(12), 1888-1906. https://doi.org/10.1016/j.jsxm.2016.09.020

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