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Hypoactive sexual desire disorder is an abnormality of sex that is mainly typified by the nonexistence of the need for sexual practices and dreams. For hypoactive sexual desire disorder (HSDD) to meet the definition of a disorder, it “must cause marked distress or interpersonal difficulties and not be better accounted for by another mental disorder, a drug (legal or illegal), or some other medical condition” (Moynihan, 2005, p.192). HSDD is categorized into several subtypes.
Although hypoactive sexual desire disorder is considered a loss of sexual desire, even loss of sexual desires for a given current partner is also considered to have HSDD. Clinicians present this disorder as a problem that requires medical interventions. However, critics argue that asexuality is being subjected by studies in HSDD to positions that are similar to homosexuality during times of discrimination of certain types of sexual affiliation and inclinations.
Causes and Symptoms
While attempting to evaluate the causes and symptoms of HSDD, it is important to note that low sexual desire is not principally an indication of the presence of the disorder because of the need to satisfy the precondition that a given problem must cause interpersonal difficulties together with marked distress to meet the definition of a disorder (Moynihan, 2005). It also needs not to be explained by some sort of medical challenges.
Faced with this dilemma, Mitchell and Mercer (2009) reveal that a description of the cause of HSDD is problematic. Symptoms and causes can be approached from the dimension of the description of what causes low sexual desires among people. Among men, despite the existence of various types of HSDD, or for discussion of this paper, low sexual desire, most men are diagnosed with three main types of HSDD.
The first type of HSDD that is prevalent among men is the generalized lifelong HSDD. For this type, men have no desire or have little desire for being simulated sexually by self or by a partner. In the case of the second type (situational-acquired HSDD), men have previous interest for sexual stimulation by their present partners.
However, this interest dwindles so that the current partners hardly stimulate them anymore. Nevertheless, I prefer being stimulated by other partners or by themselves (Moynihan, 2005). The third type of HSDD is the generalized-acquired HSDD. In this type of HSDD, men have had sexual desires at some time in their life. However, they are not interested in being sexually aroused either on a solitary basis or by future life partners.
Under normal circumstances, it is incredibly challenging to distinguish the three types of HSDD. However, as Moynihan (2005) informs, the three types do not have the same etiology. For instance, the causes of the generalized lifelong HSDD are not known among many clinicians.
For acquired generalized HSDD, its cause is known. The cause includes medical and health challenges, including psychiatric challenges, high prolactin levels, and low testosterone levels. Basson (2007) suggests that people’s sexual desire is controlled by the interaction of excitatory and inhibitory factors.
The balance for the above two factors is theoretically portrayed in the neurotransmitters within some selected areas of the brain. In this regard, Clayton informs that a reduction in sexual activities among people may be accounted for by “imbalance between neurotransmitters with excitatory activities like dopamine, norepinephrine, and neurotransmitters with an inhibitory activity such as serotonin” (2010, p.8).
Acquired-generalized HSDD may also emanate from the effects of various medical interventions. The probable sources of situational/acquired HSDD comprise affiliation troubles, persistent sicknesses, and troubles in intimacy. The scholarly evidence for these causes is subject to interrogations. Some causes of the HSDD are arrived at based on empirical studies while others are based on clinical observations among persons who possess the disorder (Mitchell & Mercer, 2009).
Opposed to men, several factors may cause HSDD among women. These include emotional discomforts, therapeutic troubles, or even a high quantity of prolactin. Concentrations of some hormones may also cause of HSDD among women. Low sexual desires among women are also believed to be caused by relationship challenges and exposure to stressful life experiences.
A study conducted by Mitchell and Mercer (2009) reveals that women who suffer from HSDD do not have a significant association with reduced sexual stimuli. However, they have weaker positive association sexual stimuli relative to women who do not suffer from HSDD disorder (Mitchell & Mercer, 2009).
For both women and men, HSDD may be characterized by symptoms such as recurrent loss of sexual fantasies together with a desire for sexual activities. People may also experience distress due to hormonal disturbances, which may cause interpersonal difficulties.
Tantamount to other sexual dysfunctions, HSDD is treated from a relationship perspective. Theoretically, it is possible to offer treatment interventions to persons suffering from HSDD for persons who are diagnosed with the disorder outside the relationship context.
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However, it is crucial to note, “Relationship status is the most predictive factor accounting for distress in women with low desire…distress is required for a diagnosis of HSDD” (Clayton, 2010, p.8). The involvement of partners in therapy interventions is one of the plausible treatment alternatives for HSDD.
A therapist identifies the biological together with the psychological cause of hypoactive sexual desire disorder. Hence, the treatment procedure is dependent on the diagnosed cause of the disorder. In case the cause of the disorder is not related to organic causes or psychological causes, the clinician may recommend for addressing communication issues among the patients and working on various mechanisms of enhancing education on sexuality and intimacy.
In this context, Basson (2007) argues, “problems occur due to unrealistic perceptions about what normal sexuality is and when people are concerned that they do not compare well to that” (p.67). This statement reveals the importance of education in the treatment process of HSDD.
For men, treatment options are dependent on the type of HSDD with which they are diagnosed. However, as Basson (2007) informs, low probabilities exist for raising the sexual desire among men who suffer from generalized lifelong HSDD. Hence, a couple may only be trained on how it can adapt to this challenge.
In case of the acquired situational HSDD, biological causes of the problems are identified and proactively addressed using appropriate medicinal interventions. For acquired-generalized HSDD, psychotherapy is a viable treatment option. Other possible treatment options are also available.
For instance, Mitchell and Mercer (2009) insist, “As neurotransmitters and sex hormones have modulatory functions on sexual desire; treatment intervention has been evaluated in multiple clinical trials” (p.2438). One such intervention is the use of Intrinsa. It functions by the release of testosterone via the skin of an individual by finding its way to the bloodstream. This testosterone material is approved for utilization by post-menopausal females who are under treatment for estrogen substitution by Procter and Gamble.
Sexual dysfunction is a phenomenon that affects people irrespective of their race, gender, age, and other demographic characteristics. To exemplify the extents to which sexual dysfunctional afflict people from different background, a case study for female sexual dysfunction in India is discussed in this section.
In India, every aspect of life event experience is subjected to some sort of cultural explanations that are often accompanied by some form of mongering. In particular, two chief grounds reveal why the sexual issue is subjected to mongering. Political and social controls for various social expressions act as reservoirs for ignorance and shame.
Therefore, it becomes incredibly difficult for some Indians to understand and deal proactively with issues relating to sexual satisfaction or even handle effectively any sexually related challenges, including female sexual dysfunction through rational ways. The repercussions for this case are that many women having HSDD go untreated.
Secondly, as Moynihan argues, “popular culture has greatly inflated public expectations about sexual functions and the importance of sex to personal and relationship satisfaction” (2005, p.193). Consequently, in the Indian context, people need acquiring high sexual rewards through their partners, although they possess no adequate tools for use to achieve rewards.
Historically, people in India are fed with myths that advance the perception that sex is natural. Therefore, it is an automatic and biological function. Hence, it cannot be learned. As they anticipate excessive levels for performance together with enduring pleasure, people look for simplistic solutions, especially when affected by HSDD. Such solutions include the use of Viagra, which has become a rampant intervention among many people in India, especially men who have low sexual desires.
Basson, R. (2007). Sexual Desire/Arousal Disorders in Women. New York: The Guilford Press.
Clayton, H (2010). The Pathophysiology of Hypoactive Sexual Desire Disorder in Women. International Journal of Gynecology, 110 (1), 7–11.
Mitchell, R., & Mercer, H. (2009). Prevalence of Low Sexual Desire among Women in Britain: associated factors. The Journal of Sexual Medicine, 6(9), 2434–2444.
Moynihan, R. (2005). The marketing of a disease: Female sexual dysfunction. BMJ 330 1(1), 192–194.