Hypoactive Sexual Desire Disorder

Key facts

• Hypoactive sexual desire disorder (HSDD) is a persistent or recurrent lack of sexual desire that causes personal distress, not just an occasional dip in interest.
• It affects both women and men, though it is diagnosed more often in women.
• Causes are rarely one thing: hormonal shifts (low oestrogen after menopause, or low testosterone in men), psychological factors such as anxiety, depression or relationship stress, and certain medicines including antidepressants and hormonal contraceptives.
• Treatment depends on the cause and can include hormone therapy, psychological support such as cognitive behavioural therapy or sex therapy, and reviewing contributing medicines.

What drives HSDD

The causes are rarely one thing. Hormonal shifts, falling oestrogen after menopause or low testosterone in men, frequently reduce desire. Psychological factors such as anxiety, depression, relationship stress or a history of trauma are equally common contributors. Chronic illness, fatigue, and certain medicines, particularly antidepressants and hormonal contraceptives, can suppress desire as a side effect. HSDD is best understood as a mix of physical, emotional and relational factors rather than a single cause.

How it's addressed

There is no single fix, since treatment depends on what is driving the problem. Hormone therapy can help when low oestrogen or testosterone is the main driver. Psychological support, including cognitive behavioural therapy or sex therapy, addresses anxiety, relationship strain or past trauma. Where a medicine such as an antidepressant or hormonal contraceptive is contributing, a doctor may review and adjust it. A focused history and, where relevant, blood tests help identify which of these applies to you.

When to see a doctor

See a doctor or sexual health specialist if low desire is persistent and causes you distress. Speaking openly with a clinician is the most reliable first step toward finding out what is driving it and what will help.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.