By Joshua R. Gonzalez MD | Sexual Health + Urology
Understanding Hypoactive Sexual Desire Disorder (HSDD)
When it comes to sexual health, women’s concerns are often underrecognized and undertreated, despite the profound impact they can have on quality of life and intimate relationships. One of the most common yet overlooked conditions is Hypoactive Sexual Desire Disorder (HSDD)—a persistent lack of sexual desire that causes personal distress. At Joshua R. Gonzalez MD | Sexual Health + Urology, we believe that women deserve comprehensive, compassionate care for all aspects of sexual wellness, including HSDD.
What is Hypoactive Sexual Desire Disorder?
HSDD is characterized by a persistent or recurrent absence of sexual fantasies and desire for sexual activity, which causes marked distress or interpersonal difficulty. It’s important to differentiate this condition from a naturally lower libido that isn’t bothersome to the individual. In HSDD, the key factor is distress—if a woman is not troubled by her low desire, it typically doesn’t meet the criteria for HSDD.
Causes of HSDD
The causes of HSDD are multifactorial, meaning they can stem from physical, psychological, and emotional factors. Some common contributors include:
- Hormonal changes (e.g., menopause, postpartum, birth control use)
- Medical conditions (e.g., diabetes, thyroid disorders, depression)
- Medication side effects (e.g., antidepressants, antihypertensives)
- Relationship challenges (e.g., lack of communication, unresolved conflict)
- Stress and fatigue
- Negative body image or past trauma
Why HSDD Often Goes Undiagnosed
Despite being the most common type of female sexual dysfunction, many women do not seek help for HSDD. Reasons include:
- Embarrassment or fear of judgment
- Belief that low desire is a “normal” part of aging
- Lack of awareness that treatments exist
- Hesitancy to discuss sexual health with healthcare providers
Unfortunately, many healthcare providers may also lack the training to diagnose or manage female sexual dysfunction, leading to further neglect of this significant issue.
Diagnosis and Treatment
At Joshua R. Gonzalez MD | Sexual Health + Urology, diagnosis begins with a detailed, confidential consultation that includes medical history, sexual health history, and discussion of symptoms. We take a holistic approach to uncover potential underlying causes and provide tailored recommendations.
Treatment options may include:
- Lifestyle modifications (stress management, sleep optimization, exercise)
- Counseling or sex therapy (individual or couples therapy)
- Hormonal therapy (if hormonal imbalance is present)
- FDA-approved medications for HSDD, such as:
- Flibanserin (Addyi)
- Bremelanotide (Vyleesi)
- Addressing relationship dynamics and improving intimacy
Our goal is to provide a safe, nonjudgmental space where women can explore their concerns and receive evidence-based, personalized care.
Comprehensive Q&A on HSDD
Q: How do I know if I have HSDD or if I just have a naturally low libido?
A: The key difference lies in distress. If your low sexual desire is causing personal frustration or relationship difficulties, it may be HSDD. If you’re content with your level of desire, it likely doesn’t require treatment.
Q: Is HSDD common?
A: Yes. Studies suggest that up to 10% of women may experience HSDD at some point in their lives, making it the most prevalent form of female sexual dysfunction.
Q: Can HSDD be cured?
A: While there may not be a “cure” for all women, many experience significant improvement through treatment. Addressing underlying causes, trying FDA-approved medications, and making lifestyle changes can lead to better sexual satisfaction and overall well-being.
Q: Are medications for HSDD safe?
A: Both Addyi and Vyleesi are FDA-approved for premenopausal women with HSDD. Each has potential side effects, which we will thoroughly discuss during your consultation. Not all women are candidates for medication, but for some, it can be life-changing.
Q: Can postmenopausal women be treated for HSDD?
A: Absolutely. While some medications are approved specifically for premenopausal women, hormonal therapy and other interventions can be effective for postmenopausal women. We tailor treatment based on your unique needs and stage of life.
Q: Is it normal to lose sexual desire after childbirth?
A: Yes, many women experience lower libido postpartum due to hormonal shifts, sleep deprivation, and emotional changes. However, if desire does not return or causes distress, seeking care is beneficial.
Q: Will talking to a urologist help with a “female” issue like HSDD?
A: Dr. Joshua R. Gonzalez is a specialist in sexual health for both men and women. He has extensive experience in diagnosing and treating female sexual dysfunction and is dedicated to providing comprehensive, judgment-free care.
Take the First Step Toward Sexual Wellness
If you’re struggling with low sexual desire and it’s affecting your well-being or relationships, know that you are not alone—and help is available. At Joshua R. Gonzalez MD | Sexual Health + Urology, we are passionate about addressing this unmet need and empowering women to reclaim their sexual health and confidence.
Contact Information
Joshua R. Gonzalez MD | Sexual Health + Urology
📍 5757 Wilshire Blvd, Suite 475, Los Angeles, CA 90036
📞 Phone: (323) 607-2895
🌐 Visit our website for more information or to request a confidential appointment.