Hyposexuality

Sara J. Petermann ** Hyposexuality **

Hyposexuality is a sexual disorder associated with exceedingly low libido, which inhibits one’s sex drive, also referred to as hypoactive sexual desire disorder (HSDD). This dysfunction was defined in 1987 by the American Psychiatric Association and is characterized by ‘‘Persistent and pervasive inhibition of sexual desire. The judgment of inhibition is made by the clinician’s taking into account factors that affect sexual desire such as age, sex, health, intensity and frequency of sexual desire, and the context of the individual’s life. In actual practice this diagnosis will rarely be made unless the lack of desire is a source of distress to either the individual or his or her partner” (Jutel, 2010).
 * Understanding the dysfunction**

There is no one cause of hyposexuality. In some people it may be due to hormonal imbalances, while in others it is because of psychological or social stressors. It is a misconception that HSDD only affects women. Hyposexuality can affect men as well; however it is less prevalent due to their naturally higher sex drives and testosterone levels. Women also have the added obstacles of menopause, as well as post-pregnancy decline in sex drive. **“**The disorder affects approximately 20% of the total population and is far more common in females than males” (Bupropion, 2001).

Hyposexuality is frequently confused with asexuality. Asexuality is a complete lack of sexual attraction, with no desire for or interest in sex. It can, but usually does not cause the distress that characterizes those with hyposexuality.

Hyposexuality may emerge as a secondary result of other disorders. Neurologic conditions such as epilepsy are often examined for occurrences of hyposexuality in patients. In addition, studies have been conducted that show that patients suffering from chronic psychoses such as schizophrenia also suffer from a high rate of sexual dysfunctions such as hyposexuality (Raja, 2003).




 * Sexual desire and relationships**

Those with low sexual desire tend to have a unique relationship dynamic. A study of asexual (not hyposexual) participants showed “Benefits included avoiding intimate relationship problems, having lower health risks and social pressures, and having more free time. Drawbacks on the other hand, were potential partner relationship problems, thinking something is wrong, negative public perception, and missing positive aspects of sex” (Jutel, 2010). However, when lack of sexual desire is an actual bodily dysfunction, frustration can build on both sides of relationships.

In all relationships it is a good idea to communicate sexual expectations and desires to one’s partner. “Normal” desire is a relative term, and may help someone determine whether they are experiencing a dysfunction. “The vexed question of ‘‘Just how often are normal people having sex?’’ surfaces in publications from //Glamour// to //New Scientist//, and figures in self-screening tools about longevity, happiness and relationship health” (Jutel, 2010). As shown in the Medscape diagram, after a basic assessment it is important to address health and/or sexual issues with your partner. If the issue is being caused by a psychosocial issue, it could be something about the relationship needs to be fixed. A study was conducted with the partners of those patients suffering from both depression and hyposexuality to see whether there was an effect on their sex drive. They found that “depressed mood is mainly associated with one’s own hyposexual desire, sexual aversion and sexual arousal problems” (Bodenmann, 2007). In other words, hyposexuality is largely a personal dysfunction that one may have to work through with the help of their partner.

Physicians tend to focus on preventing sexually transmitted diseases and pregnancy, and less on sexual pleasure and function of their patients. This fact may be confusing to someone who thinks they are experiencing hyposexuality. It can become a barrier to a patient deciding to seek care, as sexual dysfunction is associated with embarrassment. For HSDD it is particularly crucial to seek care in the instances of causal due to another disorder, or from the side effects of medication.
 * Diagnosis and treatment**

The difficulty of this communication was shown in a recent study of women with self-reported sexual problems. “Just over a third of women with any distressing sexual problems had sought formal care, most often from a gynecologist or primary care physician; about 80% of the time, the woman, rather than the physician, initiated the conversation. Only 6% of women who sought medical advice scheduled a visit specifically for a sexual problem” (Shifren et al., 2009). This data emphasizes the continued struggle for open communication between patients and health care providers. Diagnosing and treating hyposexuality can prove to be a challenge, as it presents itself differently in each person. Symptoms and personal circumstances are the most useful in examination. Tests are sometimes obtained but not often helpful. Screening tools for HSDD have been developed to help patients self-diagnose and evaluate whether to see their doctors, which tend to be effective, but qualitative cognitive interviews often work better (Rust, 2007).

How to treat HSDD depends entirely on the root cause. “The diagnosis of F(emale)HSDD, however, disregards the historical and social context of sexuality; rather it focuses on clinical detail about attitudes towards sex. The tools of diagnosis constitute a second important framing mechanism in creating the classification itself” (Jutel, 2010). Mental, emotional, and psychosocial issues may be addressed with therapy or meditation. Hormonal disorders and physical imbalances may be treated with herbs, vitamins, or prescribed medications. There is now a large market for prescription drugs aimed to treat low libido. Many of these drugs target women with versions of “female Viagra” so that they can become “equal” to men. Some substances, such as bupropion, have been documented as “safe and effective” treatments for HSDD with minimal side effects (Bupropion, 2001). Other drugs companies have advertised how common of a problem low sexual desire is in order to normalize their prescriptions. “Boehringer Ingelheim is not alone in funding the tools and providing cures for female sexual dysfunction. I have previously mentioned Proctor and Gamble, but also Pfizer (and perhaps others) have a vested interest in the development of other treatments for female sexual dysfunction” (Jutel, 2010).

Popular entertainment and media sources in the United States are increasingly referred to as hypersexualized, relating to the condition of an exceedingly high sex drive, which normalizes a high desire for sex and decreases the consideration for possibility of conditions like hyposexuality. There is a high visibility and acceptance for overt, possibly over-the-top sexuality which can make the low sex desire associated with HSDD seem more rare and increase the associated stigma. In fact, the distress aspect that defines the disorder may be exacerbated by the fact that “low” sexual desire is often viewed as abnormal. For this reason it is important to be aware of discourse regarding what is considered “normal” sexual desire.
 * Media, stigma, and consumption**

When thinking about hyposexuality and society it is also important to consider how sex can be thought of as a commodity. It is often present in advertisements for near anything that can be sold, and we are also targeted with ads for products that try to fix sexual dysfunction. “On the one hand consumer culture is based on perpetuating feelings of sexual inadequacy; on the other, the industry has recognised an opportunity for exploitation, and has designed and presented a remedy: also for sale” (Jutel, 2010). The way that companies communicate with us about the importance of sex and treating a lack of desire for sex is also important to the understanding of hyposexuality.

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 * References**