Also known as hypoactive sexual desire, it is the most common disorder and is defined as the lack of persistent or recurrent absence of sexual thoughts or fantasies and/or desire or receptivity for sexual activity, being a cause for personal distress (anxiety, frustration, angst). The most severe form is persistent or recurrent phobic aversion to sexual contact.
It is the most common sexual dysfunction in women, with an incidence of 33% in women between the ages of 18 and 50 and up to 45% in the menopause.
Sexual desire has its roots in the rhinencephalon and in the limbic region of the brain, highly dependent on hormones (androgens, oestrogens) and modulated by different mental states such as mood and depression. Motivational, affective and cognitive factors are fundamental for the adequate direction of sexual desire.
Disorders in sexual desire have different origins, biological as well as affective-motivational (relationship) and cognitive.
To follow, the most common biological causes are detailed:
Endocrines
- Hypoestrogenism
- Hypoandrogenism
- Hyperprolactinemia
- Hyperthyroidism
Affective disorders
- Depression
- Anxiety and/or phobia
Neurovegetative disorders
- Hot flushes
- Insomnia
Drugs and toxins
- Alcohol and drugs
- Antidepressants
- Antiandrogens
- Levosulpiride
The diagnosis is based on a detailed medical history and physical examination.
Depending on the data obtained, a hormonal (total and free testosterone, DHEAS, estradiol, SHBG, FSH, TSH) and psychological evaluation may be undertaken.
Due to the large number of factors participating in sexual desire, the treatment presents considerable difficulties. Where there are hormonal irregularities, a replacement treatment with testosterone or oestrogens may be indicated, or with hypoprolectinemia medication and thyroxin in cases of hyperprolectinemia and hyperthyroidism. If there were toxic or drug factors, these must be eliminated or, where possible, replaced.
Psychotherapy and sexual education will be advisable in the majority of cases.
If the disorders in sexual desire are as a result of other sexual disorders (excitability, orgasm, coital pain), these must be duly evaluated and treated.