Therapeutic Areas

Women’s Health

Hypoactive Sexual Desire Dysfunction (HSDD)

Hypoactive sexual desire dysfunction (HSDD) a medical condition characterized by a reduction or loss of sexual desire or motivation to engage in sexual activity which causes personal distress.

HSDD was medically classified defined in the 1980’s and over the decades following extensive research has been re-defined on numerous occasions.

The most recent definition by the World Health Organization’s International Classification of Diseases version 11 (ICD-11) states:

HSDD is characterized by absence or marked reduction in desire or motivation to engage in sexual activity as manifested by any of the following:

  1. reduced or absent spontaneous desire (sexual thoughts or fantasies);
  2. reduced or absent responsive desire to erotic cues and stimulation; or
  3. inability to sustain desire or interest in sexual activity once initiated.

The pattern of diminished or absent spontaneous or responsive desire or inability to sustain desire or interest in sexual activity has occurred episodically or persistently over a period at least several months and is associated with clinically significant distress.

This definition reflects the most current scientific evidence and best clinical practice.1

Prevalence of HSDD in Australia

In Australia, two large studies recruited nationally representative samples of midlife (40 – 64 years) and older women (65 – 75 years). Both studies used validated questionnaires to measure sexual desire and sexually associated personal distress. The overall prevalence of HSDD estimated by the studies was 32.2% and 13.6% respectively.2,3

HSDD is more likely to cause distress in younger women who may experience abrupt decline in hormone levels after surgical menopause. Surgically postmenopausal women, aged 50 to 70 and naturally menopausal women experience no significant differences in prevalence of HSDD.4

Impact of HSDD

Sexual dysfunction in women adversely impacts quality of life and general well-being. In a 2014 Australian study reported women with HSDD commonly report dissatisfaction in sexual activity, guilt, disconnection from their partner, feelings with frustration, hopelessness, anger, sadness, embarrassment, loss of femininity; and often have poor self-esteem.5

Another study in 2009 reported that the overall effect of HSDD on quality of life is similar in magnitude to that reported in women with other chronic conditions such as back pain or urinary incontinence. They found that HSDD was associated with a significant reduction in health-related quality of life parameters including mental health, vitality, social function, and bodily pain compared to healthy population norms.6

The precise biological and neurochemical factors contributing to the development of HSDD are complex and are not fully understood.

The HSDD Process of Care flow chart, developed by the International Society for the Study of Women’s Sexual Health (ISSWSH), provides physician guidance in determining the management of HSDD in women. These guidelines were developed by expert consensus, based on an evaluation of peer reviewed literature.

Hormone therapy forms just one part in a collective of management and treatment options for a woman diagnosed with HSDD.


Tools to assist diagnosing HSDD

The Decreased Sexual Desire Screener (DSDS) is a validated diagnostic tool to assist doctors in the evaluating HSDD.

This five question Yes/No questionnaire and diagnostic key can be supplied to doctors upon request or downloaded from the Medical Professionals section of this website.





1. Clayton A, Goldfischer E, Goldstein I, et al. Validity of the decreased sexual desire screener for diagnosing hypoactive sexual desire disorder. J Sex & Marital Ther. 2009;39:132-143.PR-1006.00

Any use or reproduction of this questionnaire without authorization is prohibited.
Reproduced by Lawley Pharmaceuticals Pty Ltd, Australia with permission from Sprout Pharmaceuticals, Inc., USA.
Copyright © 2018 Sprout Pharmaceuticals, Inc. All rights reserved.



  1. Reed G et al. Disorders related to sexuality and gender identity in the ICD-11: revising the ICD-10 classification based on current scientific evidence, best clinical practices, and human rights considerations. World Psychiatry 2016;15:205-221.
  2. Worsley R et al. Prevalence and predictors of low sexual desire, sexually related personal distress, and hypoactive sexual desire dysfunction in a community-based sample of midlife women. The Journal of Sexual Medicine 2017; 14: 675-686.
  3. Zeleke et al. Hypoactive sexual desire dysfunction in community-dwelling older women. Menopause 2017; 24: 391-399.
  4. Goldstein I et al. Hypoactive sexual desire disorder: International Society for the Study of Women’s Sexual Health (ISSWSH) expert consensus panel review. Mayo clinic Proceedings 2017; 92: 114-128.
  5. Fooladi E et al. Women’s expectations and experiences of hormone treatment for sexual function. Climacteric 2014; 17: 674-681.
  6. Biddle AK, West SL, D’Aloisio AA, Wheeler SB, Borisov NN, Thorp J. Hypoactive sexual desire disorder in postmenopausal women: quality of life and health burden Value Health 2009; 12: 763-772.
  7. Clayton AH et al. The International Society for the Study of Women’s Sexual Health (ISSWSH) Process of Care for Management of Hypoactive Sexual Desire Disorder in Women. Open Access. Mayo Clin Proc 2018;94(4):467-487.

Learn more:  Only for inclusion on the International only LP website