DSM-III

In DSM-III, this disorder is called Inhibited Sexual Desire

For more information, see Psychosexual Dysfunctions

Diagnostic Criteria

A. 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. Frequently this category will be used in conjunction with one or more of the other Psychosexual Dysfunction categories.

B. The disturbance is not caused exclusively by organic factors (e.g., physical disorder or medication) and is not due to another mental disorder.

DSM-IV

For more information, see Sexual Dysfunctions

Diagnostic Criteria

A. Persistently or recurrently deficient (or absent) sexual fantasies and desire for sexual activity. The judgement of deficiency or absence is made by the clinician, taking into account factors that affect sexual functioning, such as age and the context of the person's life.

B. The disturbance causes marked distress or interpersonal difficulty.

C. The sexual dysfunction is not better accounted for by another mental disorder (except another Sexual Dysfunction) and is not due exclusively to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

Specify type:

  • Lifelong Type
  • Acquired Type

Specify type:

  • Generalized Type
  • Situational Type

Specify type:

  • Due to Psychological Factors
  • Due to Combined Factors

Differential Diagnosis

Sexual Dysfunction Due to a General Medical Condition

Hypoactive Sexual Desire Disorder must be distinguished from Sexual Dysfunction Due to a General Medical Condition. The appropriate diagnosis would be Sexual Dysfunction Due to a General Medical Condition when the dysfunction is judged to be due exclusively to the physiological effects of a specified general medical condition. This determination is based on history, laboratory findings, or physical examination. Certain general medical conditions such as neurological, hormonal, and metabolic abnormalities may specifically impair the physiological substrates of sexual desire. Abnormalities in total and bioavailable testosterone and prolactin may indicate hormonal disorders responsible for loss of sexual desire. If both Hypoactive Sexual Desire Disorder and a general medical condition are present, but it is judged that the sexual dysfunction is not due exclusively to the direct physiological effects of the general medical condition, then Hypoactive Sexual Desire Disorder, Due to Combined Factors, is diagnosed.

Substance-Induced Sexual Dysfunction

In contrast to Hypoactive Sexual Desire Disorder, a Substance-Induced Sexual Dysfunction is judged to be due exclusively to the direct physiological effects of a substance (e.g., antihypertensive medication, a drug of abuse). If both Hypoactive Sexual Desire Disorder and substance use are present, but it is judged that the sexual dysfunction is not due exclusively to the direct physiological effects of the substance use, then Hypoactive Sexual Desire Disorder, Due to Combined Factors, is diagnosed. If the low sexual desire is judged to be due exclusively to the physiological effects of both a general medical condition and substance use, both Sexual Dysfunction Due to a General Medical Condition and Substance-Induced Sexual Dysfunction are diagnosed.

Another mental disorder

Hypoactive Sexual Desire Disorder may also occur in association with other Sexual Dysfunctions (e.g., Male Erectile Dysfunction). If so, both should be noted. An additional diagnosis of Hypoactive Sexual Desire Disorder is usually not made if the low sexual desire is better accounted for by another mental disorder (e.g., Major Depressive Disorder, Obsessive-Compulsive Disorder, Posttraumatic Stress Disorder). The additional diagnosis may be appropriate when the low desire predates the other mental disorder or is a focus of independent clinical attention.

Occasional problems with sexual desire

Occasional problems with sexual desire that are not persistent or recurrent or are not accompanied by marked distress or interpersonal difficulty are not considered to be Hypoactive Sexual Desire Disorder.

DSM-5

See Female Sexual Interest/Arousal Disorder and Male Hypoactive Sexual Desire Disorder

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