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J Sex Med. 2013 Jan;10(1):36-49. doi: 10.1111/j.1743-6109.2012.02818.x. Epub 2012 Sep 13.

Sexual desire and hypoactive sexual desire disorder in women. Introduction and overview. Standard operating procedure (SOP Part 1).

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Department of Obstetrics and Gynecology, University Women's Hospital Basel, Basel, Switzerland.



Hypoactive sexual desire disorder (HSDD) is defined in Diagnostic and Statistical Manual of Mental Disorders Fourth Edition as persistent or recurrent deficiency (or absence) of sexual fantasies/thoughts, and/or desire for or receptivity to sexual activity, which causes personal distress. As a largely subjective experience, sexual desire may or may not be accompanied by externally observable changes in sexual behavior.


Describe the models of understanding HSDD and the contributing factors to provide the basis for a diagnostic interview and guidance for care for healthcare professionals as a standard operating procedure method. Review of the literature.


There are several models which have been developed to describe sexual desire, although there is still no universally accepted definition or description of it. The models are generally divided into more general two-factor models (e.g., excitation-inhibition, appetitive-consummatory) or more specific multifactorial models (in which the different components of sexual activity and their interaction are delineated). The etiology of the disorder is generally considered as multifactorial. Biomedical factors like diseases, drugs, and hormones, and psychological factors like life events, sexual biography, affective state, etc., as well as interpersonal factors like partner satisfaction, communication, duration of the relationship, and sociocultural factors interact with each other and contribute to the individual experience of desire or lack or absence of desire. In analogy to the multifactorial pathogenesis the therapeutic approach is usually multidimensional and includes basic counseling, individual and couple psychotherapy, hormonal and psychopharmacological treatment.


The standard operation procedure for HSDD in women must be based on a biopsychosocial, multidimensional, and integrative perspective.

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