Male Hypoactive Sexual Desire Disorder

Prevalence

  • The prevalence of male hypoactive sexual desire disorder varies depending on country of origin and method of assessment.

  • Approximately 6% of younger men (ages 18-24 years) and 41% of older men (ages 66-74 years) have problems with sexual desire.

  • However, a persistent lack of interest in sex, lasting 6 months or more, affects only a small proportion of men ages 16-44 (1.8%).

Risk Factors

Temperamental

  • Mood and anxiety symptoms appear to be strong predictors of low desire in men.

  • Up to half of men with a past history of psychiatric symptoms may have moderate or severe loss of desire, compared with only 15% of those without such a history.

  • A man's feelings about himself, his perception of his partner's sexual desire toward him, feelings of being emotionally connected, and contextual variables may all negatively (as well as positively) affect sexual desire.

Environmental

  • Alcohol use may increase the occurrence of low desire.

  • Among gay men, self-directed homophobia, interpersonal problems, attitudes, lack of adequate sex education, and trauma resulting from early life experiences must be taken into account in explaining the low desire.

  • Social and cultural contextual factors should also be considered.

Genetic and physiological

  • Endocrine disorders such as hyperprolactinemia significantly affect sexual desire in men.

  • Age is a significant risk factor for low desire in men.

  • There also may be a critical threshold below which testosterone will affect sexual desire in men and above which there is little effect of testosterone on men's desire.

Symptoms

  • Persistently or recurrently deficient (or absent) sexual/erotic thoughts or fantasies and desire for sexual activity.

The judgment of deficiency is made by the clinician, taking into account factors that affect sexual functioning, such as age and general and sociocultural contexts of the individual’s life.

  • The symptoms have persisted for a minimum duration of approximately 6 months.

  • The symptoms cause clinically significant distress in the individual.

  • The sexual dysfunction is not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other significant stressors and is not attributable to these effects of a substance/medication or another medical condition.