What is hypoactive sexual desire disorder?

Hypoactive sexual desire disorder (HSDD) describes persistently low or absent sexual desire that causes personal distress. It is important to distinguish it from low desire that causes no distress — the latter does not require clinical intervention. HSDD is the most common female sexual dysfunction. Contributing factors include hormonal changes, medication effects, psychological factors (stress, anxiety, depression, relationship conflict), and physical health.

What approaches help with low sexual desire?

Addressing underlying contributing factors is the priority: stress, relationship dynamics, hormonal imbalances, medication effects, and mental health. Psychosexual therapy and relationship therapy address psychological and relational dimensions. Mindfulness practices improve sexual awareness and reduce performance anxiety. Hormonal assessment and treatment may be appropriate where deficiency is identified. The medication flibanserin (approved in the US for premenopausal HSDD) is not widely available in the UK.

Can hormonal treatment help?

Testosterone supplementation has evidence for improving sexual desire in women, particularly postmenopausally and following surgical menopause. In the UK, testosterone gel is available off-label for this indication and can be prescribed by GPs or menopause specialists. Oestrogen treatment for genitourinary symptoms of menopause may also improve sexual desire by reducing physical discomfort during sex.

When is low desire worth addressing medically?

If low desire is causing you or your relationship significant distress, seeking support is appropriate and effective. Conversely, if low or absent desire does not cause personal distress, it may simply reflect your natural level of interest rather than a disorder. A GP, psychosexual therapist, or menopause specialist can help assess whether a hormonal or psychological cause is contributing.

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Hypoactive sexual desire disorder

Hypoactive sexual desire disorder involves persistently reduced interest in sexual activity causing personal distress. Sex therapy, relationship counselling, hormonal assessment, and mindfulness-based approaches address

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Reviewed by Dr. Ian Henderson · Microbiobial Health & Medicine26 March 2026Emerging evidence

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Hypoactive sexual desire disorder is experienced as a persistent, distressing absence or significant reduction of sexual desire — including thoughts, fantasies, or motivation for sexual activity
Many people describe the experience as not simply "not being in the mood" but as a genuine absence of interest that feels foreign to their previous self
The distress is often amplified by relationship dynamics: feeling guilty about not wanting intimacy with a partner who does, or feeling disconnected from an aspect of identity that previously felt important
Hormonal changes, stress, relationship difficulties, medication side effects, and past trauma are among the most commonly associated factors

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Symptoms & Affected Systems

Contributing Factors

Supporting Lifestyle Strategies

Evidence Context

When to Seek Professional Help

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