Management of Hypoactive Sexual Desire Disorder

Hypoactive sexual desire disorder (HSDD) is one of the most prevalent female sexual dysfunctions, characterized by a persistent or recurrent lack of sexual fantasies and desire for sexual activity, associated with significant distress and interpersonal difficulties. Affecting up to 15% of women, HSDD remains underreported due to stigma, embarrassment, and limited awareness of treatment options. Its pathophysiology is multifactorial, involving an imbalance between excitatory and inhibitory neurochemical systems, modulated by sex hormones, as well as psychological, relational, and sociocultural determinants. Diagnosis requires both low desire and distress, confirmed through validated tools such as the decreased sexual desire screener and comprehensive evaluation. Management is multimodal, integrating patient validation, sexual education, pharmacological therapies, and psychotherapeutic interventions. Beyond pharmacology, HSDD must be approached as a biopsychosocial phenomenon, with sensitive listening and personalized strategies to restore sexual health and quality of life.