Hypoactive sexual desire disorder (HSDD) is a troublesome condition in which women lose interest in sex. The Society for Women’s Health Research estimates that one in ten women have HSDD, making it one of the most common female sexual health complaints.

It’s not unusual for a woman’s libido drop from time to time. Hormonal changes, medication side effects, and stress can all dampen sex drive. But these periods are usually temporary and libido returns.

HSDD is chronic and causes great distress for both women and their partners. A woman may not know why she’s lost her sex drive. Her partner might become frustrated and worry about the fate of the relationship.

Distress is an important criterion for diagnosing HSDD. If a woman does not feel bothered by her diminished libido, she probably doesn’t have HSDD.

HSDD has a variety of causes. Some are physical:

• Underlying medical conditions. Diabetes, heart disease, cancer, psychiatric conditions (depression), neurological diseases (multiple sclerosis), hypothyroidism, and arthritis can all diminish libido.
• Medications. Many drugs have sexual side effects, including decreased sex drive. The following medications lower libido in some people:
  • Antidepressants (selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants)
  • Antipsychotics (for mental health disorders like schizophrenia and bipolar disorder)
  • Beta-blockers (used to treat high blood pressure, glaucoma, and migraine)
  • Benzodiazepines (for insomnia and anxiety)
  • Oral contraceptives (birth control pills)
  • Opioids (painkillers, such as morphine and oxycodone)
• Menopause, pregnancy, and breastfeeding. Hormonal changes during these times, especially drops in estrogen during menopause, can trigger HSDD.
• Lifestyle. Caregiving, work responsibilities, or a hectic social schedule can be tiring and stressful. At the end of a long day, or a particularly demanding stretch of time, people may just be too tired to think about sex.
• Sexual problems. When sex involves pain or dysfunction, the disappointment and dissatisfaction may reduce desire.

Some HSDD causes are psychological and emotional:

• Psychological conditions. Anxiety, depression, and poor self-esteem are just some of the psychological factors that can affect sex drive. In addition, past sexual trauma and physical abuse can make the idea of sex frightening, not appealing.
• Relationship issues. Many women associate satisfying sex with the emotional connection they have with their partner. If that bond is broken, they may be less likely to want sex. This can happen if a partner has been unfaithful, if there is a lack of trust, or if the partners are unable to discuss sexual issues.

Often, a combination of these factors is the real culprit behind HSDD. For women who are experiencing chronic low sex drive, seeing a doctor is a good starting point. A complete physical can reveal – or rule out – common medical causes of HSDD. From there, it is easier to decide on a treatment plan.