Clinical Management of Hypoactive Sexual Desire Disorder

Sheryl Kingsberg, PhD, IF; Stephanie Faubion, MD, FACP, NCMP, IF


Menopause. 2019;26(2):217-219. 

In This Article

Additional Evaluation

Although a physical examination is not required to make the diagnosis of HSDD, it may be helpful in postmenopausal women in order to rule out other factors that would better explain their loss of sexual interest. For example, women with dyspareunia because of GSM may report less sexual desire as a byproduct of painful sex. Midlife is a time when myriad chronic medical conditions initially manifest.

Physical examination and in some cases laboratory testing such as thyroid and prolactin levels may help rule out other comorbid conditions. Testosterone and sex hormone-binding globulin levels are not required for the diagnosis of HSDD but are recommended if a clinician is considering off-label testosterone therapy as a baseline for monitoring therapy.[9]

If psychological or interpersonal/relationship problems appear to be a source of the low desire, referral for counseling for the couple or assessment/treatment by a psychotherapist experienced in couples therapy and/or sex therapy is warranted.