There are other potential aggravators of HSDD including problems in a relationship. Hurlbert (2005) suggests that diminished sexual desire may arise as a result of issues in an intimate relationship where the female partner may lose interest in sexual activities as a result of conditions specific to the relationship (p. 16). Hurlbert (2005) reveals that this is often one of the most prevalent correlates of HSDD in women as emotional dissatisfaction arising out of relationship matters, tends to affect sexual desire in women.
Additionally the use of oral contraceptives has been noted to be connected to sexual desire in woman. Hormone based oral contraceptives are felt to impact on female sexual functioning. Warnock (2002) points to research establishing between 5% and 13% incidence of decreased sexual desire in a study of oral contraceptive users (p. 748). The presence of mood has also been associated with the loss of sexual desire. It is suggested that 70% of persons experiencing depression also demonstrate decreases in their sex drive (Warnock, 2002, p. 748).
This evidence further substantiates the point that neurological factors may play a role in inhibiting proper sexual functioning. Mood disorders such as depression and other similar disorders, like hormones, alter the transmittal of sexually related messages from the genitals to the brain and the way the body responds to those messages. It has also been proposed that conditions related to childbirth may also contribute to the development of female HSDD. Warnock (2002) points out that certain forms of estrogen tend to increase during pregnancy by as much as 1000 times the usual levels (p.749).
However following delivery these hormone levels return to normal quite rapidly and this has implications for the development of psychological conditions such as post-partum depression. Physiological conditions such as increases in the body’s production of prolactin for the purposes of breast feeding, may lead to dryness of the vagina and an overall decreased sexual desire. Generally for women age is also a significant correlate of decreased sexual desire.
In addition to the onset of menopause a woman may also experience psychiatric disorders, or may be required to take medications that have negative sexual side effects. Warnock (2002) indicates that a common problem in aging woman is the issue of vaginal atrophy and dryness. These factors contribute to decreased sexual desire and leads to HSDD (p. 749). Because HSDD can be associated with both internal and external factors diagnostic procedures must ensure proper physical examination along with discussions on any possible home or environment factors.
Walsh and Berman (2004) recommend an internal and external gynaecological examination for women reporting decreased sexual desire. Warnock (2005) suggests that the clinician should obtain adequate information about sexual functioning prior to the patient’s present condition. Clayton (2006) advocates the use of the Sexual Interest and Desire Inventory-Female (SIDI-F) in order to estimate the severity of HSDD symptoms. After diagnosis treatment would be administered based on the characteristics displayed by the patient.
Where necessary or possible medications that are contributing to aggravated symptoms may have to be modified or discontinued (Walsh & Berman, 2004). Hormone replacement therapy has proven successful (Warnock, Bundren & Morris, 1999). To date note pharmacological treatments have been developed to treat female HSDD specifically (Warnock, 2002). There seems to be very little hope for females with HSDD because the condition is more often than not as a result of other secondary factors.
Nevertheless attempts should be made to relieve, if not eliminate the negative effects of a loss of sexual desire.
References
Clayton, A. H. , Segraves, R. T. , Leiblum, S. , Basson, R. , Pyke, R. , Cotton, D. , D’Agostino, D. , Evans, K. R. , Sills, T. L. & Wunderlich, G. R. (2006). Reliability and validity of the Sexual Interest and Desire Inventory – Female (SIDI-F), a scale designed to measure severity of female hypoactive sexual desire disorder. Journal of Sex & Marital Therapy, 32, 115-135.