HSDD – Hypoactive Sexual Desire Disorder

1. Michael Mullokandov
20.01.14
HSDD – Hypoactive Sexual Desire Disorder

2. • According to Freud, sexual expression
originates in childhood and develops over the
lifecycle.
• Freud thought that sexual energy was the
force behind all human endeavors, generating
the tension that leads artistic and intellectual
expression.

3. Animal sexual behavior takes many different forms,
even within the same species. Among animals,
researchers have observed monogamy,
promiscuity, sex between species, sexual arousal from
objects or places, sex apparently via duress or
coercion, copulation with dead animals, homosexual
sexual behavior, heterosexual, bisexual sexual
behavior, situational sexual behavior, and a range of
other practices.

4. • Human sexual behavior: any activity - solitary,
between two persons, or in a group that
induces sexual arousal.
Mating
relationship
Monogamy Polygamy Promiscuity
Orientation
Homosexuality Heterosexuality

5. • The first major national surveys of sexual behavior
published in the 1940s and 1950s.
• Kinsey’s research was based on a national sample of
11,000 interviews, but all the research subjects were
White, relatively well-educated, and middle-class.
• All the interviewers and staff members were White,
heterosexual, Anglo-Saxon, Protestant men.

6. The Kinsey Reports
• Even with bias in the sample, the Kinsey reports were the first
comprehensive, nationally based studies of sexual practices.
• Kinsey was first to report that 33% of women and 71% of men
engaged in premarital sex despite public belief to the
contrary.
– Surveys show these figures have grown to 70% of women
and at least 80% of men.
• Kinsey reported that 37% of men had experienced
homosexual contact resulting in orgasm at some point in their
lives.
Found many “unacceptable” activities to be
widely practiced.

7. • The sexual revolution refers to widespread changes
in roles of men and women and acceptance of
sexuality as a normal part of social development.
• Technological changes, such as the development of
the pill, have created new sexual freedoms.
• Now, sexuality is being influenced by the growth of
cyberspace and its impact on personal and sexual
interactions.

9. Physical or psychological sexual disorders under the DSM
The fourth edition of the Diagnostic and Statistical Manual of
Mental Disorders lists the following sexual dysfunctions:
 Hypoactive sexual desire disorder
 Sexual aversion disorder (avoidance of or lack of desire
for sexual intercourse)
 Female sexual arousal disorder
 Male erectile disorder
 Female orgasmic disorder
 Male orgasmic disorder
 Premature ejaculation
 Dyspareunia
 Vaginismus
Additional DSM sexual disorders that are not sexual
dysfunctions include:
 Paraphilias
 PTSD due to genital mutilation or childhood sexual
abuse
Other sexual problems
 Sexual dissatisfaction
 Anorgasmia
 Impotence
 Sexually transmitted diseases
 Delay or absence of ejaculation, despite adequate
stimulation
 Inability to control timing of ejaculation
 Inability to relax vaginal muscles enough to
allow intercourse
 Inadequate vaginal lubrication preceding and during
intercourse
 Burning pain on the vulva or in the vagina with contact
to those areas
 Unhappiness or confusion related to sexual orientation
 Transsexual and transgender people may have sexual
problems (before or after surgery), though actually
being transgendered or transsexual is not a sexual
problem in itself.
 Persistent sexual arousal syndrome
 Post SSRI Sexual Dysfunction
 Sexual addiction
 Hypersexuality
 All forms of Female genital cutting

10. Adapted from Laumann, E. O., Paik, A., & Rosen, R. C. (1999). Sexual dysfunction in the
United States

11. • Hypoactive sexual desire disorder (HSDD) is defined as persistent or
recurrent deficiency (or absence) of sexual fantasies/thoughts, and/or
desire for or receptivity to sexual activity, which causes personal distress.
Factors that Contribute to Desire
 Sexual desire can be described as a composite experience consisting of
different elements:
• Drive (biological component)
• Motivation (cognitive component)
• Responsiveness to sexual stimuli (response component)

12.  Sexual desire is a subjective experience with or without behavioral expression or
arousal (sexual activity).
 The subjective experience includes sexual fantasies, shifts in attention to focus on
potential erotic clues, feeling sexy, and a longing for sexual stimulation.
 The behavioral expression includes seeking sexual stimuli such as partners, places,
specific types of sexual activities, and even risk taking to acquire sex partners or
types of sexual activity.
 Sexual desire is the dynamic result of the interaction of exciting (enhancing) and
inhibiting biopsychosocial factors.

13. • The major sexual dysfunctions have no known etiology.
• No impact of women’s endocrine status on
determination of any sexual dysfunction.
• There are no indicative works on number and activity
of transmitters in HSD women.
• Feeling less rewarded after the sexual activity, the
women prone to develop low sexual desire. (process of
learning)
 An inevitable consequence is that animal models
cannot be based on solid knowledge of the etiology of
the disease they are supposed to model.

14. • ‘‘hypoactive sexual desire’’ is not easily defined in nonhuman animals. The
existence of rare or absent sexual fantasies cannot be determined, and
interpersonal problems because of low sexual desire are difficult to define
and describe
• Behavioral processes should be similar in the human and in the animal
model.
Sex as desire
recreation tool
Sex as
reproduction
tool

15. Such responses can be used to infer motivation
only when learning is asymptotic.
90 %
3 %
Control of sexual interaction
90 % 10 %

16. Sexually experienced, intact, estradiol-primed female Wistar rats were placed in an empty
compartment adjacent to a compartment with a male.

17. • Time spent in compartments
• Proceptive behaviors
• Contact–return latencies
• Percentages of exits

19. • Apomorphine (Apokyn, Ixense, Spontane, Uprima) is a non-selective dopamine
agonist which activates both D1-like and D2-like receptors.

20. • (+/–)-8-hydroxy-2-(dipropylamino) tetralin hydrobromide (8-
OH-DPAT) is a 5-HT1A receptor agonist.
• The 5-HT1A receptor is a subtype of 5-HT receptor that binds
the endogenous neurotransmitter serotonin.

21. • Paroxetine is a selective serotonin reuptake
inhibitor.

22. • Apomorphine and 8-OH-DPAT had an
Inhibiting effect on sexual behavior.
• Apomorphine had more inhibiting effect in
avoiders than approachers.
• Paroxetine had no effect on proceptive
behavior.
Do "problems" created by society
need prescription solutions?