Diagnosing HSDD

• If you suspect you may have hypoactive sexual desire disorder (HSDD), see your healthcare provider
• Don’t be embarrassed to say what’s bothering you; be calm and direct
• It’s your healthcare provider’s responsibility to help; if they don’t, find a new one
• Your healthcare provider will do tests to rule out other possible medical causes
• You’ll be asked specific questions to determine if you have HSDD
• If you’re diagnosed with HSDD, you and your healthcare provider can make a plan for treating it

Let’s say there’s a woman—call her Jill—who suspects that she might have HSDD. But because she hasn’t been diagnosed with it, she doesn’t know for sure.

Jill does know (and her partner—Alex—does, too) that it’s been a while since she’s wanted to have sex.

Jill also knows that “a while” is actually several weeks—no, wait, months—because she’s done some mental calculations while lying next to Alex, not having sex. (Or maybe Alex did the math and told her.)

Jill knows her low sexual desire is really frustrating for her. She knows her body image and self-esteem have been taking a beating because of it. And she feels guilty, stressed, and even less feminine. All because of her low sexual desire.

She knows that she really does want to want sex again. Because it used to be a really important part of her life and her relationship with Alex. And how much does Jill miss the intimacy they shared because of sex? Don’t get her started.

And while we’re at it, let’s say Jill’s spent some time here, at unblush. So she’s learned a thing or two about low sex drive in women. She knows that these things she’s feeling can be caused by HSDD. And she knows that HSDD affects millions of women. And so she wonders, “Am I one of them?”

Have you ever wondered if your low sexual desire might be HSDD? If so, here’s how you (and Jill) could find out.

See your healthcare provider
If you’re frustrated by low sexual desire and think that it may be due to HSDD, the first step to finding out is seeing your healthcare provider. This will typically be a doctor (usually a primary care physician or gynecologist), nurse practitioner or physician assistant. (And if you have access to telemedicine, you might not even need to be in their physical presence.)

Speak up
Some healthcare providers will ask their patients about sexual issues, just as part of an examination. But others won’t, often because they’re embarrassed by the topic of sexual dysfunction. Your lack of sexual desire might not be your favorite topic, either. But unfortunately, if your healthcare provider is the shy, retiring type, it’s going to be up to you to start that conversation.

I would really encourage her to figure out who she can talk to and just bring it to the forefront and deal with it.”

—Sarah P., a woman with low sexual desire who has not been diagnosed with HSDD

But there’s absolutely nothing to be embarrassed about. Sexual health is a part of overall health. If something’s interfering with that—something going on with you physically or emotionally—it’s perfectly acceptable to bring that up to your healthcare provider.

You don’t have to launch into a super-detailed description of every minute aspect of your sexual history. You might simply say, directly and calmly, “My partner and I are not having sex. My sexual desire isn’t as strong as it used to be, and that’s really frustrating for me. I’ve heard of HSDD and I’m concerned that I might have it.” (We’re not trying to write you an actual script here. But that ought to be enough for your healthcare provider to take it from there.)

One more thing: you’re talking about something very important and deeply personal during this appointment. Your healthcare provider should listen respectfully and take your concerns seriously. That’s their professional responsibility. If you feel your healthcare provider is falling short of the mark? It may be time to find one who will give you the attention you need. You deserve no less.

Get a guide for talking to your doctor

Make sure it’s not an issue “down there”
Before addressing any concern about HSDD, your healthcare provider may perform a pelvic exam or refer you for one. It’s important to see if there are any physical changes to your vaginal area that would make having sex a problem for you and cause your interest in sex to decrease.

Rule out other medical conditions
There’s no blood test for HSDD. Or a test you can, um, “utilize” in the comfort of your own bathroom (you know what we mean) like some other tests. But there are certain blood tests that your healthcare provider may order. These are to check your hormone levels, as well as screen you for certain medical conditions that can affect sexual desire.

Make sure it’s not meds
You probably already know that you should show up to your appointment with a list of all the medications you take, including both prescription and over-the-counter ones. But it’s worth a reminder. Because some medications can have the side effect of lowering sexual desire, this information can help your healthcare provider get a fuller picture of what’s going on with you.

Zero in on HSDD
Just because there’s no lab test for HSDD doesn’t mean that healthcare providers don’t have a diagnostic tool for it. This is where the DSDS comes in. That’s short for Decreased Sexual Desire Screener. The DSDS is specifically designed so that all healthcare providers can diagnose HSDD, not just experts in sexual health.

The DSDS is basically a series of questions created to drill down to the symptoms of the condition. Your answers help your healthcare provider determine whether the low sexual desire you’re feeling is HSDD. If you do have HSDD, there are medical treatments for it.

These are the first 4 DSDS questions
It’s OK for you to know them in advance. It’s not that kind of test 🙂

• In the past, was your level of sexual desire/interest good and satisfying to you?
• Has there been a decrease in your level of sexual desire/interest?
• Are you bothered by your decreased level of sexual desire/interest?
• Would you like your level of sexual desire/interest to increase?

If your answer to any of those is “no” you won’t be diagnosed with HSDD.

But if you have 4 “yes” answers, your healthcare provider will ask you for additional information.

You’ll check the following list for things that you feel may be contributing to your lower sexual desire:

• An operation, depression, injuries, or other medical condition
• Medications, drugs or alcohol you are currently taking
• Pregnancy, recent childbirth, menopausal symptoms
• Other sexual issues you may have (pain, decreased arousal/orgasm)
• Your partner’s sexual problems
• Dissatisfaction with your relationship or partner
• Stress or fatigue

If there’s nothing on the list that pertains to you and your low sexual desire, your healthcare provider may diagnose you with HSDD.

View the Decreased Sexual Desire Screener (DSDS)

If you’re diagnosed with HSDD—then what?
If it’s HSDD, then you (and Jill) will finally have an answer. You’ll know what you’re dealing with, and that may be a huge relief in itself. You’ll know it’s a treatable medical condition and, chances are, you’ll be right there in a room with your healthcare provider. That would be the perfect opportunity to discuss your treatment options—and get going on getting your sexual desire back.

(We suspect that “Alex” will be relieved, too.)