In this section, we discuss inhibited sexual desire, desire discrepancy, and sexual aversion.

Hypoactive Sexual Desire Disorder

Hypoactive sexual desire disorder (HSDD) is the absence or minimal experi­ence of sexual thoughts, fantasies, and interest prior to sexual activity, as well as a lack of sexual desire during the sexual experience (Basson et al., 2004). Until recently, HSDD was defined exclusively by lack of sexual interest, thoughts, and fantasies outside sexual activity. However, many women and some men who do not experience a “sexual appetite” do enjoy and become aroused by and desirous of a sexual experience after it has begun (Elton, 2010). Therefore, the pattern of sexual desire following, rather than preceding, sexual excitement is not consid­ered hypoactive sexual desire disorder (Laan, 2008). Although desire difficulties are the most common sexual difficulty experienced by women (see Table 14.1), significant numbers of men also experience low sexual desire and seek help for it in counseling (McCarthy & McDonald, 2009).