Treatment of hypoactive sexual desire disorder depends on many factors, including the individual and his or her relationship. Sex and marital therapy have both been found to be effective, although they may not be as effective in couples experiencing relationship

discrepancy in desire

Differences in levels of sexual desire in a couple.

difficulties on top of the sexual dysfunction. Cognitive-behavioral therapy, a form of psy­chotherapy that emphasizes the importance of how a person thinks and the effect these thoughts have on a person’s feelings and behaviors, has offered promising results. These types of therapy are brief (the average number of sessions a client receives is 16), highly instructional, and structured.

Pharmacological (drug) treatment may also be used. Although there are no drugs proven to increase sexual desire in men or women, there is evidence that testosterone may be helpful in those who have low testosterone levels (Heiman, 2002). Some studies have found that low testosterone levels in women contribute to decreased de­sire, arousal, and/or orgasm (Talakoub et al., 2002). Preliminary research has found that women who undergo testosterone replacement therapy have less sexual distress and an increase in sexual functioning. However, possible side effects include un­wanted facial hair, weight gain, acne, and a loss of head hair (Munarriz et al., 2002; Shifren et al., 2000). Other studies have found that testosterone levels in women have little to do with overall sexual desire and functioning (S. R. Davis et al., 2005). Because testosterone is largely responsible for male sexual desire, low male sexual de­sire has historically been treated with testosterone injections. However, the majority of men who experience low sexual desire have normal levels of testosterone (Wespes & Schulman, 2002).

Sometimes it is not one partner’s level of desire that is the problem but the dis­crepancy in desire between the partners. Many couples experience differences in their levels of desire—one partner may desire sex more often than the other. One partner may desire sex only once a month, whereas the other may desire sex once a day. Often, the partner with a lower level of desire will show up at a therapist’s office and not the partner with higher desire (R. C. Rosen & Leiblum, 1987). If the part­ner with the lower level of desire was paired with someone with an equal level of sex­ual desire, there would be no problem. People experiencing low levels of sexual de-

| aphrodisiac

A substance that increases, or is believed to increase, a person’s sexual desire.

sire may turn to aphrodisiacs for help (see the accompanying Sex in Real Life, “What Is an Aphrodisiac?”).

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