No Desire / No Lubrication

Decreased Sexual Desire In Female
Self Testing Questionnaire of Decreased Sexual Desire in females:

1 In the past, was your level of sexual desire or interest good and satisfying to you? Yes No
2 Has there been a decrease in your level of sexual desire or interest? Yes No
3 Are you bothered by your decreased level of sexual desire or interest? Yes No
4 Would you like your level of sexual desire or interest to increase Yes No

Do you feel any of the following contributing to your current decrease in sexual desire or interest:

1 An operation, depression, injuries, or other medical condition Yes No
2 Medications, drugs, or alcohol you are currently taking Yes No
3 Pregnancy, recent childbirth, menopausal symptoms Yes No
4 Other sexual issues you may be having (pain, decreased arousal or orgasm) Yes No
5 Your partner’s sexual problems Yes No
6 Dissatisfaction with your relationship or partner Yes No
7 Stress or fatigue Yes No

Screener is based on Validation of the DSDS, Clayton et al: J Sex Med 2009;6:730-738

The DSM –IV of American Psychiatric Association (TR) defines Hypoactive Sexual Desire Disorder (HSDD) as a deficiency or absence of sexual fantasies and desire for sexual activity, which causes marked distress or interpersonal difficult. This is not accounted for by a medical, substance –related, psychiatric, or other sexual condition.
HSDD can be’ situational’ or ‘generalized’. Situation HSSD is lack of desire of sex with certain partner, certain types of stimulation or situations. Generalized HSSD is complete lack of desire at all situations, with all types of stimuli and with any partner.
Another way of classifying HSDD is ‘acquired’ or ‘lifelong’. Acquired HSSD develops after a period of normal functioning, while the lifelong HSDD is present right from the beginning.

Do I have HSSD?
You can draw conclusions whether you are suffering from HSDD or not, using the above questionnaire. Interpretation of your responses is given below:

1-4 questions: 
If the answer is yes to all of 1-4, answer: The screener determines that you may qualify for the diagnosis
of Hypoactive Sexual Desire Disorder.

5-11 Questions:
If the answer to any question 5-8, or 11 is yes add: You should also seek consultation with your doctor to determine if a medical condition or problem is contributing to your current decrease in sexual desire or interest.

If the answer to question 9 is yes add: Your partner may need to seek consultation with a Sexual Physician

If the answer to question 10 is yes add: You and your partner should consider professional counseling in addition to consulting your Sexual Physician.

In the extreme form of HSDD, the patient not only lacks sexual desire, but may also find sex to be repulsive, revolting, and distasteful. Phobic or panic responses may be present in extreme cases of HSDD. HSDD may be the result of either physical or emotional factors

Common sex-drive killers:

Sex-Drive Killer: Stress
You may be the kind of person who does many things well when under stress. But feeling sexy isn’t likely to be one of them. Job stress, money troubles, caring for a sick family member, and other stressors can decrease libido. To keep your stress levels in check, learn helpful stress management techniques (eg: Meditation, Yoga) or seek the advice of a counselor or doctor.

Sex-Drive Killer: Relationship Problems
Unresolved relationship problems are one of the most common killers of sex drive. For women in particular, emotional closeness is a major ingredient in sexual desire. Simmering arguments, poor communication, betrayal of trust, and other barriers to intimacy can steer your sex drive off the road.

Sex-Drive Killer: Alcohol
A drink or two doesn’t always put you in the mood. Alcohol famously makes you feel less inhibited about sex. But it can also numb your sex drive. And even if it doesn’t numb your sex drive, inebriation can be a turn-off for your partner. All of this goes for recreational drugs, too.

Sex-Drive Killer: Too Little Sleep
If your sexual get-up-and-go is gone, maybe you’re getting up too early or getting to bed too late. Or maybe you have insomnia or sleep apnea. Whatever it is that’s interfering with your sleep, it’s also interfering with your sex drive. Too little sleep creates fatigue. Fatigue saps sex drive.

Sex-Drive Killer: Parenting
Parenting itself doesn’t kill sex drive. But it can be hard to find time to be intimate when the kids are under foot. Hire a baby sitter (or bring the grandparents) for some time to nurture your relationship. New baby in the home? Try scheduling sex during the baby’s nap time.

Sex-Drive Killer: Medication
Drugs commonly linked to libido loss include:
• Antidepressants
• Blood pressure medications
• Antihistamines or anti-allergic drugs
• Oral contraceptives (some studies show a link; others don’t)
• Chemotherapy
• Anti-HIV drugs
• Synthetic progesterone-medroxyprogesterone
• Proton-pump inhibitors (used for peptic ulcers treatment)
Changing to a different medication or different dosage may solve the problem. Other drugs may affect sex drive, too. If your sex drive shifted into park soon after beginning a new medication, talk with your doctor. Never stop taking a medication without consulting your doctor.

Sex Drive Killer: Body Image
It’s hard to feel sexy if your self-esteem suffers from poor body image. For example, feeling ashamed of being too heavy (even if you’re not) will douse your love light. If your partner has these feelings, it can really help to reassure him or her that you still find him/her sexy. And there’s a flip side to the equation: Working out not only enhances your self-esteem, but also ups your sex drive.

Sex-Drive Killer: Obesity
Being overweight or obese is linked to a lack of sexual enjoyment, desire, and difficulties with sexual performance. The reason isn’t clear, but may be linked to self-esteem, unsatisfactory relationships, social stigma, and other psychological issues.

Sex-Drive Killer: Erectile Dysfunction
Erectile dysfunction (ED) is a different kind of sexual disorder than loss of libido But men with ED worry about how they will be able to perform sexually. And that worry can drain their sex drive.

Sex-Drive Killer: Low T
Testosterone increases sex drive. As men age, their testosterone levels may decline slightly. Not all men lose the desire for sex when their testosterone levels drop — but many do. Testosterone is linked to sex drive in women, too. But a woman’s hormonal balance is more complex than a man’s and many factors are at play. It’s not at all clear whether testosterone therapy is as safe and effective in boosting sex drive for women as it is for men.

Sex-Drive Killer: Depression
It doesn’t seem fair. Many antidepressants can lower your sex drive — and so does depression. But if your sex drive has drooped, is might be a sign that you’re depressed. Clinical depression is a serious, but treatable condition.

Sex-Drive Killer: Menopause
About half of women report reduced sex drive around the time of menopause, even though they believe it important to maintain an active sex life. Menopausal symptoms, such as vaginal dryness and pain during sex, may make sex less comfortable. But the hormonal changes of menopause are only part of the picture. An aging woman concerned about her sex drive should also consider the quality of her relationship, her body image and self esteem, medications she is taking, and her physical health.

Sex-Drive Killer: Too Little Intimacy
Sex without intimacy is a sex-drive killer. Intimacy isn’t just a code word for sex. If your sex life is in neutral, try spending more non-sexual intimate time together – alone. Talk, snuggle, trade massages. Learn to express affection without having to have sex. As intimacy builds, so does sex drive

Symptoms

The HSDD patient complains of a lack of interest in sex even under circumstances that are ordinarily erotic in nature, such as pornography. Sexual activity is infrequent and eventually is absent, often resulting in serious marital discord. HSDD may be selective and focused against a specific sexual partner. When boredom with the usual sexual partner is the cause and frequency of sex with the usual partner decreases, real or fantasized sexual desire toward others may be normal or even increased.
If the cause of HSDD falls into a detectable category such as abnormalities of the genitalia, or is due to a related condition such as a prolactinoma, chronic renal disease, diabetes mellitus, genetic disorder, or is familial in nature, the patient will manifest the signs and symptoms of the comorbid (co-occurring) condition. It is important to identify such causes, as their presence will usually dictate appropriate therapy.

Treatments
Currently, there is no approved drug or pharmacological treatment for HSDD and psych
otherapy has proved to be only minimally effective. A primary goal of therapy is aimed at removal of the underlying cause of HSDD. The choice of medical therapy or behavioral or dynamic psychotherapy depends on the cause. If the cause is related to a medical condition, therapy is directed toward the cure or amelioration of that condition. Examples include cure or amelioration of underlying comorbid conditions such as genitourinary infections, improvement in diabetic control, avoidance of substance abuse and of medications that may be potentially responsible.

Therapy should also be directed towards other accompanying sexual disorders such as erectile dysfunction, which may be contributory. In cases where insufficient testosterone is suspected as a possible cause, serum androgen levels should be tested. A testosterone level less than 300 ng/dl in males and less than 10 ng/dl in females indicates a need for supplemental replacement therapy. If the cause is deemed to be of an interpersonal nature, Couple Therapy
 
may be beneficial, in which case the support and understanding of the sexual partner is essential.Tricyclic antidepressants (TCAs) or monoamine oxidase inhibitors(MAOIs) or Selective Seratonin Reuptake Inhibitors (SSRIs) may help in the treatment of accompanying depression or panic symptoms.

A recent study has reported that almost a third of nondepressed women with HSDD responded favorably to therapy with sustained release tablets of bupropion hydrochloride. The responders noted significant increases in the number of sexual arousals, sexual fantasies, and in the desire to engage in sexual activities. Bupropion hydrochloride (sold as Wellbutrin by Glaxo Wellcome) is currently approved by the FDA for the treatment of depression. Its favorable action on HSDD may be attributable to its enhancement of certain neurotransmitters that affect sexual desire, principally norepinephrine and dopamine.