Absence of Desire

The authors deserve thanks for emphasizing a biopsychosocial approach, which clarifies that erectile dysfunction (ED)—in contrast to what is widely assumed—is not restricted to functional aspects but is a complex problem that requires interdisciplinary treatment. With regard to the impaired appetence (which merited but a brief mention in the article), it should usefully be added that this is an independent pathology, described in the DSM-IV-TR as “hypoactive sexual desire disorder” (HSDD), which unfortunately thus far has received far too little attention compared with ED. The clinical symptoms of HSDD are characterized by an absence of sexual fantasies and desire, which puts individuals thus affected under great psychological strain. The prevalence of up to 15% comes close to that of ED itself and directly contradicts the myth that men’s sexual desire is constant (1, 2). To explore sexual desire diagnostically, the questionnaire of the Sexual Desire Inventory (3) is a useful tool, in order to distinguish HSDD from ED. Since the possible causes that are currently under discussion include factors such as depression, hypogonadism, age, fears and anxieties, and conflicts within the affected man’s relationship, it would be highly desirable if in future the existence of HSDD in men were to meet with greater attention in clinical practice as well as the research arena..
DOI: 10.3238/arztebl.2010.0350b