Is It Depression or Hypoactive Sexual Desire Disorder?
Having no interest in sex can stem from trouble in your relationship or even certain medical conditions. Yet it can also be a side effect of depression. Here's how to understand why you're feeling differently about sex.
By Beth W. Orenstein
Medically Reviewed by Pat F. Bass III, MD, MPH
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It’s one of the last taboo topics, but having little or no interest in sex may not be as unusual as you think. According to the International Society for Sexual Medicine, about 10 percent of women across all age groups have low or no interest in sex, a condition known as hypoactive sexual desire disorder (HSDD). And the numbers may be even greater. Some studies have found that as many as a third or more of women lack interest in sex at some point in their lives.
Hypoactive sexual desire disorder can run the gamut from having lost interest in sex with your partner to never having had sexual desires. You might be experiencing “a reduction in or complete absence of sexual desire, sexual fantasies, and sexual activity that causes significant problems in functioning and relationships,” says Joseph Cilona, PhD, a psychologist in New York.
Having no interest in sex can make you sad and lonely, but beyond that, researchers have found a connection between hypoactive sexual desire disorder and depression. When scientists at the University of Virginia looked at more than 1,000 women diagnosed with HSDD, they found more than 30 percent also had been diagnosed with or had symptoms of depression.
Of course, those numbers also mean that most people have HSDD without depression. Sara Rosenquist, PhD, a sexual and reproductive health psychologist in North Carolina, says that women (and men) with HSDD don't necessarily feel badly about it — “wistful” maybe, but not depressed.
Cilona agrees that if you have HSDD, you may have mood symptoms, "but they are not usually significant enough to meet the criteria of clinical depression." On the other hand, having depression could be the reason for a lack of sexual interest. Depression usually involves mood symptoms, such as low mood, lethargy, lack of motivation, difficulty concentrating, difficulty sleeping, and feelings of helplessness, hopelessness, and worthlessness. It may or may not include a lack of sexual desire, he adds.
To add to the confusion, consider that the antidepressants usually used to treat depression can sometimes lead to hypoactive sexual desire disorder, says Rose Hartzell, PhD, a sex therapist and researcher at San Diego Sexual Medicine in California.
Do You Have HSDD or Depression?
How do you tell whether you have HSDD or whether your sexual dysfunction is a symptom of your depression? Start by asking yourself these questions:
- Am I sleeping well?
- Am I eating well?
- Am I taking pleasure in the things I normally like to do?
“If you answer yes to these questions, chances are good your low sexual desire is from something else and not depression,” says Hartzell.
If the opposite is true, and you can’t sleep or you're sleeping too much, have no appetite or are overeating, and feel as if your life is not worth living, you could be suffering from depression and not just low libido and should seek professional help, she says.
Also take a close look at your relationships. Relationship troubles are one of the biggest risk factors for HSDD. Are you and your partner constantly fighting over little things? Are you afraid your partner no longer finds you sexy? You could have HSDD because you have relationship issues.
Getting the Right Treatment
It’s important to know whether your low libido is hypoactive sexual desire disorder or a symptom of depression because treatments may be different. If your HSDD stems from relationship issues, you can be helped with couples therapy, sex therapy, or psychotherapy. You may want to go by yourself or with your partner.
Your HSDD also could be caused by a physical problem such as breast cancer, a hysterectomy, or menopause. If that’s the case, your doctor may suggest medications to treat your libido. There is no FDA-approved drug specifically for treatment of hypoactive sexual desire disorder, but medications such as hormones and antidepressants may help.
Reshaping your ideas about sexual intimacy is another step to consider. Stop thinking it’s all or nothing, suggests Cilona. “Many women will avoid any kind of sexual contact whatsoever when the thought of intercourse or orgasm seems too much," he says. "But you can have sexual contact that doesn’t involve or necessarily end in intercourse or orgasm. And without the pressure of going all the way, you might be surprised at the mood boost you get once you get going.”
If you’re diagnosed with depression, keep in mind that some antidepressants depress libido. “Low libido is a side effect of selective serotonin uptake inhibitors, which are commonly prescribed for depression," Hartzell says. "If you are on SSRIs for depression and have low libido, talk to your doctor about alternative medications you can take.”
Whether you’ve lost interest in sex because of relationship or health issues or as a symptom of depression, there are ways to rekindle your interest. The first step is often talking to your doctor openly to get the help you need.
Video: 6 Unexpected reasons of low sexual desire in men!
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