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Sex Health Blog

Talking about HSDD

No matter what stage your relationship is in, it’s frustrating when your partner doesn’t want the same things you do. And when that thing is sex, your relationship can become more complicated.

You might have started out with a very satisfactory sexual relationship. It might have been exciting and fulfilling. But now, perhaps her interest has waned. She doesn’t want to have sex. Or if she agrees to it, you feel like she’s not completely there emotionally.

Your partner might have hypoactive sexual desire disorder, often called HSDD. HSDD occurs when women lose their interest in sex. They no longer fantasize about it or feel inclined to have it, even if they’re in a good relationship. HSDD causes personal distress and, quite often, problems in relationships that are hard to resolve.

HSDD happens to about one in ten women and is the most common sexual issue for them. Unfortunately, it’s not always talked about, so it can be mystifying.

If your female partner has low sex drive, here are some things to think about.

It isn’t (necessarily) you.

You might worry that your partner no longer finds you attractive, or that she’s having sex with someone else. But oftentimes, that’s not the case.

A woman’s sex drive has a strong biological component, most notably with hormones and neurotransmitters. Some chemicals work to excite sexual desire; some inhibit it. If these excitatory or inhibitory chemicals are out of balance, a woman’s desire can decrease.

Hormonal changes can seriously interfere with a woman’s interest in sex, especially during and after menopause. Even though women have less testosterone than men, they still need some to spark their libido. Some women benefit from testosterone therapy for HSDD.

Some medications, like antidepressants, can also have sexual side effects like lowered libido.

If your partner is losing interest in sex, consider her life stage and overall health. A visit with her doctor may be the first step in getting her desire back.

It could be her lifestyle.

Is your partner stressed out at work? Is she exhausted by family caregiving responsibilities? Has she been sick lately?

Stress and anxiety can affect a woman’s sex drive. She just may be too tired or unable to relax enough to want sex with you.

If you think this is the case, consider things you can do to help her. Treat her to a massage when she comes home from a difficult day at work. Take the kids to the movies so she can have some time to herself. Offer to help out with whatever responsibilities she’s juggling. Or, just be there for her and listen when she wants to talk.

Remember, you and your partner is a team. If you pick up some of the slack, she might come around.

It could be your relationship.

How well have you and she been getting along? Are there other problems in your relationship that need attention? Have you been walking on eggshells with each other? Have there been problems with boredom, trust, or infidelity?

She might be reacting to any number of issues. Why not get them out in the open? Again, think about what you can do to make her feel better about your relationship. Could therapy help? Some couples choose to have therapy together. Other people feel better going alone. Talk to your partner and see what she is most comfortable with.

Therapy can also help with past issues and trauma that may be holding her back sexually. Past sexual abuse, incest, and rape can have an enormous effect on a woman’s sexual functioning.

Don’t blame her.

Your partner isn’t avoiding sex with you to be mean. She isn’t deliberately willing her libido to vanish.

Understand that it’s probably frustrating for her, too. And it may be very difficult for her to bring up the subject. Think about it. How do you tell your partner that you just don’t want to be intimate, especially if intimacy has been satisfying in the past? She may be just as baffled as you are.

She may also feel conflicted about sexual desire. Many women are brought up to believe that “good” girls shouldn’t want to have sex. The fact that she notices her low sex drive may make her feel that she was not “good” in the past.


Sex is often seen as a taboo subject. It shouldn’t be. Intimacy is an important part of a couple’s relationship and if something isn’t working, talking about it can be part of the solution. Bringing up the subject yourself may put her at ease.

If you feel awkward discussing sex with your partner, think about what you’d like to say ahead of time. Don’t be accusing. Don’t say that your relationship’s sexual problems are all her fault. She probably feels responsible to a degree.

Instead, you might tell her that you’ve noticed changes in your relationship, that your sexual relations aren’t what they used to be. Ask her how she feels about it and if there is anything you can do to help. Be open to her ideas. If appropriate, gently suggest seeing a doctor or therapist. Offer to go with her if she wants you to.

You’re not selfish to think of your own needs. But don’t threaten to have sex outside the relationship or give her an ultimatum. This will likely make her feel even more upset. Remember, she might not completely understand why her sex drive has diminished either.

Make this a conversation about the two of you. Discuss ways that you and she can work on this together.