Treatment

Psychotherapeutic interventions for hypoactive sexual desire are generally combinations of behavioural, cognitive, psychodynamic, and marital techniques. No specific treatment regimens have been agreed upon anecdotally by clinicians, nor have any been validated by scientific study. Outcome studies of eclectic treatments demonstrate that 50 to 70 per cent of men and women with disorders of sexual desire appear to achieve modest gains immediately following therapy. However, a marked deterioration in desire is noted at 3-year follow-up.(2,3° and 3!) Half of the individuals who report success after treatment do not maintain heightened desire 3 years later. Paradoxically, however, couples in these studies report improved and sustained levels of sexual satisfaction despite the regression in levels of sexual desire.

There are reports that testosterone may be helpful to certain groups of women in restoring sexual desire, such as surgically menopausal women. (32> Davidson et al.(33) proposed that androgens may act to facilitate and maintain sensitivity to or pleasurable awareness of both sexual thoughts and activity. In a review of empirically validated treatments for sexual dysfunction Heiman and Meston(34) state: 'Although testosterone has been shown to increase sexual desire in men and women, its effect may be limited to these individuals with abnormally low levels of bioavailable testosterone. No controlled studies in which the effect of testosterone on humans who had adequate testosterone levels but low desire was directly tested.' Segraves and Althof (35> echo this statement by saying, 'There is no pharmacotherapy for primary psychological hypoactive sexual desire with established efficacy'.

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