Why does passion wane? A qualitative study of Hypoactive Sexual Desire Disorder in married women

Hypoactive Sexual Desire Disorder (HSDD) is a prevalent and disabling condition for women and their partners. With one in three women experiencing a significant lack of interest in sexual activity, it is the most common female sexual dysfunction. It is also the most treatment resistant. Despite increased awareness of the problem, we have seen an increase in cases of low sexual desire over the past two decades. There is currently no standard treatment modality recommended for HSDD because of difficulties (1) defining the vague concept and (2) establishing what is normal. Recently, clinicians have favored a treatment relational approach because of the importance of interpersonal influences for women. Yet, treatment outcomes have not improved and HSDD remains poorly understood semi-structured interviews, participants were asked what causal attributions they make and barriers they perceive to their loss of sexual desire. Grounded theory methodology was utilized to identify emergent themes and build a comprehensive theory about loss of desire. Three core themes emerged from the data which appeared to represent dragging threes on sexual desire. They are (1) institutionalization of relationships, (2) over-familiarity with one\u27s partner, and (3) the de-sexualization of roles within these relationships. Based on these core themes, a model of female sexual desire is presented. It is a model of dilemmas, or paradoxes, that women appear to experience related to sex. On one hand, women work toward and value marriage and the meanings associated with it, such as security and family. Ironically, however, their sexual needs are in direct competition with its very ideals. The extent to which couples navigate these dilemmas may be a determinant in successful treatment for HSDD; Until now, anger, communication problems and other relationship influences have been stressed in the literature as reasons for loss of desire and the focus of clinical interventions. However, our data suggest that reasons that married women lose desire may have more to do with factors such as physical attraction, lack of sexual novelty, and role incompatibility than relationship factors. Clinical implications are discussed and possibilities for future research explored