Causes

Hypoactive (low) sexual desire is more frequent in women than in men. The most common organic cause is lack of some hormones -the androgens- which are related to both female and male sexual desire. Testosterone deficiency is the result of a disease called hypogonadism. Many times, however, the problem is secondary; it is due to another sexual problem. For example, men with erectile dysfunction experience sexual desire reduction or women having pain during sexual intercourse may feel averted to sex. In addition, there are some chronic diseases, pharmaceutical agents and chronic pain that may be correlated with hypoactive sexual desire disorder (HSDD). 

Thus, a male check-up should start from the Urologist and a female check-up from the Gynaecologist. Once the organic cause is ruled out, then the Trained  Sexologist will take over, in order to investigate and identify the causes of the problem and recommend the appropriate treatment. 

When there is different degree of sexual desire in the couple

Many couples experience sexual disappointment because one of the two partners may have more or less sexual desire than the other. Usually, the partner with the hypoactive (low) sexual desire is considered to be the one "having the problem" and who has to find a solution. However, although some personal factors may lead to reduction of one's sexual desire, for many couples it is the dynamics of the relationship that may make the two partners not coordinate one with the other. Therefore, instead of attributing the problem to one of the two, it is much wiser to try and manage the diversity of the two as a whole. This approach allows the therapy to focus on the couple and the partners' inbetween interactions, instead of focusing only on one of the two. 

It has been found out that when a couple goes for therapy to treat sexual desire problems, most of the times they have already 'concluded' which one of the two is 'the problem' and want to focus only on this particular partner. However, following new therapeutic considerations, most couples find it very enlightening, reviving and hopeful when they realize that both of them have their share to the problem and, above all, that they can both together resolve the problem and increase their sexual satisfaction.

One dynamics often developed in couples is when one of the two partners -the one who most of the times approaches more his/her partner- takes the initiative and finds delight in trying to make his/her partner "open up". At the same time, the person who gets approached and avoids the inititative, enjoys being desired and responding whenever s/he feels like doing so.  

However, as time passes by, the more the same partner expresses his/her sexual desire for the other, the more distant the other one may get. Thus, a vicious cycle is created. With the lapse of time, these roles consolidate and arguments between the two arise, including accusations such as "You always have sex on your mind!" or "You never want to have sex". Very often the phenomenically organic/hormonal problem of hypoactive sexual desire (HSDD)  turns out to be the result of the above cyclicity. 

Yet, couples initiating their therapy have the potential to get out of this vicious cycle. Even if it is only the one partner who chooses to make a turn, the dynamics can be affected positively. However, when both partners get involved in the therapy, the results can be really more substantial and impressive. Taking into account the 'relationship' and the potentials of each partner, the couple can learn to settle their differences, in such a way that they allow their relationship to evolve and, thus, increase their sexual satisfaction.