Brotto et al, 2011

Another #paperIlike is Brotto, Petkau, Labrie, and Basson’s 2011 paper, “Predictors of Sexual Desire Disorders in Women,” published in the “Journal of Sexual Medicine.”

They compare two clinical diagnoses-hypoactive sexual desire disorder (HSDD) and the recently proposed Sexual Desire/Interest Disorder (SDID) – to see what, if any, hormonal and lifestyle factors predict diagnostic symptoms. (The different diagnoses are part of an ongoing debate about changing the APA’s DSM classifications for women’s sexual dysfunctions – but that’s another post.)

They do a whole lot of hormone measuring, only to conclude that essentially NO hormonal measure is helpful in predicting or measuring either approach to diagnosing desire disorders in women.

Other things that did not differentiate levels of symptomatology were mood and relationship.

So what WAS predictive?

“[P]sychosexual history (i.e., sexual debut, past sexual experiences); developmental history (i.e., assessment of early attachment relationships, significant events as a child); history of sexual abuse; current and past psychiatric status (i.e., diagnoses of Axis I and II disorders”

Women with the more intense symptomatology of SDID were more likely than women who fit the criteria for HSDD to report a history of sexual abuse, but overall the single strongest predictor of low desire was psychiatric history.

This is a complex paper that bears careful and thorough reading if you’re interested in the DSM-5 developments. They even discuss attachment, a topic not usually addressed in this kind of literature yet which is, in my opinion, totally crucial.

For folks less interested in the diagnostic minutiae, the takeaway message is: if you’re experiencing low desire, your hormones have nothing to do with it. It’s your past or your discomfort with the present. Both of which are eminently treatable. Yay! One of the keys is increasing your attunement to pleasurable sensations inside your body.