National Differences in Patient–Clinician Communication Regarding Hypoactive Sexual Desire Disorder



This article is corrected by:

  1. Errata: ERRATA Volume 6, Issue 11, 3225, Article first published online: 29 October 2009

Irwin Goldstein, MD, Sexual Medicine, Alvarado Hospital, 6719 Alvarado Rd, Suite 108, San Diego, CA 92120, USA. Tel: 619 265-8865; Fax: 619 265-7696; E-mail:


Introduction.  Despite greater awareness and openness about sexual problems among women, many patients remain reserved about discussing such problems with their doctor. Clinicians are often reluctant to ask about sexual dysfunction.

Aim.  To learn how clinicians can communicate more effectively with patients who have hypoactive sexual desire disorder (HSDD) by exploring the language used by patients and clinicians in the United States, France, and Germany when describing the symptoms, causes, and correlates of HSDD.

Methods.  Independently conducted face-to-face, semi-structured interview with 127 clinicians involved in the treatment of female sexual dysfunction (FSD) and 95 women with FSD who were screened for HSDD using a brief adaptation of the Sexual Interest and Desire Inventory-Female®.

Main Outcome Measure.  Language used by clinicians and patients.

Results.  Clinicians and patients found FSD a difficult subject to discuss. Recognition of the term HSDD was low, with “decrease in sexual desire” preferred. Distress, currently integral to the diagnosis of HSDD, was an unpopular term. It implied to participants a state of fear or anxiety and a degree of severity not reflected by their feelings about the condition. Key feelings conveyed by patients included low self-esteem, frustration, confusion, dissatisfaction/discontent, concern, anger, embarrassment, stress, depression, and a sense of being incomplete. Clinicians were frustrated by the lack of effective treatment options for HSDD, which contributed to reluctance in discussing sexual health with patients. Patients were increasingly motivated to seek treatment, with an “improvement in level of desire” identified as the most meaningful treatment outcome, rather than an increase in satisfying sexual events.

Conclusions.  More carefully constructed definitions, based on understanding the common language between clinicians and patients, would improve doctor–patient communications and set common expectations for treatment of HSDD. Defining HSDD in simpler, non-psychiatric terms such as “decreased sexual desire” illustrates how HSDD can be translated into more patient-friendly language. Goldstein I, Lines C, Pyke R, and Scheld JS. National differences in patient–clinician communication regarding Hypoactive Sexual Desire Disorder. J Sex Med 2009;6:1349–1357.