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Standard Operational Procedures for Low Sexual Desire in Men


  • Eusebio Rubio-Aurioles MD, PhD,

    Corresponding author
    1. Clinical Research, Asociación Mexicana para la Salud Sexual, A.C. (AMSSAC), Mexico City, Mexico
    • Eusebio Rubio-Aurioles, MD, PhD, AMSSAC, Tezoquipa 26, Delegacion Tlalapan Mexico DF, Mexico City, Mexico DF, 14000, Mexico. Tel: +525555733460; Fax: +525555131065; E-mail:

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  • Trinity J. Bivalacqua MD, PhD

    1. The James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD, USA
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Introduction.  Low sexual desire in men is a condition that has received little attention; nevertheless it occurs with high frequency. Clinicians are in need of clear guidelines to address this problem.

Aim.  To develop standardized operational procedures to be implemented with men presenting low sexual desire/interest (LSD/I).

Methods.  Review of relevant evidence-based literature and published guidelines, integrated with expert opinion.

Main Outcome.  Operational procedures for LSD/I that are recommended for clinical practice with various degrees of support from published evidence.

Results.  A new classification scheme is proposed; LSD/I is proposed as an umbrella term for which hypoactive sexual desire disorder (HSDD) is only a subtype. The following standard operational procedures are described: (i) Detection of LSD/I: screening for LSD/I, screening for LSD/I in patients with other sexual dysfunctions; (ii) Diagnosis and assessment of etiology: diagnostic criteria for LSD/I, assessment of depression status, assessment of relationship status, assessment of endocrinologic status, diagnostic criteria for HSDD in men; (iii) Treatment: treatment of LSD/I secondary to low testosterone, treatment of LSD/I secondary to elevated prolactin, treatment of LSD/I secondary to other endocrinologic disorders, treatment of LSD/I secondary to depressive illness and or anxiety disorders, treatment of LSD/I secondary to relationship conflict and treatment of HSDD. A diagnostic and treatment algorithm is presented.

Conclusions.  LSD/I is a common condition that should be identified in patients; it is recommended that this condition be actively investigated by the clinician. Once the diagnosis of LSD/I in men is confirmed, a thorough search for possible causes needs to include both biological and psychological causes. Treatment should be etiologically oriented. Rubio-Aurioles E and Bivalacqua TJ. Standard operational procedures for low sexual desire in men. J Sex Med **;**:**–**.