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A Standardized Diagnostic Interview for Hypoactive Sexual Desire Disorder in Women: Standard Operating Procedure (SOP Part 2)


  • Johannes Bitzer Prof.,

    Corresponding author
    1. University Women's Hospital Basel, Basel, Switzerland
    • Johannes Bitzer, Prof., Department of Obstetrics and Gynecology, University Hospital Basel, Spitalstrasse 21, Basel 4031, Switzerland. Tel: +41 61 265 90 99; Fax: +41 61 265 91 99; E-mail:

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  • Annamaria Giraldi MD, PhD,

    1. Sexological Clinic, Psychiatric Center Copenhagen, Ringhospitalet, Denmark
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  • Jim Pfaus Prof.

    1. Center for Studies in Behavioral Neurobiology, Department of Psychology, Concordia University, Montréal, QC, Canada
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Introduction.  Taking into account that Hypoactive Sexual Desire Disorder (HSDD) is a patient-reported symptom and that the disorder is in general the result of the interaction of biological and psychosocial factors (see part 1), it is necessary to provide healthcare professionals with an operating procedure that is patient centered and multidimensional.

Aim.  Describing a patient-centered and multidimensional standard procedure to diagnose and manage HSDD on a primary care level.

Methods.  Review of the literature. Semistructured interview and description of process.

Result.  The interactive process with the patient follows several steps: initiation, narrative of the patient to understand the individual profile of the disorder, differentiating questions, descriptive diagnosis, exploration of conditioning biomedical, individual psychological, interpersonal, and sociocultural factors (including biomedical examinations), establishment of a biopsychosocial comprehensive explanatory diagnosis, which can be summarized in a nine-field matrix. This matrix will serve as orientation for therapeutic interventions adapted to the individual person. These interventions should always be based on basic counseling as a basis of treatment. Then adapted to the individual condition specific hormonal treatments (mainly estrogen and testosterone alone or combined) can be used after exclusion of contraindications. In patients with predominant psychosocial factors contributing to HSDD individual or couple psychotherapy is indicated. Psychopharmacological drugs are in development and partially investigated and will add to the therapeutic possibilities in the future.

Conclusion.  This model can serve as an ideal basis for the approach to the female patient with HSDD. It can be adapted to the individual clinical setting. Bitzer J, Giraldi A, and Pfaus J. A standardized diagnostic interview for Hypoactive Sexual Desire Disorder in women: standard operating procedure (SOP part 2). J Sex Med **;**:**–**.