For some biological, psychological, or socio-environmental reasons, some adult males have no interest in making love or having sexual intercourse. These people do not feel arousal sensations or fantasies about performing sexual activities. If such problems are occasional and not pervasive, then it could be normal, but if they are frequent and regular, then it leads to male hypoactive sexual desire disorder. It can also be associated with erectile or ejaculatory problems.
Male hypoactive sexual desire disorder (MHSDD) is diagnosed when a male lacks sexual interest, sexual thoughts, and fantasies for at least 6 months. Due to this lack of desire, men with MHSDD are often distressed and have wounded cognitive processes, which often lead to depression and anxiety. Men at their older age are three times more liable to be diagnosed than men at a younger age. This disorder varies in terms of prevalence; men with MHSDD may have persistent or lifelong symptoms. In an earlier edition of DSM-IV, it was a non-specific gender disorder. However, now been given a different name as a specific gender disorder. This was due to various reasons for sexual arousal for both men and women. Other than that, to diagnose MHSDD, it was a compulsion to have a persistent or continuous lack of desire for sexual activity, which is now not a criterion for MHSDD in DSM-V. The low desire for the sexual activity must be present for at least six months before the diagnosis can be granted.
Considerably epidemiology studies state that it has not yet examined full-blown criteria for MHSDD. Researchers are still studying this disorder to explain its prevalence rates adequately. Few questions have not been managed to be asked accurately to men having MHSDD. Researchers are not yet sure about its persistence of six months and whether psychological distress is attending or not. It was found that the underlying disorder had been estimated more in Asian men than in European men (0.7%–81.4 vs. 0%–65.5%).
This part of the topic will focus on the causes and consequences of low sexual interest in MHSDD. A few factors are tilted below
Biological factors − A decrease in sex hormone levels can decrease MHSDD. When androgen levels and testosterone levels are dropped in males, MHSDD is much more likely to occur, indicating a low desire for sexual activities. A syndrome named hypogonadism diminished functional activity of sex hormones (gonads), has been observed between 3-7% in younger males (30-69) and 18% in older males (above 70) in men when diagnosed with MHSDD. This relationship between age and low sexual desire hints that older men are more likely to be diagnosed with MHSDD. Surprisingly, men with hypothyroidism are at severe risk of fetching MSHDD as hypothyroidism is usually related to low levels of sexual desire. Other than this, varied intoxication of medications such as SSRIs, SNRIs, and antidepressants are responsible for provoking an intense passion for sex.
Psychological factors− One primary psychological factor that causes MHSDD is that society has heightened the role of men in sexual activity. Men are supposed to demonstrate pleasurable sex with their partners, and this creates psychological pressure on men and decreases their interest in sexual activity. Men engaged with a non-attractive partner and with zero commitments in their relationship are most likely to show low interest in sexual activity. Also, men with poor body posture and lack of early ejaculation may lose routine in sexual activity. Men with a history of psychiatric disorders are at a higher risk of MHSDD than men with zero mental health issues. It is said that psychological factors are more responsible for MHSDD rather than hormonal and biological factors, as psychological disturbance can lead to a significant risk of performing low in sexual activity, which directly decreases the level of desire to perform sex.
The treatment literature on low sexual desire in men is inadequate; however, specific treatments can be applied to MHSDD. Testosterone injections have helped increase the levels of testes to produce sufficient amounts of sperms which can cause a desire to perform sex. It is said that when prolactin is elevated, men are likelier to have a low desire for sex. With proper medications, prolactin levels can be controlled. Other than that, medications to control hypothyroidism in men act as a supplement to increase sexual desires.
Various psychotherapy is evident in MHSDD. As psychological causes are more that lead to MHSDD, proper therapies for the underlying disorder are very much helpful. One therapy is cognitive behavioral therapy (CBT) which focuses on emotion-centered and behavior strategies adapted to correct false cognitive dissonance. Cognitive-affective-behavioural (CAB) therapy also helps to modify the relationship with a partner through skill training and communication training. Along with this, the Good enough sex (GGS) model can help men to accept their underlying disorders and differences with their partners, which states that it is okay to perform at your optimum level during sex.
Male hypoactive sexual disorder is clustered under sexual dysfunction, which is a significant disorder and is now differentiated as a separate disorder. Earlier it was diagnosed as combined sexual dysfunction for males and females. It is now interpreted separately, which indicates a low desire for sexual activities, indicating significant distress in males. It leads to impairment in sexual desires and a lack of arousal in carrying out the sex. Causal factors that lead to MHSDD focus more on psychological factors where psychotherapy can put an end to reconstructing and impaired cognitive thoughts.