Physical Examination

A physical examination is necessary when HSDD is acquired and generalized in a man. However, one might legitimately ask what to look for since HSDD can be seen as a symptom of a disorder, or, as a syndrome (i.e., as a collection of symptoms which result from a wide variety of causes). When associated with another disease, loss of sexual desire may resemble other phenomena like loss of appetite or fatigue—symptoms linked to many different medical and psychiatric disorders ranging from depression to cancer, and not having any specific physical findings.

When no specific cause of HSDD is apparent from the history, one must then consider an unrecognized disorder (like renal, cardiac, or endocrine disease) when conducting a physical examination. The principal endocrine disorders would be hypoandrogen states and hypothyroidism. Signs of the former can be subtle and in men, are often delayed. When considering hypogo-nadism, examination of the testes is mandatory. "Since generalized disease and endocrine disorders can coexist, the presence of the former does not necessarily mean that the explanation for sexual desire loss has been found and that a search for an accompanying endocrine disorder, is, therefore, unnecessary." (12; p. 180).

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