Presence of Another Sexual or Gender Disorder in a Patient or Partner

Sexual Dysfunctions

Three studies demonstrate that it is common for HSDD to be associated (or comorbid or correlated) with another sexual dysfunction. However, correlation is not the same as causation. The same factor(s) may result in both disorders. Nevertheless, the observation is at least noteworthy, and beyond that, may be etiologically meaningful.

1. Segraves and Segraves reported on 906 subjects (including 374 men) who had been recruited for a pharmaceutical company study of sexual disorders (20). Only the men will be discussed in this chapter. They were described as age 51 (SD = 10.1), and 30% (n = 113) had a primary diagnosis of HSDD. Almost half (47%) had a secondary diagnosis of erectile impairment and a few (n = 3) had retarded ejaculation (patients with premature ejaculation were excluded from the study).

2. Schiavi reviewed 2500 charts of individuals and couples referred between 1974 and 1991. This survey included 1775 men, of which 13.3% (n = 236) were 60 years old or older (range 60-84). Most of the men (66%) were diagnosed with erectile disorder but 28% had HSDD either alone [3% (n = 8)] or associated with another sex-related diagnosis [ED—14% (n = 34); PE—11% (n = 27)]. In some, ED was the cause while in others it was the result. In most "it was not possible to determine the primary dysfunction" (36: p. 115).

3. Together with colleagues, Schiavi also examined the psychobiology of a group of sexually healthy men aged 45-74 living in stable sexual relationships (36; pp. 41-53). Seventy-seven couples were studied. One of the issues considered was a comparison of men with and without a sexual dysfunction. Seventeen men met their criteria for erectile dysfunction and five for HSDD (22% and 6.5%, respectively, of the total group). They found a significant difference in the age of the HSDD men who did and did not have accompanying ED (70.8 and 58.6 years, respectively). They added that the number of men with HSDD was too small to do any statistical comparisons with men who were not experiencing this disorder.

Sexual Difficulties in a Partner

Sexual difficulties in a partner, for example, intercourse-related pain experienced by a woman, may result in profound change in the level of sexual desire in the other person.

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