(061) Prevalence and Comorbidities of Hypoactive Sexual Desire Disorder: A Narrative Review

Abstract Introduction Hypoactive Sexual Desire Disorder (HSDD) is defined as a lack of motivation for sexual activity as manifested by decreased or absent desire and associated personal distress for at least 6 months. HSDD accounts for 59-66% of female sexual dysfunction. Despite the high prevalence, only 38% of medical trainees indicate they have learned about the condition and 36.9% of urologists treat female sexual dysfunction. By assessing potential comorbidities and geographical considerations, we hope to inform clinical practice, urging for increasingly effective and individualized management of HSDD. Objective Our review aims to provide a comprehensive overview of existing population studies discussing HSDD prevalence to assess and compare comorbid states or other considerations that may contribute to reported prevalences. Methods This literature review analyzed peer-reviewed studies published until 2024. Articles were identified from the following databases: PubMed, ScienceDirect, and Oxford Academic. The search terms “hypoactive sexual desire disorder prevalence” OR “hypoactive sexual desire disorder epidemiology” OR “hypoactive sexual desire disorder population study” were used to ensure we reviewed all relevant literature on the topic of interest. The frequency of comorbidities were reported in the context of each study. Results Our review included 12 studies that discussed prevalence, associated factors, and comorbid states. HSDD is prevalent in 6% to 32% of individuals aged 20 to 70 worldwide and tends to be more prevalent in sexually active partnered individuals compared to those who are single. Several studies show that the prevalence of HSDD remains the same throughout life, while other studies show variability with HSDD peaking at 25 to 34 years old. HSDD was shown to be more prevalent in the US and Australia, and less prevalent in Western Europe. Research into genetic factors has shown that low sexual desire is 35% heritable, though this study did not include distress associated with lack of desire. Twelve biological comorbidities and three psychological comorbidities were reported by the studies overall, with the most common being surgical menopause (OR = 2.1, 95%CI = 1.4-3.4, p = 0.001). Arousal and orgasm problems was also reported by one study which could have both biological and psychological etiologies. Natural menopause, oral contraceptive use, pregnancy in the last year, genitourinary infection, urinary incontinence, fatigue, diabetes, hypertension, lubrication problems, vasomotor symptoms, pelvic floor dysfunction, anxiety, depression, and antidepressant use. Conclusions This review highlights the substantial global burden of HSDD and the wide variability in reported prevalence, underscoring the influence of demographic, geographic, and methodological differences across studies. The identification of numerous biological and psychological comorbidities-particularly surgical menopause, mood disorders, and genitourinary conditions-emphasizes the need for clinicians to adopt a comprehensive, biopsychosocial approach to evaluation. Our findings support the need for improved clinician training and more individualized, culturally informed management strategies to better address this complex condition. Disclosure No.