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Advisor(s)
Abstract(s)
Introduction. There are problems with the existing definition of hypoactive sexual desire disorder (HSDD) in that
desire for sex and sexual fantasy are not a universal experience.
Aims. To explore: (i) women’s motivations to engage in sexual activity; (ii) frequency and predictors of sexual
fantasies; (iii) sexual arousal; (iv) recognition of sexual arousal; and (v) association between relationship duration and
these variables.
Methods. Three thousand six hundred eighty-seven women completed a web-based survey of previously pilot-tested
items.
Main Outcome Measures. Investigator-derived self-report questions of sexual desire and arousal, and sexual fantasies.
Results. Among women who easily became aroused, 15.5% reported only engaging in sex if they felt sexual desire at
the outset whereas 30.7% typically or always accessed desire only once they were aroused. Women in longer-term
relationships engaged in sex with no sexual desire more often (42%) than women in short-term relationships (22.4%)
(P < 0.001). The percentage of women that reported fantasies only sometimes was 52.5%. A logistic regression
revealed that religion (odds ratio [OR] = 1.45; P < 0.001), difficulty getting aroused (OR = 0.511; P < 0.001), responsive
desire (OR = 0.919; P < 0.05), and frequency of orgasm (OR = 1.11; P < 0.05) were significantly associated with
sexual fantasy. After controlling for age, relationship duration was negatively associated with frequency of initiating
sex (r = -0.116, P < 0.001), women’s satisfaction with their own sexuality (r = -0.173, P < 0.001) and sexual satisfaction
with the partner (r = -0.162, P < 0.001).
Conclusions. Results reflect diversity in women’s motivations for sex, and there is evidence that responsive desire
occurs in women with and without arousal difficulties. We strongly recommend relationship duration as well as
adequacy of partner sexual stimulation to be recognized in any future diagnostic framework of dysfunction. Clinical
implications as well as those for future diagnostic nomenclature are considered.
Description
Keywords
Sexual desire Hypoactive sexual desire Models of sexual response DSM-IV-TR Classification
Citation
Journal of Sexual Medicine, 7, 1454-1463