by Dr Dave M. Jenkins

Created on: February 10, 2007   Last Updated: April 18, 2007

So the relationship starts off great. And along comes the first sign of problems. How well do new couples handle this hiccup? For many couples, sex becomes the expression field. The bedroom becomes a hothouse for social tensions (Bader, 1998). Sex is a big part of healthy relationships. Each couple expresses their own unique sexuality differently. But how many couples communicate to their partner just what their needs are? Too often, couples hold their partners responsible for their sexuality. When in fact, we are all responsible for our own sexuality and satisfaction. At issue is personal responsibility. How can this be increased and does therapy encourage it? Human sexuality has become largely dissociated from reproduction and from the estrus cycle and is much more plastic and subject to learning and experience (Kaplan, 1996).

There are many types of sexual disorders but my primary focus will be held to hypoactive sexual desire disorder (HSDD). Every behavior makes sense within its context. But what kind of sense does HSDD make within a relationship? I intend to explore the development and relational ramifications of such a disorder within its context. The scope of this review will focus on the psychological aspects of HSDD and explore the impact of intimacy and compatibility. My interests are confined to heterosexual relationships.

Definition
What is hypoactive sexual desire disorder? And whom does it affect? According to the DSM-IV it is the absence of sexual fantasies and desire for sexual activities and causes distress or interpersonal difficulties. HSDD is specified as lifelong vs. acquired and generalized vs. specific. We must also make mention of sexual desire. It is a subjective, psychological experience or state that can be understood as an interest, wish, need or drive toward sexual activities (Regan, 1999).

HSDD affects both men and women equally (Renshaw, 2001). However Davies (1999) cites sources indicating women experience HSDD more then men. They see men as having erectile dysfunction rather than problems with desire. Here we witness male bias within research. This view of sexuality continues to support the dominant male view. The view, that men are always ready for sex but are somehow betrayed by their penis.

HSDD develop because of a variety of reasons and sources. The primary reasons for HSDD are intimacy-wedges. Many things can become an intimacy-wedge. They range from medical reasons (Samelson & Hannon, 1999) to hormonal (Bartik, Legere, &

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