What are the treatment options for hypoactive sexual desire disorder (HSDD)?

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Last updated: May 5, 2025View editorial policy

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From the Research

Low libido in men with hypogonadism can be effectively treated with testosterone replacement therapy (TRT), as evidenced by the most recent and highest quality study 1.

Treatment Approach

When addressing low libido, it is essential to first consult a healthcare provider to evaluate potential underlying medical causes, such as hormonal imbalances, medication side effects, or chronic conditions.

  • Hormone therapy, including testosterone supplementation for men with levels below 300 ng/dL, can be an effective treatment option 1.
  • Psychological approaches, such as sex therapy, cognitive behavioral therapy, or relationship counseling, are also crucial in addressing anxiety, stress, or relationship issues that may contribute to low libido.
  • Lifestyle modifications, including regular exercise, stress management techniques, adequate sleep, limiting alcohol consumption, and maintaining a balanced diet, can significantly improve libido.

Testosterone Replacement Therapy

TRT has been shown to improve sexual activity, hypogonadal symptoms, and sexual desire in men with hypogonadism and low libido 1.

  • The treatment should aim to achieve testosterone concentrations in the mid-normal range during treatment with any of the approved formulations, taking into consideration patient preference, pharmacokinetics, formulation-specific adverse effects, treatment burden, and cost 2.
  • Clinicians should monitor men receiving TRT using a standardized plan that includes evaluating symptoms, adverse effects, and compliance, measuring serum testosterone and hematocrit concentrations, and evaluating prostate cancer risk during the first year after initiating TRT 2.

Important Considerations

  • TRT is not recommended for men who are planning fertility in the near term or have certain medical conditions, such as breast or prostate cancer, palpable prostate nodule or induration, or elevated hematocrit 2.
  • The use of hepatotoxic androgens should be avoided, and testosterone treatment induces reversible suppression of spermatogenesis 3.

References

Research

Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline.

The Journal of clinical endocrinology and metabolism, 2018

Research

Testosterone Replacement Therapy in Hypogonadal Men.

Endocrinology and metabolism clinics of North America, 2022

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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