
Women with hypoactive sexual desire disorder (HSDD) feel a persistent lack of sexual desire, causing personal distress.
Because other health conditions and situations can contribute to low libido, one of the first steps in diagnosis is a thorough medical exam. If a doctor determines a cause, such as a medication side effect, past sexual trauma, hormonal changes at menopause, or breastfeeding, then addressing that cause may be all that is needed.
One key to diagnosis is a woman’s personal distress. Sex drive varies from one woman to another and what bothers one might not bother another. Also, the cause of low desire is not always clear-cut. There may be several factors involved.

One tool that helps doctors assess HSDD is the Decreased Sexual Desire Screener.
The Decreased Sexual Desire Screener (DSDS) is a diagnostic questionnaire consisting of five questions. It is designed so that providers who are not experts in sexual medicine can still accurately diagnose HSDD. It takes only a few minutes to administer.
The DSDS is used to diagnose acquired HSDD. Women with acquired HSDD have lost interest in all partners and types of sexual activities. It occurs after a woman has had normal sexual functioning for some time.

The DSDS begins with these four questions:
- In the past, was your level of sexual desire/interest good and satisfying to you?
- Has there been a decrease in your level of sexual desire/interest?
- Are you bothered by your decreased level of sexual desire/interest?
- Would you like your level of sexual desire/interest to increase?
If a woman answers “no” to any of these questions, she is not diagnosed with HSDD.

The fifth question of the DSDS asks the woman to indicate any factors that may be contributing to her loss of sexual interest. They are as follows:
- An operation, depression, injuries, or other medical condition
- Medications, drugs, or alcohol she is currently taking
- Pregnancy, recent childbirth, menopausal symptoms
- Other sexual issues she may have (pain, decreased arousal or orgasm)
- Her partner’s sexual problems
- Dissatisfaction with her relationship or partner
- Stress or fatigue

If a woman answers “yes” to questions 1-4 and “no” to all of the items in question 5, she can be diagnosed with HSDD.
If she answers “yes” to questions 1-4 and “yes” to any of the items in question 5, then she might be diagnosed with HSDD at her doctor’s discretion.