Abstract Hypoactive SexualDesire Disorder (HSDD) is one
of two sexual desire disorders in the Diagnostic and Statistical
Manual of Mental Disorders (DSM) and is defined by the
monosymptomatic criterion ‘‘persistently or recurrently deficient
(or absent) sexual fantasies and desire for sexual activity’’
that causes ‘‘marked distress or interpersonal difficulty.’’ This
article reviews the diagnosis of HSDD in prior and current
(DSM-IV-TR) editions of the DSM, critiques the existing criteria,
and proposes criteria for consideration in DSM-V. Problemsincomingto
a clearoperationaldefinitionof desire, thefact
that sexual activity often occurs in the absence of desire for
women, conceptual issues in understanding untriggered versus
responsivedesire,therelative infrequencyofunprovokedsexual
fantasies in women, and the significant overlap between desire
andarousalarereviewedandhighlight theneedforrevisedDSM
criteria forHSDDthat accurately reflect women’s experiences.
The article concludes with the recommendation that desire and
arousal be combined into one disorder with polythetic criteria

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