Reaching a diagnosis
Uncovering hypoactive sexual desire disorder (HSDD) in your practice
Regardless of how familiar you may be with HSDD, you could make a real impact in your patients’ lives by initiating a more candid conversation with them. There are a range of validated screening tools and they vary in their degree of detail and usefulness, depending on clinical specialty. But some of the screeners can be easily incorporated into routine clinical practice. This includes brief screening questionnaires that may be administered in either a waiting room or an office setting, preparing patients for the conversation and validating their sexual health concerns.
Described below are easy-to-use, validated screening tools that have been developed by clinicians to help you diagnose and assess HSDD.
The Decreased Sexual Desire Screener (DSDS) for generalized acquired HSDD in women1
The DSDS is a validated tool to assess sexual problems and diagnose low desire in women. This 5-question diagnostic tool may be filled out by patients in the waiting room to help clinicians identify and begin a conversation about HSDD.
The first 4 items address the diagnostic criteria for low sexual desire. The fifth question helps rule out potential medical conditions and other psychiatric problems, enabling the clinician to understand some of the contextual factors that might be contributing to low desire.
The Female Sexual Function Index (FSFI)2
The FSFI is a longer-form diagnostic than the DSDS that can help clinicians identify the primary problem. The FSFI is a validated, 19-item, self-reported questionnaire that can be incorporated into clinical evaluation of sexual desire and arousal disorders in women. It also can help discern between desire/arousal disorders and other medical disorders.
The test’s 19 questions cover 6 domains: desire, arousal, lubrication, orgasm, satisfaction, and pain.
The Female Sexual Distress Scale-Revised (FSDS-R)3
The FSDS-R is a validated, self-administered measure of personal distress associated with HSDD. It’s a 13-item questionnaire that has proven discriminant validity. It also has demonstrated high test-retest reliability and consistency in measuring sexually related personal distress in women with HSDD.
The FSDS was originally developed to quantify sexually related personal stress and was revised in 2008. The FSDS-R differs from the FSDS in that it includes one additional question to rate distress related to low sexual desire.
Sheryl Kingsberg, PhD, IF
Case Western Reserve University School of Medicine
Dr. Kingsberg is a consultant for AMAG Pharmaceuticals, Inc. and Palatin Technologies, Inc.View resources
References: 1. Clayton AH, Goldfischer ER, Goldstein I, DeRogatis L, Lewis‐D’Agostino DJ, Pyke R. Validation of the decreased sexual desire screener (DSDS): a brief diagnostic instrument for generalized acquired female hypoactive sexual desire disorder (HSDD). J Sex Med. 2009;6(3):730‐738. 2. Rosen R, Brown C, Heiman J, et al. The female sexual function index (FSFI): a multidimensional self‐reported instrument for the assessment of female sexual function. J Sex Marital Ther. 2000;26(2):191‐208. 3. DeRogatis L, Clayton A, Lewis‐D’Agostino D, Wunderlich G, Fu Y. Validation of the female sexual distress scale‐revised for assessing distress in women with hypoactive sexual desire disorder. J Sex Med. 2008;5:357-364.