Patient's question:
Hello expert,I have been sexually active for nearly a year. However, I have no sexual desire at all. My husband has tried every possible way to increase foreplay to boost my libido, but I still don’t feel anything. I also have very little or almost no vaginal. Later, I discovered that direct clitoral stimulation for a period of time—while focusing very intently—can lead to climax, but there is no sensation inside the vagina. Sometimes, to satisfy him, I have to pretend to feel something.
I would like to ask the doctor, what are the possible causes of sexual apathy? Under what circumstances is it incurable? Please, could the doctor explain in detail?
Doctor's answer:
Hello: Hypoactive sexual desire disorder (HSDD), also known as sexual desire inhibition, refers to a persistent or recurrent insufficient or complete lack of sexual fantasies and desire for sexual activity. It is a condition that affects both men and women. In Traditional Chinese Medicine (TCM), it is referred to as "yin lěng" (cold yin) and "nǚ zǐ yīn wěi" (female genital atrophy).### I. Etiology and Pathology:
#### (1) Western Medicine:
1. Psychological Factors: There are several categories:
(1) Sexual Trauma Factors: Such as sexual assault, incest, fear of pregnancy, or fear of contracting sexually transmitted infections (STIs).
(2) Chronic Fatigue: Due to work stress, busy social engagements, or excessive mental exertion, which affects the function of the central nervous system.
(3) Abstinence or Excessive Indulgence: Over time, this can disrupt the function of the spinal cord's central nervous system, leading to a gradual aversion to sexual activity and suppression of sexual desire.
(4) Poor Spousal Relationship or Differing Views on Sex: Lack of proper sexual knowledge, or prolonged inability for women to achieve climax, leading to boredom with sexual life.
2. Organic Factors: Almost all chronic diseases can lead to HSDD, primarily by affecting the nervous and endocrine systems, reducing the level of sexual hormones in the blood.
3. Medication Factors: Certain medications can lower libido, such as antihistamines, marijuana, phenytoin, reserpine, spironolactone, and anti-androgen drugs.
#### (2) Traditional Chinese Medicine:
TCM believes that the root of HSDD lies in the heart, liver, spleen, and kidneys. The causes include insufficient innate and acquired nourishment, emotional distress, prolonged illness leading to physical weakness, and an excess of phlegm and dampness internally. The fundamental pathogenesis involves qi stagnation, phlegm obstruction, depletion of essence, and insufficient qi and blood.
### II. Main Symptoms:
Mild cases exhibit low libido, where married individuals have very little desire for sexual intercourse and do not demand it even if they go months without engaging in it. Severe cases...