LNSLNS The authors deserve thanks for emphasizing a biopsychosocial approach, which clarifies that erectile dysfunction (ED)—in contrast to what is widely assumed—is not restricted to functional aspects but is a complex problem that requires interdisciplinary treatment. With regard to the impaired appetence (which merited but a brief mention in the article), it should usefully be added that this is an independent pathology, described in the DSM-IV-TR as “hypoactive sexual desire disorder” (HSDD), which unfortunately thus far has received far too little attention compared with ED. The clinical symptoms of HSDD are characterized by an absence of sexual fantasies and desire, which puts individuals thus affected under great psychological strain. The prevalence of up to 15% comes close to that of ED itself and directly contradicts the myth that men’s sexual desire is constant (1, 2). To explore sexual desire diagnostically, the questionnaire of the Sexual Desire Inventory (3) is a useful tool, in order to distinguish HSDD from ED. Since the possible causes that are currently under discussion include factors such as depression, hypogonadism, age, fears and anxieties, and conflicts within the affected man’s relationship, it would be highly desirable if in future the existence of HSDD in men were to meet with greater attention in clinical practice as well as the research arena..
DOI: 10.3238/arztebl.2010.0350b

Prof. Dr. med. Markus A. Kuczyk
Dipl.-Psych. Annika Simon
PD Dr. med. Axel Stuart Merseburger
Klinik für Urologie und Urologische Onkologie
Medizinische Hochschule Hannover (MHH)
Carl-Neuberg-Str. 1, 30625 Hannover, Germany
merseburger.axel@mh-hannover.de
1.
Meuleman EJ, van Lankveld JJ: Hypoactive sexual desire disorder: An underestimated condition in men. BJU Int 2005; 95(3): 291–6. MEDLINE
2.
Maurice WL: Sexual desire disorders in men. In: Leiblum SR, ed. Principles and practice of sex therapy. 4th edition. New York, NY u.a.: Guilford Press 2007; 181–211.
3.
Spector IP, Carey MP, Steinberg L: The sexual desire inventory: development, factor structure, and evidence of reliability. J Sex Marital Ther 1996; 22(3): 175–90. MEDLINE
4.
Rösing D, Klebingat KJ, Berberich H, Bosinski H, Loewit K, Beier K: Sexual dysfunctions in men – Diagnosis and treatment from a sexological interdisciplinary perspective [Sexualstörungen des Mannes – Diagnostik und Therapie aus sexualmedizinisch-interdisziplinärer Sicht]. Dtsch Arztebl Int 2009; 106(50): 821–8. VOLLTEXT
1. Meuleman EJ, van Lankveld JJ: Hypoactive sexual desire disorder: An underestimated condition in men. BJU Int 2005; 95(3): 291–6. MEDLINE
2. Maurice WL: Sexual desire disorders in men. In: Leiblum SR, ed. Principles and practice of sex therapy. 4th edition. New York, NY u.a.: Guilford Press 2007; 181–211.
3. Spector IP, Carey MP, Steinberg L: The sexual desire inventory: development, factor structure, and evidence of reliability. J Sex Marital Ther 1996; 22(3): 175–90. MEDLINE
4. Rösing D, Klebingat KJ, Berberich H, Bosinski H, Loewit K, Beier K: Sexual dysfunctions in men – Diagnosis and treatment from a sexological interdisciplinary perspective [Sexualstörungen des Mannes – Diagnostik und Therapie aus sexualmedizinisch-interdisziplinärer Sicht]. Dtsch Arztebl Int 2009; 106(50): 821–8. VOLLTEXT