Partner responses to low desire among couples coping with male hypoactive sexual desire disorder and associations with sexual well-being

Abstract

Abstract Background Hypoactive sexual desire disorder (HSDD) is characterized by persistently low desire and associated distress. Low desire is one of the most common sexual complaints among men and is associated with poor well-being. Interpersonal factors are key to understanding low desire, yet there are few dyadic studies of HSDD in men. Previous work on genito-pelvic pain and low desire in women has established that greater facilitative (eg, affectionate) partner responses are associated with greater sexual satisfaction and function and that more negative (eg, critical) or solicitous (eg, sympathetic, avoidant) partner responses are associated with lower sexual satisfaction and function. Examining how partner responses are associated with adjustment to HSDD may shed light on the interpersonal dynamics of this understudied sexual dysfunction. Aim In a cross-sectional study, we examined whether partner responses to low desire in men were associated with sexual desire, sexual satisfaction, and sexual distress for both members of the couple. Methods Men with HSDD and their partners (N  =  67 couples) completed measures of facilitative, negative, and avoidant partner responses to men’s low sexual desire—as perceived by the man with HSDD and self-reported by their partner—and sexual desire, sexual satisfaction, and sexual distress. Data were analyzed using multilevel modeling guided by the actor–partner interdependence model. Outcomes Outcomes included the partner-focused subscale of the Sexual Desire Inventory–2, Global Measure of Sexual Satisfaction, and Sexual Distress Scale–Revised. Results When men with HSDD perceived more facilitative partner responses to their low desire, they and their partners reported greater sexual satisfaction. When men with HSDD perceived and their partners self-reported more negative partner responses, they each reported lower sexual satisfaction. In addition, when men with HSDD perceived more avoidant partner responses, their partners reported greater sexual distress. Partner responses were not associated with sexual desire for either member of the couple. Clinical Implications Findings support the importance of the interpersonal context for HSDD in men and suggest potential future targets of treatment when working with affected couples. Strengths and Limitations This study is one of the only dyadic studies of HSDD in men, as assessed via clinical interview or self-report symptoms reviewed by the clinical team. Despite our best efforts to recruit this sample over 6 years, the small size limited power to detect all predicted effects. Conclusion More facilitative and fewer negative or avoidant partner responses to low desire are associated with greater sexual well-being in couples coping with HSDD.