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Postmenopausal hypoactive sexual desire disorder: ongoing challenges.

Zhihua Zhu1,2, Lu Zhu1,2, Bing Song3

  • 1Reproductive Medicine Center, the First Affiliated Hospital of Anhui Medical University, Anhui, China.

Menopause (New York, N.Y.)
|January 20, 2026
PubMed
Summary
This summary is machine-generated.

Hypoactive sexual desire disorder (HSDD) is common in women, especially postmenopausal individuals. Addressing systemic barriers is crucial for improving diagnosis and treatment of HSDD in this population.

Keywords:
Hormone therapyHypoactive sexual desire disorderMenopausal womenPostmenopausalTreatment

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Area of Science:

  • Reproductive Health
  • Neuroendocrinology
  • Women's Health

Background:

  • Hypoactive sexual desire disorder (HSDD) is the most prevalent sexual dysfunction in women.
  • Pathogenesis involves brain excitation-inhibition imbalance and hormonal deficiencies.
  • Postmenopausal women experience unique risks due to endocrine changes and aging.

Purpose of the Study:

  • To review the prevalence, barriers, and future research directions for HSDD in postmenopausal women.
  • To highlight the underdiagnosis and undertreatment of HSDD in this demographic.
  • To identify systemic and societal factors impacting HSDD management.

Main Methods:

  • Systematic literature searches of PubMed, EMBASE, and Cochrane Library (2000-2025).
  • Inclusion of key older studies and screening for relevance to HSDD in postmenopausal women.
  • No language restrictions applied during study selection.

Main Results:

  • HSDD is highly prevalent in postmenopausal women but frequently underdiagnosed and undertreated.
  • Significant structural barriers (provider training, access, policy) and societal barriers (diversity, disparities, stigma) impede care.
  • Systemic issues contribute to widespread clinical neglect.

Conclusions:

  • Addressing systemic barriers is essential for improving HSDD care in postmenopausal women.
  • Future research must focus on diverse populations, diagnostic clarity, provider education, and policy reform.
  • Enhanced public education and targeted interventions are needed to improve outcomes.