442 Sexual Dysfunctions
ment. Each of these factors may contribute differently to the presenting symptoms of dif-
ferent men with this disorder. 
Prevalence 
The prevalence of male hypoactive sexual de sire disorder varies depending on country of
origin and method of assess ment. Approximately 6% of younger men (ages 18–24 years)
and 41% of older men (ages 66–74 years) have problems with sexual desire. However, a
persistent lack of interest in sex, lasting 6 months or more, affects only a small proportion
of men ages 16–44 (1.8%). 
Development and Course 
By definition, lifelong male hypoactive sexual desire disorder indicates that low or no sex-
ual desire has always been present, whereas th e acquired subtype would be assigned if the
man’s low desire developed afte r a period of normal sexual desire. There is a requirement
that low desire persist for approximately 6 months or more; thus, short-term changes in
sexual desire should not be diagnosed as  male hypoactive se xual desire disorder. 
There is a normative age-related decline in se xual desire. Like women, men identify a
variety of triggers for their sexual desire, and they describe a wide  range of reasons that
they choose to engage in sexual activity. Although erotic visual cues may be more potent
elicitors of desire in younger men, the potenc y of sexual cues may decrease with age and
must be considered when evaluating men for hypoactive sexual desire disorder. 
Risk and Prognostic Factors 
Temperamental. Mood and anxiety symptoms appear to be strong predictors of low de-
sire in men. Up to half of men with a past  history of psychiatric symptoms may have mod-
erate or severe loss of desire, compared with only 15% of those without such a history. A