Hypoactive Sexual Desire: Integrating Sex and Couple Therapy

Gerald R. Weeks and Nancy Gambescia

Overview – Table of Contents

The lack of sexual desire, known clinically as hypoactive sexual desire (HSD), is generally recognized as the most common sexual problem in America. Over 50% of couples presenting for treatment will complain of insufficient sexual desire in one or both partners. Thus, all clinicians are very likely to encounter HSD in both individual and couple therapy practices.

Here, Gerald Weeks and Nancy Gambescia present a treatment model for HSD based on the integration of medical and psychological interventions. This book provides clinicians with the theoretical and practical tools to understand and treat this complex problem.

The book opens by providing a general background about HSD and describing the overall framework of the problem. The authors then review theories about the presence, absence, and normative amounts of sexual desire and cover factors that contribute to the lack of [sexual] desire from the individual perspective. Both nonpsychiatric and psychiatric factors are examined.

Later chapters discuss the relational and intergenerational factors that place couples at risk for developing HSD. The physiology of sexual desire and the biological factors that can diminish it (such as hormonal deficiencies, chronic illnesses, and the sexual side effects of some medications) are also discussed. Finally, the authors provide a comprehensive assessment approach for HSD and outline basic principles and strategies for treatment.

A couple's lack of sexual desire is a challenging issue for the clinician, but treatment is a rewarding endeavor. Every practitioner who wants to help couples revive their sexual relationship in the context of a significantly enhanced couple relationship will benefit from this book.

Praise for Hypoactive Sexual Desire:

“The lack of sexual desire, known clinically as hypoactive sexual desire (HSD), is generally recognized as the most common sexual problem in America. Here, Gerald Weeks and Nancy Gambescia present a treatment model for HSD based on the integration of medical and psychological interventions. This book provides clinicians with the theoretical and practical tools to understand and treat this complex problem….Finally, the authors provide a comprehensive assessment approach for HSD and outline basic principles and strategies for streatment.”
     ––Family Therapy

“…an excellent resource for the seasoned and for the newly minted therapist. The authors frequently remind the reader of the complexity of hypoactive sexual desire and that it is always multifacotrial; they repeatedly warn against the temptation to attribute its presence to a single cause. …Weeks and Gambescia take care throughout to emphasize the systemic nature of HSD…They anticipate pitfalls for the practitioner and innoculate against them. Their definitive stance on this perspective is very persuasive… Clinicians will appreciate the detailed skills, techniques, questions, and exercises that the authors include. In an easy-to-read style, the authors explore the multiplicity of risk facotrs for HSD…this book will have a broad audience; it is a must read; a definitive text on HSD.”
     ––Sandra Levine Slover, M.S.W., Journal of Sex and Marital Therapy

'Here is an academically rigorous yet professionally useful text on hypoactive sexual desire, probably the most difficult of the sexual disorders to treat. Gerald Weeks and Nancy Gambescia have written the most comprehensive and clinically relevant text to date on the topic. This book will be immediately useful to sex therapists and other clinicians who treat hypoactive sexual desire, and to students in all of the clinical disciplines.'
      - Terry S. Trepper, Ph.D.
Director, Family Studies Center
Professor of Psychology and Professor of Marriage & Family Therapy
AASECT Certified Sex Therapist and AAMFT Approved Supervisor
Purdue University, Calumet

'Weeks and Gambescia have given us a brilliant new work that explains their use of systems therapy in treating sexual dysfunctions. Clinical examples abound and the bibliography is extremely helpful. Any serious student or practitioner, particularly psychologists, psychiatrists, and marital therapists, will find this book very useful.'
      - Martin Goldberg, M.D.
Director Emeritus, Penn Council for Relationships

'Hypoactive Sexual Desire is clearly one of the best and most comprehensive works in the contemporary literature on sexual desire composed by two of the world's foremost authorities. It is written with the clinical perspicacity and critical-mindedness that provides readers with a valuable resource.'
      - Frank M. Dattilio, Ph.D., ABPP
Department of Psychiatry, Harvard School of Medicine and University of Pennsylvania School of Medicine

'Up to now, low sexual desire has been dealt in piecemeal fashion in the literature. Finally, all the information necessary to understand and treat one of the most common disorders in couple therapy has found its single, complete umbrella. To use an overworked cliché that this is a 'must read' does not do justice to this book. It should be on the list of required readings for graduate students in all marriage and family therapy programs, as well as in the hands and minds of professionals in those fields. Sex therapists may want to use this book as their bible!'
      - Luciano L'Abate, Ph.D.
Professor Emeritus, Georgia State University

About the Authors

Gerald R. Weeks, Ph.D., is a professor at the University of Las Vegas. He published the first professional textbook advocating the integration of the fields of sex and marital therapy. Since the publication of that work in 1987, he has been a leader in integrative therapy in the field of sex therapy.
Nancy Gambescia, Ph.D., is on the teaching and supervisory faculty of Penn Council for Relationships in Philadelphia, a division of Jefferson University. She also maintains an active private practice specializing in relationship and sex therapy in Rosemont, Pennsylvania. Most recently, Weeks and Gambescia have published Erectile Dysfunction: Integrating Couple Therapy, Sex Therapy, and Medical Treatment (Norton).

ISBN: 0-393-70344-4
November, 2001
Hardcover, 288 pages