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This paper reviews the psychological and medical literature from 1970-1989 on controlled treatment studies of hypoactive sexual desire disorder (HSDD). A marked lack of scientifically adequate treatment studies was identified. Specific recommendations for future research in this area are made, including the use of operationally defined diagnostic criteria, thorough medical screening prior to study entry, use of adequate controls, appropriate group matching on prognostic variables, and use of 'blind' rating of outcome by both subject and rater wherever possible. Additional research and treatment issues are discussed. KEY WORDS: sexual desire, hypoactive desire disorders, androgen.

This study reports the effects of the antilibidinal drug, medroxyprogesterone acetate (MPA) on nocturnal penile tumescence (NPT) during sleep, tumescence responses to provocative audiotapes during wakefulness in the laboratory, and sexual behaviors in the hospital environment, in a conduct-disordered sexually aggressive male, who had not responded to previous treatment. NPT, laboratory tumescence, and sexual behaviors in the hospital environment were all decreased. Testosterone levels declined by 73% within 2 weeks of starting the drug and prolactin levels increased 300% across the treatment period. The effects on NPT and laboratory arousal were still partially in evidence 2 months after the drug had been stopped, although testosterone levels had returned to predrug levels. Some differences between the NPT and daytime test data are discussed in terms of the probable importance of testosterone to erotic fantasy. NPT may be a useful addition to present methods for examining the effects of drugs used to suppress socially unacceptable sexual behaviors.