It is not easy to adequately respond to the question as to what exactly we are trying to cure when treating a woman for hypoactive sexual desire disorder (HSDD) due to the fact that the clinical symptoms of desire disorders are so complex. Firstly, we lack knowledge concerning all the determining factors of female libido and the many circumstances that may affect it. Secondly, female desire disorders are very frequent and often do not respond well to the treatments available. Although the recent development of newly approved drugs for the treatment of HSDD offers new treatment possibilities, no consensus has as yet emerged in the management of this disorder.

There are two paradigms by which to study sexual behavior: firstly the “reproductive” motivation, and secondly the “erotic” motivation, with HSDD generally affecting the latter. The author here lists the main factors involved in the learning of erotic behavior (such behavior is indeed the result of a learning process), from the most simple to the most complex; from hormones to the cultural context, taking account of emotions and cognitions. In the second part of the article, the author attempts to identify the “pathological” factors at each stage. After describing and assessing the various therapeutic tools, the author provides a general response to the question raised in the title.

The results of the initial trials done on Flibanserin presented at the Lyon convention of the European Society for Sexual Medicine (ESSM) would suggest that it is not enough to simply prescribe this drug to “cure” all cases of female HSDD. The clinical approach proposed below could be a complementary form of treatment.