Causes
Low sexual desire alone is not equivalent to HSDD because of the requirement in HSDD that the low sexual desire causes marked distress and interpersonal difficulty and because of the requirement that the low desire is not better accounted for by another disorder in the DSM or by a general medical problem. It is therefore difficult to say exactly what causes HSDD. It is easier to describe, instead, some of the causes of low sexual desire.In men, though there are theoretically more types of HSDD/low sexual desire, typically men are only diagnosed with one of three subtypes. Lifelong/generalised: The man has little or no desire for sexual stimulation (with a partner or alone) and never had. Acquired/generalised: The man previously had sexual interest in his present partner, but lacks interest in sexual activity, partnered or solitary. Acquired/situational: The man was previously sexually interested in his present partner but now lacks sexual interest in this partner but has desire for sexual stimulation (i.e. alone or with someone other than his present partner. )Though it can sometimes be difficult to distinguish between these types, they do not necessarily have the same cause. The cause of lifelong/generalized HSDD is unknown. In the case of acquired/generalized low sexual desire, possible causes include various medical/health problems, psychiatric problems, low levels of testosterone or high levels of prolactin. One theory suggests that sexual desire is controlled by a balance between inhibitory and excitatory factors. This is thought to be expressed via neurotransmitters in selective brain areas.
Acceptable empiric regimens include, but are not limited to, the following . :
•Ampicillin plus gentamicin (or amikacin) plus metronidazole
•Ampicillin plus gentamicin (or amikacin) plus clindamycin
•Ampicillin plus an expanded-spectrum cephalosporin (eg, cefotaxime [where available], ceftazidime, or cefepime) plus metronidazole
•Monotherapy with piperacillin-tazobactam
•Monotherapy with meropenem
Vancomycin should be included in the regimen (ie, replacing ampicillin or added to monotherapy) in centers where there is a high prevalence of methicillin-resistant Staphylococcus aureus (MRSA) or ampicillin-resistant enterococcal infections. Centers with significant gentamicin resistance patterns should consider amikacin in place of gentamicin. We do not recommend the use of oral aminoglycosides because this treatment can result in the development of resistant bacterial strains, and has not been shown to be more beneficial than standard care. Other clostridial toxemias
Leukemia patients, cancer chemotherapy recipients and others suffering from suppressed white blood cells (neutropenia) can be afflicted by a similar syndrome, neutropenic enterocolitis, in which the cecum is targeted by Clostridium septicum in much the same way. In neonatal intensive-care units, the syndrome of neonatal necrotizing enterocolitis may be caused in a similar way by C. perfringens, C. butyricum, and C. difficile, but this has not been proved. See also
Protein poisoning refers to a different diet-induced phenomenon. References


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