Life-long absence of sexual drive in a woman associated with 5-dihydrotestosterone deficiency

A case of a woman who presented with life-long absence of sexual drive is r eported. Although her history contained psychological factors that might ha ve been etiologic in her presentation, she had not responded to sex therapy or cognitive-behavior psychotherapy undertaken at other clinics. When seen by the author, she was found to have poorly developed external genitalia. The only abnormality discovered on endocrinological evaluation was a reduce d level of 5 dihydrotestosterone. Treatment with dihydrotestosterone gel ap plied to her vulva generated sexual drive and her ability to become sexuall y aroused.