OBJECTIVES: To describe the drivers of health care costs among commercially insured women in the United States with a diagnosis of Hypoactive Sexual Desire Disorder (HSDD). METHODS: The Thomson Reuters Marketscan® Claims Database was used to identify women aged 18-64 who received a diagnosis of HSDD from january 1, 1998-September 30, 2006. A control group of women with no indication of any sexual dysfunction was matched 3:1 to HSDD cases based on age, health plan and enrollment period. Controls were assigned the index date of their matched case. Total healthcare expenditures were evaluated for the one-year prior to and following the index date and were categorized by type of service (inpatient, outpatient medical, outpatient other, prescription). Outpatient medical services included office visits, laboratory and outpatient procedures; radiology and behavioral health services were categorized as “outpatient other”. RESULTS: A total of 2870 women were coded with an HSDD diagnosis and matched to 8610 controls. In the year prior to index, the HSDD group incurred total health care costs that were $1146 higher (p<0.001); in the year following index the same HSDD group incurred total health care costs that were $897 (p<0.001) higher. Drivers of increased health care costs in the year prior to index diagnosis included inpatient services (21.1% of the cost difference), outpatient medical services (45.1% of the difference) and prescription medications (17.3%). During the year following index diagnosis, outpatient medical services accounted for 53.4% of the cost difference, while prescription medications accounted for 33.3%. CONCLUSIONS: Women with HSDD utilize significantly more health care services and incur higher overall costs before and after diagnosis compared with women without a diagnosis of sexual dysfunction. While outpatient medical services were the largest component of overall health care costs for patients with HSDD, prescription medication costs were also significantly higher than matched controls.