OBJECTIVES: Hypoactive sexual desire disorder (HSDD) is characterized by persistent/ recurring deficiency of sexual fantasies or thoughts, and/or the absence of desire for sexual activity. Despite the potentially high prevalence of the condition, few studies have evaluated the cost of treating women with HSDD.  The current study describes healthcare utilization and costs among women suffering from HSDD relative to women without evidence of female sexual dysfunction (FSD). METHODS: Women aged 18-64 with a diagnosis of HSDD (ICD-9-CM: 302.71) were identified using the Marketscan® Commercial Claims and Encounters Databases from Thomson Reuters. Women were identified between January 1, 1998-December 31, 2007 and were matched 1:3 to women without FSD (ICD-9-CM: 302.7x; 306.51) based on age, health plan type and months with medical/pharmacy benefits. Utilization and costs were evaluated during the 12, 24 and 36- month periods following HSDD diagnosis. RESULTS: A total fo 3,975 women with HSDD and 11,925 controls were identified for the 12-month follow-up period. Women with HSDD had significantly fewer inpatient admissions (0.07 vs. 0.09) and more general outpatient medical (29.26 vs. 19.13), behavioral health office (1.82 vs. 0.71) and more radiology (3.10 vs. 2.30) visits in the 12-month follow-up period versus controls. Cost differences were also observed among women with HSDD relative to their controls – with greater costs for general outpatient medical ($3427), behavioral health office ($197) and radiology ($515) visits in the 12-month follow-up period among women with HSDD than for controls (general outpatient medical visits: $2334; behavioral health office visits: $77; radiology visits: $377; all p<0.001). Differences in utilization and costs persisted in the 24 and 36-month follow-up periods. CONCLUSIONS: Women with HSDD have higher ‘downstream’ costs than women without any sexual dysfunction. The development of treatment modalities that effectively control HSDD symptoms may present an opportunity to better manage health care utilization and costs in this population.