there is no level of testosterone that predict hsddIrrespective of whether imbalances in hormone levels play a causative role, it is likely that primary and secondary generalized HSDD involves either a predisposition toward inhibi- tory pathways in the brain48 or functional and structural neuroadaptations in these systems that result in decreased excitation, increased inhibition, or some mix of the two. Such dynamic alterations in brain function andpredicts HSDD.