It's usually not just one thing. These issues can affect each other.
"If you have pain during sex, for instance, over time you may develop low sexual desire," says Leah Millheiser, MD, director of the Female Sexual Medicine Program at Stanford University School of Medicine.
Reviving Your Libido
Talk with your doctor or a counselor about what you're going through.
"For example, your primary care doctor may be able to address the physical aspects, but you may also benefit from relationship counseling or sex therapy," Millheiser says.
Your doctor should check your overall health, review any medications you're taking, and talk with you about what you're experiencing.
If your doctor seems uncomfortable or dismissive when you bring up your sexual problems, don't give up, Marcus says. "If possible, look for a gynecologist or a sex therapist who is knowledgeable about the physical, relationship-related, and emotional components of sexual dysfunction."
Those discussions are private.
If you need medication, doctors may consider prescribing:
Estrogen skin creams, which can help if vaginal dryness makes sex painful. This typically happens when estrogen levels fall due to menopause or breastfeeding.Estrogen also comes in other forms, such as a tablet or skin patch.
ED drugs. Doctors occasionally prescribe erectile dysfunction drugs to women who have difficulty becoming aroused or reaching orgasm. These drugs boost blood flow to the genitals. But they are not likely to help someone who has a lack of desire or who can't have an orgasm, Marcus says. Women who have been through menopause may need to take supplemental testosterone for an ED drug to be effective.
Testosterone and other androgens decline as women age. These hormones may play a role in sexual function in women just like they do in men. Inwomen with low libido just before, during, or after menopause, or in women who've had surgery to remove their ovaries, some experts suggest the use of testosterone treatment. However, there are side effects, and long-term safety studies of testosterone treatment for women are lacking.
Wellbutrin, an antidepressant, may be prescribed to treat low sex drive in women who haven't been through menopause or if other antidepressants have affected their sex drive.
Every woman is different. It may take some experimenting to find what works for you.