Lack of sexual desire

Before considering a sex therapist or any kind of counseling, women may want to do some self-assessment. While therapists and physicians will ask many of these questions, there’s no substitute for self-knowledge.

Are you taking any drugs or medications? Drugs prescribed for depression, cardiovascular disease, and high blood pressure can affect sexual desire, which is why physicians often are able to prescribe a substitute, a lower dosage, or a combination of medications to eliminate the drain on drive.

Are you feeling sad, hopeless, listless, or blue? Depression can lower your appetite for everything pleasurable — from food to sex.

Are you in basically good overall health? Women with cancer, diabetes, arthritis, heart disease, alcoholism and hormonal imbalances often report lower libidos. For example, clinical studies show that about half of all arthritis sufferers have some sexual problems, The advice: Have sex at the time of day when the pain is least intense. Take a warm bath first. Talk to your doctor about timing sex with pain medication. Try new positions that won’t hurt the impaired joints.

What’s your age? Natural drops in testosterone production could cause a drop in desire. That means that both men and women may have to readjust their expectations and look at the role of playfulness and intimacy in sexuality.

What psychological factors could be interfering with sex? Are you troubled by unresolved anger, frustration, low self-image, anxiety over AIDS or sexually transmitted diseases? Do you still look at sex as “dirty?” Are you recovering from divorce, death of a partner, and past trauma? According to The Kinsey Institute New Report on Sex, these psychological barriers are the primary causes of lack of sexual desire.

Does lack of time and energy at home and at work affect your desire and time for sex?

Are you victimized by long hours, stress, commuting, money problems or a houseful of children? Are you just too tired for sex?

As a women are you experiencing specific problems such as vaginal dryness after menopause? If so, have you tried over-the-counter lubricants, or estrogen replacement therapy or hormone replacement therapy, which can relieve vaginal dryness, hot flashes, and headaches? Women often don’t realize that vaginal lubrication sometimes drops with a decline in estrogen production. While this might not affect a woman’s interest in sex, the drying and shortening of the vagina and the thinning of its walls can make sex uncomfortable or painful.

Are there conditions such as previous surgery or episiotomy, endometriosis or infections which might be leading to dyspareunia or painful intercourse?

For men, is impotence an isolated episode or a chronic problem? If so, are there medical causes which might explain the problem? For example, could a blockage to the heart arteries be preventing flow to the penile arteries? Is diabetes or hypertension present? How old is the man? After about age 55, men may have difficulty achieving and maintaining an erection, and after age 60, one in three men is affected. Is the man taking one of the 200 prescription drugs that could be affecting his ability to achieve an erection? Is there a history of surgery or radiation for prostate, rectum, or bladder cancer, depression, alcoholism or heavy smoking? Is the man under heavy stress? Does he have a fear of failure or have unresolved anger toward his partner?

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