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We asked a doctor: Why has my sex drive dropped off a cliff?

Dr. Seema Marwaha answers all your mildly embarrassing health questions in our new video series, Asking for a friend.

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A drop in sexual desire is a really common complaint in women of all ages. But do you ever wonder how much of a drop is normal, and what might be affecting it? Here, general internal medicine specialist Dr. Seema Marwaha answers some questions about why you might find yourself saying “Not tonight, honey,” more than usual.

I’ve heard hormones are behind this kind of change.

It’s true that as women age, hormonal changes can lead to a drop in desire. The body makes less testosterone – which is believed to stimulate sexual desire and arousal. And as you get close to entering menopause, you make much less estrogen, which can lead to vaginal dryness and unpredictable changes in mood.

But some women have really strong sex drives well after menopause, so we know the story doesn’t begin and end with hormones.

So what else is at play?

Studies have shown that for women, sex drive can be influenced by emotion, culture and environment, much more so than for a man.

Depression, fatigue and stress can play a major role. Even slightly altered chemistry in the brain can lead to a loss of desire, taking longer to orgasm, and simply finding sex less enjoyable.

Body image, self esteem and, for people in longer-term relationships, boredom can also have a pretty profound effect on your sex life. It’s important to think about what psychological factors might be at play — being aware of them is the first step in figuring them out.

Is screen time in the bedroom really a problem?

Yes. One 2015 study out of Brigham Young University showed that that 70 percent of couples surveyed in the U.S. said technology was interfering with their sex life, because it caused frequent interruptions in leisure time, conversations and intimacy. This “technoference” led to more fights and lower relationship satisfaction. So turn it off!

What else could be affecting my sex drive?

Your physical health affects sexual health. Low iron, an under active thyroid, or the medications you take all affect sex drive, as does vaginal dryness — all the more reason to get to know lube! If you’re having pain during sex, definitely talk to your doctor about it.

Of course, if you just don’t feel like having sex, don’t have sex! But if you wish your drive was higher, talk to your OBGYN or family doctor.

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