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If You Never Want Sex, It's Time to do Something about it.

You may have heard about "pink Viagra." That's what some call the drug intended to boost women's sex drive, Flibanserin, which was approved by the FDA on August 18 after being rejected twice before. Although the nickname is a misnomer — Flibanserin affects neurotransmitters, not blood flow to the genitals like Viagra does — it has people talking about female sexual desire. And while it's no fun to divulge over brunch that you never feel like doing it, it's a real issue. Nearly 11 percent of women 18 to 44 suffer from a distressing sexual problem. Distressing being the key word.

"No one knows what 'normal libido' is," says certified sex therapist Nan Wise, Ph.D. "It's a problem if the woman says it is." Other experts echo her opinion. What experts are split on is if meds are the answer. Flibanserin purports to treat female sexual dysfunction, meaning a reduced amount or lack of interest in sexual activity, fantasies, pleasure, or arousal (even in response to partner initiation) lasting more than six months that's not due to something else. Whether or not the drug is okayed, if this sounds familiar, ask your doc if one of these "something elses" is the source of your libido's crash.

If You Never Want Sex, It's Time to do Something about it.

Your Pill

Sex drive is partially controlled by hormones, like testosterone. And some hormonal birth control reduce testosterone production, leaving less for revving libido. By one count, as many as 25 percent of women felt interest in sex diminish on the pill, although Sandra Carson, M.D., vice president of education for the American College of Obstetricians and Gynecologists, says young women are less likely to be affected by this than perimenopausal women. Switching contraception methods — maybe to an IUD or a pill with a different formula — could be an easy first fix.

Your Mood

Both being depressed and being on antidepressants can kill your sex drive (ugh). "Sex falls off the body's priority list when you're coping with something difficult, like an illness where your energy level drops," says Emily Nagoski, Ph.D., author of Come As You Are. That may explain why issues of the thyroid, which controls metabolism, are also tied to desire shifts.

You don't have to be severely depressed to lose interest in sex; a major culprit is everyday stress. In fact, new research shows that low heart rate variability — linked to high stress levels — is associated with sexual dysfunction. "The cortisol and adrenaline that come with stress change how the brakes and gas of your sexual systems respond," says Nagoski. The Rx: exercise (physical activity signals the body that you've escaped the stressor). Sleep helps too. Get one more hour of shut-eye and there's a 14 percent higher chance you'll have sex the next night.

Your Mind-Set

Some ladies have a vibrant libido that, compared with their partner's desire or their own expectations, seems like not enough. "Many women have clear ideas about how much sex they should be having — twice a week is a typical answer — and feel anxious if they fall short," says Rachel Hills, author of The Sex Myth. Anxiety is the opposite of arousal, so being critical of your level of desire, performance, or body can hold you back. While boosting self-love isn't easy, working to better your bod can have the secondary benefit of upping your hunger for sex. "The best predictor of sexual well-being is overall well-being," Nagoski says.

Your Relationship Status

One of the benefits of an LTR is sexytime all the time, right? But that's the catch: Once you're in one, you may not want it. When you first get together, "the brain releases pleasure chemicals and baseline desire ramps up," Wise notes. "Over time, you experience what seems like lack of desire, but look at where the baseline was." It doesn't necessarily mean the relationship is bad — it's just science.

A version of this story was published as "Why Don't I Want to Have Sex?" in the September issue of Cosmopolitan.

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