What’s up, doc?

Your starting position: the doctor’s office. Decreased sex drive can be caused by physical issues in the bedroom, like an inability to orgasm, or they can be emotional, making sex look as appealing as mowing the lawn. Depression, medications, hormonal imbalances and heart conditions can all play a role. Often, it’s a mind-body combination, says Andrew Goldstein, MD, director of the Centers for Vulvovaginal Disorders and co-author of the book Reclaiming Desire: 4 Keys to Finding Your Lost Libido. If you have trouble getting aroused, intimacy can make you anxious. Likewise, if your days are one hair-pulling stress episode after the next, shutting your mind off for some nookie feels like a David Copperfield trick. 

What’s missing…besides your libido?

While our tendency might be to say, “I don’t know what’s wrong,” intuitively, we know, says psychologist Marianne Brandon, PhD, founder of Wellminds Wellbodies and co-author of Reclaiming Desire. “Ask yourself what feels most out of balance or where you need more attention and journal about it,” she says. Writing everything down is a great way to reveal what’s going on. If you’re stuck, step outside of yourself and ask, “What would my partner or best friend point to?” “Passion gets shut down when we shut down. By figuring out how you can live life more fully, that’s going to trickle down into your sex life,” Dr. Brandon says.

Contemplate your navel — and below

While some of us fall out of touch with our emotions, others lose track of our physical side. According to Dr. Brandon and Dr. Goldstein, stress and responsibilities can make us disregard what’s stirring below the belt. “Any moment can become a sensual moment,” Dr. Brandon asserts. Throughout the day, do a body scan and notice what you’re feeling in your pelvis. For women who are uncomfortable with their sensuality, it helps to put themselves into the body of someone who appears sexually confident, like Angelina Jolie. Warm baths, massages, yoga and dancing can all help you get out of your head and notice physical sensations.

Get a one-track mind

If your brain trips you up every time you do the deed, Dr. Brandon recommends meditation. “We get so focused on our thoughts that when we get into the bedroom, all we can do is think. Meditation helps us tune in to our feelings, feel our bodies and, most of all, learn how to control our thoughts,” she says.

Make your heart throb

Exercise is a key component to feeling good about your body and yourself. Working out regularly can boost mood and self-esteem, relieve stress and improve blood flow to all the right places. Plus, a little endurance training can help both marathon makeout sessions and the mad dash to the finish line. Brandon even recommends exercising right before sex (though you may want to shower first). It wakes up your body and can make you feel like you’re more aroused sexually. According to Dr. Goldstein, exercise also increases levels of the hormone dopamine, which is responsible for feelings of desire.

Novelty is more than a tacky gift store

Speaking of desire, if you ate your favorite food for every meal of every day, eventually you’d grow tired of it. Your sexual appetite works the same way. According to anthropologist Helen Fisher, PhD, author of Why Him, Why Her?, doing novel things together stimulates the reward area of your brain, responsible for craving, obsession, motivation and elation. “It can give you that spurt of intense, romantic love,” she says. That’s why going on vacation often stimulates your sex drive. Exploring new things, taking a class together or surprising your mate with sexy lingerie or a sunset picnic can help reignite passion.

It takes two to tango

But maybe your husband doesn’t help out enough around the house, or your wife is always nagging you. When you feel criticized or unsupported by your spouse, the last thing you want to give him or her is sex, explains marriage therapist Michele Weiner-Davis, MSW, founder of DivorceBusting.com, and author of The Sex-Starved Marriage. Even if you once tore each other’s clothes off as soon as you made eye contact, squabbles and past resentments can rear up in place of passion.

Instead of turning it into a blame game, sit down when you’re not angry and offer specific ways that you will help each other. She can offer to watch the kids while he watches football. Or he may offer to clean the house while she meets up with her friends. A man who helps out around the house is the female equivalent of porn, says Weiner-Davis.

Just do it

Have you ever said to yourself after sex, “Wow, remind me why I didn’t want to make love”? According to Weiner-Davis, it’s extremely common to not be in the mood until your partner starts touching you. We think we have to be turned on in order to have sex, but for over 50 percent of the population, desire comes only after you’ve been sexually stimulated, she explains. Even if you’re feeling neutral about sex, do it anyway.

The alternative? “In most relationships, there’s one spouse who needs to feel connected emotionally before being physical. The other spouse needs to feel close physically before investing themselves emotionally. Each spouse is waiting for the other one to change before they give, and this is a deadly waiting game,” Weiner-Davis says. When we feel like our needs aren’t being met, we hold out instead of trying to bring out the best in our partner. Weiner-Davis’ advice: Work on giving your partner what they need, even when you don’t want to, and you’ll find they’re more receptive to your own needs.