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My Sex Drive Has Decreased Since I Turned 40. How Do I Get My Orgasm Back?

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We're bringing you this Q&A from the Sex Files in our January/February 2019 print issue, featuring advice from sexologist Dr. Carol Queen.

My sex drive has really decreased since I turned 40. I'm easily distracted and it seems like it takes a miracle for me to orgasm. My partner is incredibly helpful but I'm just not getting there. I used to be very sexual and always orgasmed. I just want my orgasm back. — Feeling Old

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I wouldn't call you old, but you might be perimenopausal. One of the many effects of the body's shifting hormone levels can be the feeling that your arousal and responsiveness are muffled or attenuated. Many think this is just part of midlife, but not everyone heading into menopause experiences a decline in pleasure. It might be worth a visit to a physician to find out whether your hormone levels are particularly low. I'm not a fan of long-term hormone replacement therapy, but some folks swear by it for getting through menopause and out the other side.

There are a couple of other possibilities as well. The change you describe is also a notorious side effect of both depression and (irony of ironies) anti-depressants. Have you been experiencing any symptoms of depression? Are you on anti-depressants? What about other meds? Pharmaceuticals that affect blood flow and the nervous system could also have this sort of effect; heart and diabetes meds are known for sexually suppressive side effects. I've also noticed that folks who become sedentary at mid-life can experience this, only to see a fairly miraculous reversal when they start exercising.

Speak to a doctor, preferably one who knows something about sexuality and menopause. If some other illness is causing this effect, you certainly want to know so you can deal with it. Ask the doc about any medications you're on. Do you smoke? Stop ASAP. Are you moving your body enough? Walking, dancing, and other forms of exercise (especially core workouts) can make a difference. Consider adding new elements to your sexual repertoire: vibrators, erotic talk, sexy movies, and other turn-ons might get your motor running again.

Carol Queen's latest book (written with Shar Rednour) is The Sex & Pleasure Book: Good Vibrations Guide to Great Sex for Everyone.

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This article originally appeared in the January/February 2019 print edition of BUST Magazine. Subscribe today!

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