Hormones, including the sex steroids (estradiol, progesterone, and testosterone), adrenal hormones (DHEA and cortisol), thyroid hormones, and prolactin can influence desire.
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Vaginal dryness (atrophic vaginitis) can lead to painful intercourse, which can certainly lead to a low interest in sex.
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Certain medications can be toxic to sex drive. Medications for depression/anxiety, oral birth control pills, opioid pain medication, B-blockers (for hypertension) and even some over-the-counter anti-histamines like Benadryl may contribute to decreased desire.
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Genital mismatch (defined as the increased in diameter of the vaginal canal, often in conjunction with decreased size of the erect penis) is extremely common as sexual partners age, after childbirth, weight gain, chronic straining (from constipation or difficulty with urination), and pelvic injury (often from pelvic surgery).
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Lifestyle factors can also interfere with libido. Lack of sleep, lack of exercise, poor diet or increased stress can interfere with intimacy. Depression/anxiety and weight gain can change your comfort level with your body and sexuality and can negatively impact interest in sex.
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Other gynecologic concerns can play a role. These include: dyspareunia (chronic painful sexual intercourse), lichen sclerosus (a condition that causes changes in the appearance of the skin of the vulva, results in chronic itching, pain, and scarring of the vulvar tissue), vulvar vestibulitis (a chronic pain syndrome possibly linked to chronic yeast, bacterial vaginosis, or HPV infection), other vaginal infections, or heavy, prolonged menstrual bleeding.
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Peyronie’s Disease can affect men at any age and interfere with a man’s ability to have sexual intercourse.
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This can cause both a loss of libido as well as erectile dysfunction.
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