Dear Dr. Patti:

My sex drive is at its lowest right now. Two months ago I enjoyed being intimate, but now I don't have any desire whatsoever to have sex, and for the past two weeks I have been just lying in bed, motionless, letting my husband "do his thing."

S

Dear S:

You are suffering from the number one reported sexual problem facing American women today: low sexual desire. Let's look at the basics.

First, desire is part physical (the body must be able to produce a response to certain arousal cues) and part mental or emotional (there must be a thought or a feeling to create a response in the body). Men, unlike women, often respond more readily to visual stimulation, such as pretty pictures of scantily clad women in men's magazines. Women, on the other hand, tend to be taken in by the nature of a love story, such as the bulk of romance novels. It's possible that what used to turn you on has drifted away in your life and that you need new stimulation (note: I said new stimulation, not a new partner).

In fact, most couples find that after time the desire to be sexual with their mate does decline. When that happens, based on the couple's personal preferences, it's a chance to rekindle the fire that started it all in the beginning. Think about what made you attracted to the man at your side in the first place, and reconnect with those memories. Just remembering the "old days" and the heat that once was there may be enough to ignite those embers.

If you are in midlife, you may be in or past menopause. Unless your body is still manufacturing ample amounts of its sexual hormones, especially the hormone for sexual desire (testosterone), you may never awaken on your own. I suggest that you consult your medical provider (I vote for a gynecologist) to get a thorough assessment and to make sure that you are not suffering a lack of desire based on physiological factors. If that turns out to be the case, prescription hormonal therapies or natural remedies can help. Read about alternatives on our boards and archives, on the iVillageHealth channel and at my Website.

Also, try to get in touch with what happened to you at that juncture two months ago. That's where you will find some clues. Keep in mind that desire is a delicate part of your sexuality. It can be dampened by emotional baggage such as depression, anger, drugs, stress, performance anxiety, overworking, too little affection, low self-esteem and poor health. Women tend to be highly critical of their own bodies, which can shut down the pleasure dome of the self. When that happens, regaining a sense of control by initiating an exercise program and restructuring your diet (if it's not as nutritious as it could be) may be all you need. If you're looking for more ways to boost your positive self-talk, read How to Stubbornly Refuse To Make Yourself Miserable About Anything -- Yes, Anything! or, another good one, You Can't Afford the Luxury of a Negative Thought.

If your mind and heart are holding your libido hostage, it's time to free it.