If you’ve suddenly lost that lovin’ feeling, it may be time to look at what’s happening in your relationship. “The most common cause of desire problems for women has to do with partner issues—and a lot of women don’t realize that’s what’s going on,” says Holly Thacker, M.D., director of the Center for Specialized Women’s Health at the Cleveland Clinic, and author of The Cleveland Clinic Guide to Menopause. “Obviously, you have to have a partner you’re attracted to, and if there are marital or emotional issues in the relationship, that can be a problem when it comes to desire.” After all, Dr. Thacker points out, “the brain is the most important sex organ.”

If the romantic flame still burns bright in your relationship but you just don’t feel any spark, there’s probably something going on physically or emotionally that has nothing to do with your partner. Identifying what’s going on is the first step to reclaiming your sex life.

Health Havoc
Hormonal imbalances—ranging from elevated prolactin levels (the hormone that stimulates breast milk production) to menopausal shifts in estrogen and testosterone levels—can thwart your libido. “Anything that causes a decline in testosterone can create a drop in sexual desire or response for women,” says Barbara Bartlik, M.D., a psychiatrist and sex therapist with Weill Medical College of Cornell University in New York City. Hypothyroidism, a disorder in which the thyroid gland produces too little thyroid hormone, can cause a woman to experience low libido, and feel run down, depressed and sluggish. Meanwhile, diabetes and hypertension can impair blood flow and nerve function throughout the body, including the genital area, which can diminish sexual desire.

Medication Mayhem
Taking oral contraceptives can reduce testosterone levels, which can lessen desire in women who have low testosterone levels to begin with. Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), like fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft), are notorious for dampening sexual desire.

Oral corticosteroid medications, which treat autoimmune disorders or asthma, also can lower libido by suppressing the release of sex hormones, says Dr. Thacker. Anti-hypertensive medications also can lead to a drop in desire, and if you’re taking high doses of statin drugs to lower your cholesterol, you might end up lowering your libido, too.

Mood Matters
Between your already overflowing plate of work, home, childrearing, volunteer and other responsibilities, sex may not be much of a priority. “Evolutionarily speaking, the reason for having sex is to reproduce,” Dr. Thacker notes. “If you’re stressed out, anxious or depressed, the sex hormone cycle gets knocked off course because you need to attend to your own basic survival needs, not reproduction.” So it’s not just your mind-set: Stress or depression could be affecting your body in ways that sap your desire.

Locating Your Lost Libido
If your sex drive has done a disappearing act, the first step is to seek professional help. “If you have any kind of change in sexual function, visit a physician you feel comfortable discussing these issues with, whether it’s your internist or your OB/GYN,” Dr. Thacker says. Your doctor should take a complete medical history, do a thorough physical exam, and order a battery of blood tests to tease out hidden medical conditions that could be responsible. If a particular condition is to blame, getting it treated can help you get back in the mood. If a medication is draining your desire, switching to another drug or altering the dose could help. And, if an emotional or relationship issue is at the heart of the problem, therapy could make a difference.

You also may need to use some extra creativity between the sheets. “Especially if you have a medical condition that’s affecting your sex life, you need to use all the mental and physical stimulation at your disposal,” says Dr. Bartlik, the sex therapist. “It may take more fantasy, more erotic material and more stimulation to get you interested.” But it’s worth the effort, so that you and your partner can get some sexual satisfaction again.