Hiya, Pinkies, and happy Healthy Thursday. I'm no longer soliciting questions for my book, What's Up Down There? Questions You'd Only Ask Your Gynecologist If She Was Your Best Friend, but your questions keep rolling in, so I thought I'd answer a few of them here. Here you go!

I really adore my lover, but I'm just never in the mood anymore. I don't want to lose him. Is there anything I can do to turn my juices on?

I hear you, sister. This is a tough one. Sex drive in women is a complex beast. While men may need little more than a pretty smile to get them in the mood, most women require more. Factors that can contribute to decreased libido include (among others):

• Feeling tired or stressed
• Side effects from medications such as birth control pills/patch/ring or anti-depressants
• Feeling unsafe or unloved in your relationship
• Hormonal imbalance
• History of sexual abuse or trauma
• Chronic medical conditions, such as diabetes or high blood pressure

Unlike men, who may pop a Viagra or put on a porn video to get in the mood, a woman’s libido is fussy. A few questions I'd like to know about you:

Do you masturbate? Does that still feel sexy to you?

Are you able to orgasm, either by yourself or with a partner?

Are you on birth control pills or other medications?

Have you hit menopause?

Do you feel safe and happy in your relationship?


How do you feel about your body image?

Take this quiz to help you determine what might be affecting your desire. If masturbation is still fun and you’re able to orgasm, chances are that it’s more psychological than physical. If you're on the Pill or menopausal, it could be hormonal. If you're feeling unsafe or unloved in your relationship, or if you're constantly dissing your body, these factors can take a toll and are worth discussing with a therapist.

If decreased sexual arousal distresses you, talk to your doctor, who can investigate whether there’s a medical reason for your low libido. Ask your doctor whether switching the brand of your birth control pill or trying another form of contraception might help. If you are menopausal, have had your ovaries removed, undergone chemotherapy, or are breastfeeding, talk to your doctor about whether systemic or local hormones might help you.

If your doctor gives you the clean bill of health, here are a few tips you might try to give your libido a boost.

• Schedule intimate dates. If you’re waiting for until 11pm to think about hooking up, your body might have other ideas. Plan morning dates or early evening dates to give your body the chance to feel stimulated.
• Try Laura Corn’s 101 Nights of Grrreat Sex (or Grrreat Romance, if you’re not as daring). This book includes tear-out pages of fun seductions For Him or For Her. Some are pretty risqué, but all are sexy. Just the simple act of planning a seduction can be a turn on.
• Experiment with erotic film, books, or magazines. Keep an open mind and check out whether anything turns you on.
• Have a hey day at a sex toy store. You never know what might get you in the mood.
• Try erotic role-playing. Maybe you’ve always wanted to hook up with a cop. Perhaps your boyfriend would play along.
• Talk to your doctor about a trial of testosterone cream. It's not for everyone, but some of my patients swear by it.
• Try sexual arousal aids, such as Zestra, a sexy botanical oil that may be just the trick for you.

Keep in mind that every woman is unique, so no one thing works for every individual. But the more you set the intention to spice up your sex life, the more likely you are to succeed. Do you want your sex drive to improve? Say so. Talk to your girlfriends. Write about it in your journal. Commit to it. Then, with an open mind, set forth. You just might be surprised.

What about you Pinkies? What works for you? The collective wisdom of all of us is much more powerful than my one opinion. Let's talk about sex! Don't be shy...

Big Pink love to you all,

Dr. Lissa

Lissa Rankin, MD's book What' s Up Down There? Questions You'd Only Ask Your Gynecologist If She Was Your Best Friend will be published by St. Martin's Press in Fall, 2010. To make an appointment with Dr. Lissa, call CLEAR Center of Health, the integrative medicine practice where she works in Mill Valley, CA.