1. Primary care physicians
Your first stop with any sexual health concern should be your general practitioner, says Irwin Goldstein, MD, director of San Diego Sexual Medicine and editor in chief of The Journal of Sexual Medicine. In addition to the basics, such as listening to your heart and checking your blood pressure, your doctor should be on the lookout for other conditions.
Your primary care doctor should do the following.
- Review your medications to see if you are taking a drug that could affect your sex drive.
- Screen you for diabetes and for depressionboth can cause libido problems.
- Review your overall health and your health history.
- Determine whether you have pain associated with other health conditions, even arthritis, as this can lower your desire for sex.
- Test your blood for anemia, high cholesterol, hormonal imbalances (including thyroid, testosterone, or estrogen shortages), and other underlying conditions that could be affecting your sexual health.
- Ask you lifestyle questionssleep deprivation can have a profound effect on sex drive, as can alcohol or recreational drugs.
- Ask about your relationships and sex life.
Also tell your doctor about any sex-related pain, such as pain in the penis when it's erect due to Peyronie's disease , or pain in the vulva or vagina that's caused or exacerbated by penetration. Physical pain can morph into psychological avoidance, says Marjorie Green, MD, director of the Mount Auburn Female Sexual Medicine Center in Cambridge, Mass., and a clinical instructor at Harvard Medical School. As Dr. Green puts it, "If every time you put your finger out, I hit it with a hammer, what would you stop doing?"
2. Sexual medicine doctors
These professionals describe their job as detective work. For example, what at first may appear to be low sex drive may turn out to be related to erectile dysfunction.
Often people wait a long time before seeking medical care for a sexual problemeither because they are embarrassed or because they are not taking it seriouslyand that can compound the issue, even when it stems from a physical problem that has a straightforward, physical solution. "By the time you talk to someone [about your physical problem], the pain is also in your head," says Dr. Green.
Your regular doctor or your sexual medicine doctor may refer you to a therapist of some kind to explore psychological reasons for your sex drive problems. Relationship issues can cause libido problemsas can a whole host of personal or cultural factorsand a referral to a couples counselor or sex therapist may be in order.