I am a 34-year-old woman. Throughout my 20s I enjoyed sex so much I found it difficult to resist. I was fairly promiscuous and my body became aroused without effort. Now, seemingly out of nowhere, my libido and interest in sex have almost disappeared, which has devastated me. I strongly suspect it’s due to a drop in hormone levels.

I am very healthy, not stressed, don’t drink or smoke and have a good relationship with a communicative and supportive man. But sex is now often painful, as I struggle with a loss of natural lubrication and I feel “closed up” and unaroused. I now feel I have to have sex when I simply don’t want it and my partner feels discouraged that I never initiate. Even in the event that I feel aroused psychologically by an idea or fantasy, my body won’t respond.

I was totally unprepared for this development. Is this it? Was that my sex life? Am I an idiot for not knowing something everyone else is aware of: that there is a significant hormonal shift after your 20s but before menopause?

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Your sex life has not disappeared and there is no sinister secret about libido loss. Under the best circumstances people can have fabulously exciting sex throughout their lives. There is a reason why you are not sexually inspired and it needs to be discovered so it can be fixed. Since you are suspicious about your hormone levels, see a doctor right away and have a general checkup, because there are all kinds of medical – and psychological – conditions that can lower libido. Consider that certain medications can affect sexual response. Also think carefully about the triggers that led you to have exciting sex in your 20s. When having sex with many people becomes a well-entrenched pattern it can be difficult to switch to a monogamous sexual relationship. It could be that the casual – maybe even anonymous – style of your earlier sex life meant that you never learned to be truly intimate with one person. It does take time to become comfortable sharing who you truly are sexually with another human being and perhaps in making this switch to settling down, you lost the essential elements that made sex exciting for you. It is possible to recreate erotic elements in your current partnership – you just have to figure out what they are.

• Pamela Stephenson Connolly is a US-based psychotherapist who specialises in treating sexual disorders.

• If you would like advice from Pamela on sexual matters, send us a brief description of your concerns to [email protected] (please don’t send attachments). Each week, Pamela chooses one problem to answer, which will be published online. She regrets that she cannot enter into personal correspondence. Submissions are subject to our terms and conditions.

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