Causes

Sexual problems often develop when your hormones are in flux, such as after having a baby or during menopause. Major illness, such as cancer, diabetes, or heart and blood vessel (cardiovascular) disease, can also contribute to sexual dysfunction.

Factors — often interrelated — that contribute to sexual dissatisfaction or dysfunction include:

• Physical. Any number of medical conditions, including cancer, kidney failure, multiple sclerosis, heart disease and bladder problems, can lead to sexual dysfunction. Certain medications, including some antidepressants, blood pressure medications, antihistamines and chemotherapy drugs, can decrease your sexual desire and your body's ability to experience orgasm.

• Hormonal. Lower estrogen levels after menopause may lead to changes in your genital tissues and sexual responsiveness. A decrease in estrogen leads to decreased blood flow to the pelvic region, which can result in less genital sensation, as well as needing more time to build arousal and reach orgasm.

  The vaginal lining also becomes thinner and less elastic, particularly if you're not sexually active. These factors can lead to painful intercourse (dyspareunia). Sexual desire also decreases when hormonal levels decrease.

  Your body's hormone levels also shift after giving birth and during breast-feeding, which can lead to vaginal dryness and can affect your desire to have sex.

• Psychological and social. Untreated anxiety or depression can cause or contribute to sexual dysfunction, as can long-term stress and a history of sexual abuse. The worries of pregnancy and demands of being a new mother may have similar effects.

  Long-standing conflicts with your partner — about sex or other aspects of your relationship — can diminish your sexual responsiveness as well. Cultural and religious issues and problems with body image also can contribute.