The Sex Files

During the therapy session, Debra tells Dr. Berman she doesn't feel much sensation in her genitals, but she says that hasn't always been the case. Dr. Berman suspects the problem may be hormonal and sends Debra to get her hormones checked.

At the doctor's office, Debra uses an external vibrator and watches an erotic video, but she still doesn't climax. "I feel completely drained," she says. "I feel like somebody plugged me into something and sucked all my blood out of me."

Debra's test results show that she is perimenopausal. "Usually in your late 30s into your early 40s, there's a drop in estrogen which causes dryness and thinning of the vaginal tissue," Dr. Berman says. "[It also causes] a drop in testosterone, which will affect your libido, your interest in sex and your sexual response."

Dr. Berman says low libido is the most common complaint she sees among women. "A lot of women don't know that stress—chronic stress—will not only make you not want to have sex, but chemically it will negatively affect your testosterone levels," she says. "As will hormonal contraceptives."