Live Your Best Sex Life

Step 4: See Your Doctor

After Dr. Berman's second appearance, The Oprah Winfrey Show set up an anonymous call line to field questions about sex. One married 64-year-old woman left a message saying, "I have always had orgasms, had a fabulous sex life, and want to know why my orgasms at this stage of my life are 'mini' when they were 'major'—like fireworks. And now they're like little roller coaster rides that go down and up and down and up...but no explosions."

Leave your anonymous sex questions for Dr. Berman.

Dr. Berman says there could be perfectly natural reasons for the sudden change—it could be how the caller feels about her relationship, body or emotions or could be related to anxiety or depression.

However, it could be something more serious. That's why Dr. Berman's fourth step is to see your doctor.

"For that woman who's 64, it may be that things are changing in her pelvic floor muscles. It may be that things are changing for her hormonally and maybe that she's on medications that are negatively affecting her sexual response," Dr. Berman says. "Don't rule out the physical when you're looking at your whole sexual equation."