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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."