In our conservative society, it has long been thought that women aren't supposed to have a sex drive. Or if we do, we aren't supposed to talk about it.
Thankfully, such cultural taboos are slowly disappearing. As we become more liberal, we are beginning to accept and understand that women's sexual issues are very important within the context of their overall physical, psychological and emotional health.
A woman's sex drive is no trivial thing and could mean all the difference in a relationship. If her desire cannot match her partner's, relationship problems could occur when the sex fizzles out.
Libido - which is the drive or desire to have sex - is almost like a switch in a woman's body that can be turned on or off.
Libido is a fickle thing and can sometimes be fired up, or very subdued. Some women may have a very strong sex drive, while others do not. Or some women may find that their libido, once very high, has waned and they have lost interest in sex.
When you are stressed, your body produces a hormone called cortisol to prepare your body for situations of heightened stress. Unfortunately, cortisol also has an impact on the levels of testosterone and oestrogen in the body, which influence libido.
Low libido is a complex issue and is very heavily influenced by many factors in a woman's life. The good news is, if you identify the causes of low libido in your life, you could probably quite easily address the cause and hopefully reverse the situation.
This article lists out some of the most common sex drive killers and possible ways to overcome them.
Have a headache? It's not an excuse - stress is probably the number one libido killer among women. We face so many challenges, issues and distractions in our daily lives that it is no wonder we are in no mood for sex.
For many of us, stress has become a permanent condition or state of being. From the moment we wake up to the last second before we fall asleep, we are constantly planning, thinking, working, negotiating, scolding, and most of all, worrying.
In the midst of all that, how can a woman be expected to feel sexy?
Stress also affects a woman's hormones. When you are stressed, your body produces a hormone called cortisol, which prepares your body for situations of heightened stress. Unfortunately, cortisol also has an impact on the levels of testosterone and oestrogen in the body, which influence libido.
What can you do to reduce your stress? Ironically, sex is one answer. But it is a Catch-22 situation - sex relieves stress, but you can't have sex if you're stressed.
You can try relaxing activities like yoga, meditation, taking a warm soak in the bathtub, or having a massage.
Most importantly, however, you have to turn off your mind and give your full attention to your partner. Have a quiet meal together, talk to each other or just hold each other for a while - sex is about you and your partner, not you and the clamouring voices in your head.
It seems like an obvious thing, but you would be surprised at how many women struggle through problems with their sex life without addressing the problems in their relationships.
This may be because many relationship problems are not acknowledged by either party. The issues may stem from old or simmering arguments, poor communication, emotional distance and lack of intimacy, or lack of commitment.
You don't have to be fighting to have relationship problems - if you're not talking and enjoying each other's company, then something is definitely wrong. And if you're not doing either of these, you certainly won't be having sex.
You need to resolve the problems between you and your partner before you can regain your libido. The issues have to be honestly discussed and you need to communicate openly with each other in order to regain each other's trust.
Alcohol, drugs and smoking
These three poisons are generally acknowledged to be bad for anyone's health, but they have particularly negative effects on a woman's libido.
Many of us have the misconception that alcohol acts as an aphrodisiac of sorts, largely due to movies and TV shows that often show women having a glass of wine to "get in the mood".
While alcohol can lower your inhibitions, it can also numb your sex drive, senses and responses.
Many recreational drugs have similar effects to alcohol. Marijuana, amphetamines (speed, crystal meth) and opiates (heroin, cocaine) not only reduce libido, but also produce problems with sexual performance.
For instance, marijuana and opiates lead to vaginal dryness, which makes intercourse painful or uncomfortable.
Smoking is also bad for libido, as it literally affects blood flow to vessels that are involved in sexual intercourse. Let's not forget that the image (and smell) of a woman smoking is also terribly unsexy.
Lack of sleep
If you're not getting enough rest at night, then your energy will be sapped and sex will be the last thing on your mind at the end of the day.
Every person needs seven to eight full hours of sleep every night, for their body and mind to be properly rested.
If you're having trouble sleeping, try to look for the cause of the problem. It could be environmental factors, like noise or light, disturbing your slumber.
If you have sleep apnoea or chronic insomnia, then you need to see a specialist to investigate the possible underlying causes and address those problems.
Babies (and children)
The little ones are wonderful additions to the family, but they can get in the way of romance and sex. Not only are you constantly fussing over them, it is also hard to find time and privacy to be intimate with your husband.
This problem is easily overcome if you put your mind to it and find some creative solutions.
Get a babysitter, or family or friends, to look after the children while you have a night out with your husband. Children also sleep, remember? So their nap or bedtime can be romance time for you.
Childbirth and breastfeeding can also be impediments to discovering your sex drive. Childbirth causes pelvic nerves and muscles to become stretched or injured, which reduces the sensitivity of the genitals.
Breastfeeding lowers levels of oestrogen, causing the vagina to become dry and penetration to be painful. Nursing also increases the levels of a hormone called prolactin, which lowers testosterone levels and reduces sexual desire.
Fortunately, these issues are temporary and the effects on libido only last for as long as you are breastfeeding and/or recovering from delivery. Even if you can't or don't have sex, you can still maintain a warm and loving relationship, by talking and cuddling with your partner.
Another issue related to childbirth is postpartum depression. Women with this condition will also suffer from, among other things, lack of desire for sex. Postpartum depression is not merely the "blues", but a very serious condition that should be treated with professional help.
For that matter, even depression that is not related to pregnancy can kill your sex life. If you suffer from feelings of sadness, emptiness, worthlessness, suicidal tendencies, and fatigue that interfere with everyday life, you should get professional treatment.
You should also be aware that antidepressants can interfere with sex drive, so talk to your doctor about this.
The irony is that a lot of medications that improve your health and make you feel better in many other ways, also can cause you to lose your desire for sex.
Some medications that are commonly linked to libido loss are antidepressants, blood pressure medications, antihistamines, sedatives, chemotherapy, anti-HIV drugs and non-steroidal anti-inflammatory drugs (NSAIDs).
However, the worst thing you can do is to stop these medications without your doctor's advice. Speak to him or her first and discuss the possibility of alternative medications that will not affect your sex drive, or other methods that can help to boost it up.
Loss of libido can be a frightening thing, and so few women have the courage to ask for help. But if you know what could be causing it, you can take the first step towards addressing it. In the next article for this column, I will continue to discuss more about causes of low libido in women.
The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader's own medical care.
Datuk Dr Nor Ashikin Mokhtar is a consultant obstetrician & gynaecologist (FRCOG, UK).