I am a 20 year old nurse. I have been with my husband for 3 years. We are very much in love but I have absolutely no libido. I used to have an insatiable sex drive from the time I was 13, but when I hit about 18 it tapered off into nonexistence. My husband is an excellent lover but I am not reaching orgasm with him any more (or at all because I don't masturbate any more either). So what happened to my sex drive? I have not changed my medications except for my birth control pills which are Lybrel, and that was just in the last 2 months. Do you have any clue what is wrong or what I can do about it. My husband is very sweet and understanding but it still adds stress to our relationship, as you could imagine. Any input would be greatly appreciated.

Libido is correlated to hormones. The timeframe of 13-20 suggests perhaps an imbalance of sorts hormonally. BC pills could be a culprit to the hormonal connection. Other challenges not mentioned would be trauma and assault. But for a moment let's consider confusion. At age 13 and to be sexually active carries some pretty weighty dynamics that involve not only early physical proclivities, but also early sexual mapping. By age 18, you might feel like the mystery of sex has somewhat dampened. With perceptual maturation, possible hormonal imbalance, and it isn't such a stretch for one to imagine walking the dog is competing for bedding a lover, even a good one! Don't despair, have a good work up with your MD and relate the question of hormone levels in YOUR body. Remember, prescriptions are management for the many, not necessarily the few. Without tests, it's a guess as to what effects (besides contraception) your pills do for you. Note: I make the assumption that you have not experimented with other forms of birth control to see if your sexual emotions change. - Answer provided by Stephen Craig Heelan, M.S., R.M.H.C.I Diplomate American Board of Sexology Practicing Forensic Sexology Forensic Court Services, defray7600@mypacks.net, www.genesisforensicgroup.com.

I would recommend getting your hormone levels tested first. Testosterone levels are largely responsible for our sex drive. If the levels are too low then so is our sex drive. Find a specialist in your area who can help you with this, such as an endocrinologist or an ob/gynecologist. If that is the case, you can inquire about a low-dose testosterone cream. You may alsowant to have your birth control pills re-evaluated. If that's not the problem, there may be some deeper issues you can explore with a sex therapist. - Answer provided by Krista Bloom, Ph.D. Board Certified Clinical Sexologist, Drbloom@healingcouch.com, www.healingcouch.com.

Twenty is a very young age to have your sex drive disappear. You say that you changed your birth control medication. Have you been using the pill since you were 18? The pill can have an effect on your sex drive. Please discuss with your physician. - Answer provided by Stephanie Buehler, PsyD, Psychologist and Certified Sex Therapist, drbuehler@cox.net, www.thebuehlerinstitute.com.

Birth control pills have been shown to decrease libido and inhibit orgasm. You may want to consider alternative birth control methods such as condoms. Also, depression and stress can contribute to a decreased sex drive. I am not sure if this is the case for you, but since you are a nurse I assume that you are familiar with the symptoms of depression. Exercise has also been shown to increase your sex drive and reduce stress, so it could be helpful to add this to your life. After making lifestyle changes such as ensuring you are not overworking, eating healthy, avoiding smoking, and exercising and there is still no change it could be helpful to seek couples or individual counseling. This could focus on identifying the triggers to your decreased libido and improving your sex drive. - Answer provided by Parvonae Fernandez, M.A., Psy.D., southfloridasexpert@gmail.com, www.myspace.com/southfloridasexpert

To read more Q & A's or to ask a sex therapist a question, click here.