DEAR DOCTOR K: I’m a woman in my mid-50s. Lately I haven’t been able to become sexually aroused. What could be wrong?

DEAR READER: Sex is complicated. You probably already know that. Sexual desire surely resides in the head, but other parts of the body can affect desire as well. In particular, the genital organs communicate with the brain. Likewise, the brain communicates with the genital organs. Desire in the brain causes changes in the pelvic organs. Perceiving these changes can, in turn, enhance sexual desire.

There is a condition called sexual arousal disorder.

Many things can cause or contribute to this disorder. Medical conditions such as hypothyroidism and diabetes can dampen sex drive. Medications, including antidepressants and anti-seizure drugs, can have sexual side effects. Emotional and psychological issues also can profoundly affect sexual desire – and performance.

Sexual arousal disorder in women often occurs after menopause, when estrogen levels drop.

Another issue might be vaginal dryness. For many women, over-the-counter lubricants and vaginal moisturizers are enough to relieve vaginal dryness. If these products don’t help, low-dose vaginal estrogen products are available by prescription.

The most widely studied treatment for boosting female sexual desire is testosterone. Most studies have found a benefit. Even though testosterone is described as a “male” hormone, women also make testosterone – but in much lower amounts than men. It does stimulate desire in women as well as men, along with arousal and orgasm.

Another option, if your problem is not just physical, is sex therapy. A therapist can help you identify thoughts, feelings and behaviors that might be interfering with your sexual enjoyment. A therapist will also help you communicate your needs and enhance feelings of intimacy between you and your partner.