Sex & Drugs (Hold the Rock 'N Roll)

Here’s how it happens: the Pill gets processed through the liver, where it increases levels of a protein called sex hormone-binding globulin (SHBG). This affects your sexual appetite because the SHBG binds with testosterone, the primary libido hormone, making it less available to the body -- which can leave you less interested in sex. This can occur in any woman who’s on the Pill, but midlife women are more affected because they’re already experiencing hormonal changes.

Even if you go off the Pill, the libido-reducing levels of SHBG remain in your body for at least several months, according to new research from Boston University. Some doctors believe the effect may last for years, though there is no firm data. “Women who started on birth control pills when they were relatively young and stayed on them for several years seem most likely to be affected,” Clayton says.

Mood Boosters

The run-up to menopause is the time of life when women are likeliest to develop depression serious enough to require treatment -- which often takes the form of antidepressants, the most bothersome of all sex-dampeners. Particularly potent are SSRIs (selective serotonin reuptake inhibitors), a category that includes the widely prescribed Prozac, Zoloft and Paxil. SSRIs counter depression by making the neurotransmitter serotonin more available in the brain. “Unfortunately, too much serotonin can inhibit orgasm and sexual interest,” says Richard Balon, MD, a professor of psychiatry at Wayne State University School of Medicine, in Detroit.

Probably 40 to 50 percent of women on SSRIs have sexual side effects, Balon estimates, and their ranks are likely to grow because many women over 40 are switching from treating hot fl ashes with hormones to relying on antidepressants, especially Paxil, Zoloft and Effexor (an SSRI relative).

How to Switch Your Sex Life Back On

Talk to your doctor. If your sex drive is stuck in low gear or you often stop short of climaxing, it may be possible for you to switch drugs or reduce the dosage. Be sure to do so under your doctor’s care; altering a drug regimen is a risky move to make without medical supervision.