Top libido busters, from medical conditions to stress, could be causing your lowered sex drive.

Sometimes you can’t when you want to. Sometimes you want to when you can’t.

Sex drive killers come in all guises. They strike men and women, young and old. They can target your brain and your body. For Bonne Oliverio, a retired information specialist who lives just outside Cleveland, the drugs she takes for multiple sclerosis cause vaginal dryness, a real anti-aphrodisiac.

“For 45 years, I’ve had a really good, solid marriage, especially sexually,” says Oliverio, 65, who was diagnosed with multiple sclerosis about 15 years ago. “But the medication and pain really interfere with our sex life.”

Causes of Libido Loss

Medications that often drag down your sex drive include antidepressants and blood pressure medications, antihistamines and — ironically — oral contraceptives. But meds are just one of a myriad of libido busters. Other common culprits include:

Erectile dysfunction. ED might not cause a drop in your sex drive, but worrying about it sure can.

Menopause. Hormonal changes can make sex painful, but don’t ignore the other related causes that can sap your sex drive. Low self-esteem and body image blues are big turnoffs.

Depression. A vicious cycle, depression can cause your sex drive to dip precipitously, and that drop-off can further fuel your depression.

Stress. Worrying and wooing do not mix. Stress keeps you from focusing on your partner — and your pleasure — and saps the energy you need to perform.

Alcohol. You may feel like Don Juan after a couple of drinks, but alcohol can leave you feeling numb just when you need to be aroused.

Other causes include sleeplessness, lack of intimacy, obesity — we could go on. Sex drive killers are legion, after all. Rare, though, are doctors who ask their patients about their sex lives.

“Doctors are just not good at asking about it, even gynecologists,” says Carolyn Nemec, MD, a family physician who specializes in female sexual dysfunction and sexual medicine at the Cleveland Clinic.

Nemec has been Oliverio’s physician for the past two years. Their initial conversation led to a treatment — an estrogen ring that reduces dryness — that has helped Oliverio get her groove back. In fact, successful treatments exist for many causes of low libido, if only you and your doctor talk about it.

But, says Nemec, “One study found that doctors asked about their patients’ sex lives only 5% to 10% of the time. We need to do better. People are suffering and we aren’t asking.”

How to Increase Your Libido

Check out these three tips to help keep your sex drive from getting stuck in neutral.

Technique matters. “Know your body and how it works,” says Carolyn Nemec, MD. “We can pick up a cookbook, so why can’t we pick up a sex book?”

Take care of your ticker. “Cholesterol, anything that affects the heart, that reduces blood flow, affects sex,” Nemec says. “And people who exercise have more and better sex.”

Get tested. Hormone imbalances can cause trouble for men and women, Nemec says. Ask your doctor to see how your levels measure up.