Ladies, what’s holding your libido back? Let’s fix that.

If sex has lost its thrill, if it feels more like a chore than ever, you’re not alone. Starting in the 30s, lack of desire is the biggest sexual problem women report.

Maybe your sex drive is just fine, thank you very much—or it is low but you’re OK with that. Great. But if low sexual desire bothers you, if it’s taking a toll on your romantic relationship and your quality of life, you want solutions.

Sure, the pharmaceutical industry wants to sell you its little pink pill, but Addyi (flibanserin) doesn’t work very well and has plenty of side effects and drawbacks.

The good news is that there are many reasons why libido may flag—and thus, many ways to bring it back. The key is to identify what’s holding you back and find solutions. Over the years, we’ve spoken to many physicians, naturopaths, psychologists and sex therapists about female libido.

Here are some of the most common reasons their patients give for a lack of desire—and targeted solutions.

If sex hurts now…

Consider: A lubricant, a moisturizer or low-dose estrogen.

Vaginal dryness and thinning becomes a huge sexual obstacle for many women as they get older. But you don’t have to just accept it as the new normal. There are over-the-counter products that can help. Start with a lubricant that’s used during sex to make things go…more smoothly. If that doesn’t quite do the trick, add in a moisturizer such as Replens. Moisturizers are used regularly (not just before sex) and have a longer-lasting effect than lubricants. Many women use both lubricants and moisturizers. If those aren’t enough, some perimenopausal and postmenopausal women find relief with a prescription for low-dose estrogen. You can get this in the form of a tablet (a vaginal suppository), a cream or even a vaginal ring. According to The North American Menopause Society, these products aren’t absorbed much beyond the vagina, so they don’t carry the same health risks as hormone replacement therapy. They make vaginal tissue thicker and more flexible so that sex is more comfortable.

If hot flashes keep you from getting in the mood…

Consider: The Peruvian herb maca.

This is one of naturopathic physician Laurie Steelsmith’s favorite natural remedies for a lagging libido. Maca balances the entire hormonal system, helps to reduce stress hormones (which can sap energy), increases sex drive and alleviates desire-dampening symptoms of menopause such as hot flashes, night sweats and insomnia. (It can also help men improve sperm quality.) The recommended dose for women is 1,000 milligrams twice a day. As with any supplement, talk with your doctor first, especially if you have high blood pressure, since maca may increase blood pressure. (To learn more, see Bottom Line’s Women, Increase Your Sex Drive Naturally.)

If your mood meds are dampening your desire…

Consider: A non-SSRI antidepressant—or exercise.

SSRIs, which are prescribed for depression or anxiety, can have the unfortunate side effect of killing desire, arousal and orgasms. Not all antidepressants work this way, though, so talk to your doctor about an SSRI alternative such as bupropion (Wellbutrin) or duloxetine (Cymbalta). If switching meds isn’t an option for you, being more physically active could help. A 2013 study from The University of Texas at Austin found that 30 minutes of exercise just before sex improves libido and sexual functioning for women on antidepressants. A possible explanation: Aerobic activity brings blood flow to the genitals. In case you’re wondering, the same sexy effect has also been shown in other studies on depressed women who aren’t taking mood medications…and in healthy nondepressed women. Of course, exercise is a great mood lifter in general and can help treat depression, so it’s a win not only in the bedroom—but in your life.

If you can’t stop thinking about your body…

Consider: Being more “mindful.”

Many women lack awareness of sensation and arousal during sex because we’re too busy thinking about the grocery list or knocking around self-doubts like, Do I look fat right now? If this sounds like you, try practicing mindfulness in the bedroom, suggests neuropsychologist Marsha Lucas, PhD, author of Rewire Your Brain for Love: Creating Vibrant Relationships Using the Science of Mindfulness. The key: Being attuned to the present moment, without judgment. The famous sex researchers Masters and Johnson coined a technique called sensate focus that can help with awareness during sex. To practice sensate focus, you and your partner take turns experiencing what it’s like to touch and be touched—when he or she runs his fingers up and down your back, for example—in both nonsexual and sexual ways. This exercise helps you pay attention to the experience so you can enjoy it more.

If you’re just never in the mood…

Consider: Low-dose testosterone.

You may think of testosterone as a male hormone, but women have it in their bodies, too, and some doctors think it’s actually important for female desire. This hormone gradually declines in women after peaking in their 20s. Some ob-gyns swear by it for their postmenopausal patients dealing with desire issues. Testosterone products aren’t FDA-approved for women, but your ob-gyn can still prescribe them off-label to you if you’re in menopause. To limit side effects, you need a special low-dose preparation—often 1/10th the amount used for men—which your health-care provider can order at a compounding pharmacy. Warning: Never use a testosterone product designed for men.

 If it’s not like what you remember…

Consider: Adjusting your expectations.

That may sound like settling, but here’s the thing—experts say that many of us have unrealistic expectations about what sex should be like in our long-term relationships. Very often, we want it to be just as thrilling as it was in the early days. Research has also found that, for every month a woman is in a relationship, her desire lessens a bit. Simply knowing this might help you—and your partner—stress about it less. And knowing that sex usually changes over time (even with the same partner), and that this doesn’t necessary mean anything is wrong with the relationship, can keep us motivated to keep the spark alive. For more tips, see Bottom Line’s How Women Can Feel Sexier Again (Without Popping a Pill).

What works for you? Do you have any sexual-health questions that you’d like our experts to answer? Leave a comment and let us know!