Has your sex drive taken a nose dive?

You're not alone. According to findings published in the Journal of the American Medical Association, an estimated 43 percent of women reported experiencing sexual dysfunction. Problems ranged from a lack of reaching orgasms to zero sexual desire.

Dr. Julia P. Poytner, who is a regular contributor to sexual-health-info.blogspot.com, pointed out 10 things that impact your sexual desire and 10 ways to put the vroom back in to your sex engine:

Oral contraceptives can impact the production of testosterone, which is important to the blood flow to your vagina and the sensitivity of the vagina opening.

Solution: If you've noticed your sex drive has declined since going on the pill, Poytner advises talking to your gynecologist to see if you should switch to an ultra- low dose, or 20 microgram, pill or to a different birth control method, such as an IUD or condoms.

Depression can cause you to not only feel sad and worthless and fatigued, but it also can reduce your interest in sex.

Solution: If you suspect this is the root of your derailed sexual libido, seek professional counseling. Be aware, though, that your physician might recommend anti-depressants that also can reduce your sex drive. Let your physician know up front that the depression has affected your sex drive. Also let your physician know if the condition worsens or doesn't change with anti-depressant treatment.

Antidepressants, such as Prozac and Paxil, are big culprits in lowering libido and impairing orgasms. Other culprits: blood-pressure-lowering drugs, which can interfere with nerve signals; and antihistamines, which not only dry up sniffles but also zap your vaginal lubrication.

Solution: Talk to your physician about the effects of the drugs so he or she can adjust your medication that does not affect your sex drive. And, using Zestra (zestraforwomen.com), over-the-counter topical botanical oil that you massage on the clitoris, labia and vaginal opening during foreplay, enhances arousal and orgasm. In the case of dryness caused by antihistamines, a water-based lubricant can be used during sex.

Poor body image. Your partner might think you're the hottest sex kitten in the world. But if you're not feeling great about your body, hair or even skin, you likely won't purr with abandon.

Solution: Do a "cue analysis." Recall the time when you felt on top of your game sexually. What were you wearing? How were you eating and exercising? And what perfume and shoes made you feel hot? These cues can help you slip back into your sexy mindset and habits. Go out and replace that little black dress that doesn't fit anymore with one that makes you feel good in the body you now have. Or get back into an exercise routine that will create chemicals in your brain that lift your mood and your energy levels.

Menopause leads to an abrupt drop in estrogen, which reduces vaginal lubrication. And it cuts production of testosterone production in half, which can trigger a sudden dip in your sex drive. Add in the other symptoms of menopause - weight gain, fatigue and difficulty sleeping - and your sex drive can nose dive.

Solution: Have an honest talk with your physician. Once he or she rules out other medical problems, try some of these options: a doctor-approved exercise regimen to improve blood flow, using the botanical oil Zestra during foreplay, self-pleasuring to promote blood flow and incorporate fantasy work to bring erotic thoughts back into your mind. Talk honestly with your partner about your body changes and that just because you need a lubricant doesn't mean he doesn't still turn you on. And try a vibrator, which is more intense than a hand and can help with dulled arousal. In some cases, your physician might advise prescribing oral or topical testosterone to increase sexual urges.

Health problems such as high blood pressure, high cholesterol, diabetes, thyroid disorders and autoimmune disorders such as lupus can all affect a women's sexual desire.

Solution: Discuss your change in libido with your physician. He or she might prescribe medication to treat the health condition, life style changes such as exercising more and eating healthier foods. Ask your physician if a topical estrogen might help.

Relationship problems can douse your passion.

Solution: Don't ignore problem so it becomes an emotional crises or leads you and your partner to Splits Ville. First, have your healthcare provider rule out physical problems that could cause a lower libido. Regardless of the problems, you and your partner need to communicate and discuss and try to resolve the issues in a quite place away from distractions. If this doesn't work, seek professional counseling.

Stress from juggling work, family and friends, meeting deadlines and paying bills is enough to send many women diving into bed to hide under the covers every night. Forget about slipping into something sexy for a little romp in the sheets.

Solution: Stress causes hormone cortisol to increase and alters testosterone and estrogen that influence your sex drive. Ironically, having sex - in particular, having orgasms - is a known stress reliever because the chemical oxycotin is released during sex. Oxycotin combats high cortisol levels. But if you're too stressed to romp in the sheets, find other ways to relax first, such as exercise, Yoga or meditation.

Childbirth and breastfeeding can both impact sexual desires. Childbirth can cause pelvic and muscle damage, reducing genital sensitivity. Breastfeeding reduces levels of estrogen, which keeps the vagina lubricated and flexible. This could cause painful penetration. Breastfeeding also increases the hormone prolactin, which curbs sexual desire. Add in postpartum depression that some women experience and sleep deprivation, and sex is the last thing on your mind.

Solution: Talk to your physician about a change in sexual libido and let him or her rule out physical causes or postpartum depression. Keep in mind that breastfeeding is a temporary situation. Allow yourself time to adjust to lack of sleep. In the meantime, find ways to stay connected to your partner by talking or cuddling.

Bedroom monotony can cause sex to become ho-hum.

Solution: Spice up your sex life with some variety. Explore new positions through books or videos. Change the time of the day you have sex. More importantly, find time to reconnect with your partner, even if it means hiring a babysitter so you can book a romantic night out.