How do we proceed in issues regarding libido? There's clearly multiple factors that may influence intimacy and readiness for sex, with various perspectives on expectations and beliefs about what constitutes a normal sex life. Some patients are ready to have a full and frank discussion, while others may need the GP to set the tone that they can discuss this important issue. This requires attention towards obstacles and inhibitors to a therapeutic conversation about sex, the language used, the verbal and non-verbal expresssion that leaves the patient feeling comfortable enough to confide what's on their mind. 

Once the discussion is facilitated, then the factors that influence libido can be addressd with a view to managing the issue. 

Where to go next? 

Medication- Hormonal adjustments: Oestrogen or Testosterone?

Wider influences- other medical conditions, mental health, strain, relationship challenges or expectations?