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"Libido maintenance is complicated," admits Judith Reichman, M.D., the frank "hormone maven" you've seen on PBS, The Today Show, and Oprah!. Few physicians are able to help or are comfortable helping women whose dwindling sexual urge interferes with sexual pleasure, intimacy, and expression of affection. I'm Not in the Mood examines the medical reasons for the loss of libido as women age. Reichman concludes that although estrogen replacement makes sexual activity more comfortable and pleasurable, it has no effect on sexual desire, whereas testosterone does. "From an ovarian point of view, many of us are testosterone-deprived, if not downright deficient," asserts Reichman. Testosterone deficiency can result in diminished desire and arousability, insensitivity of the clitoris and nipples, and difficulty reaching orgasm. She discusses the "good news" about and "dark side" of taking testosterone. Reichman wisely avoids blaming testosterone deficiency for every sexual woe, however. She describes "Seven Sexual Saboteurs": psychological concerns, couple trouble, medications, disease, surgery, pain, and a partner with erectile difficulties. For each, she explains the problem and her recommended solution. She discusses (and, generally, dismisses) other products that are used or advertised as libido enhancers and gives advice about how to talk to your partner and to a sex therapist. --Joan Price
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