Health officials have expanded access to a libido-boosting pill for women, approving its use beyond menopause. Flibanserin, sold as Addyi and first cleared by the U.S. Food and Drug Administration (FDA) in 2015 for premenopausal women, can now be prescribed to women up to age 65.

Low libido is prevalent, health experts say; it affects between 40 to 70 percent of women. “Frankly, when you look at sexual issues throughout the lifespan, even 20s, 30s, 40s, low libido is the most common sexual complaint,” says Dr. Lauren Streicher, clinical professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine and host of the Come Again podcast series.

Reasons run the gamut, doctors say. Low libido can result from medication side effects, stress, fatigue, pain during sex, mental health or mood. Biological changes, such as menopause, can also affect a woman’s sex drive.

“Any of those factors may be contributing to decreased libido; it’s rarely just one thing for a woman, so it’s complex,” says Dr. Selena Zanotti, an obstetrician and gynecologist with the Cleveland Clinic. And it’s “very different” for women than for men, she adds.

Health conditions such as diabetes, high blood pressure and heart disease, which become more common with age, can also affect libido.

Treating low libido

The wide variety of contributing factors makes treating low libido difficult.

“When you see anybody for sexual health concerns, you really have to go through their complete medical history,” Zanotti says.

“There needs to be some detective work,” adds Streicher, author of a forthcoming book from AARP on menopause.

For women whose lack of libido isn’t caused by another medical issue or a relationship issue, medication may be able to help.

Flibanserin was initially approved in 2015 to treat hypoactive sexual desire disorder — long-lasting or recurring lack of interest in sex — in premenopausal women. Its approval was expanded 10 years later to include postmenopausal women under the age of 65. Zanotti says research is ongoing for women over 65.