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Any of the factors below can be libido dampening, and its not unusual to experience a range of them at once: hormonal changes that affect arousal vaginal dryness or pain with intercourse lack of sleep from night sweats or insomnia medication side effects that decrease libido and arousal increased stress caregiving responsibilities, such as for kids and aging parents relationship challenges discomfort and distress from hot flashes body image and confidence concerns Its normal for sexual desire to ebb and flow over the years, months, and days

doi: 10.1111/pcmr.12232

Studies such as bone scanning with a gadolinium-based agent and chest radiography can be beneficial in assessing metastasis

However, limited practical experience makes protocol optimization challenging

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