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Hi Stephanie,
In my practice in Amsterdam (the Netherlands) the most common factor resulting in these problems, is the couples relationship being out of balance. Not wanting sex gives some power and that might be necessary to restore the balance between the 2 a bit.

From my experience, the biggest aspects to affect my sex drive have been criticism about 'not being interested', stress levels and just a mutual failure to put excitement back in our lives.

I think the mutual failure was what affected me the most. If you've been in a relationship for a while, the intimacy becomes comfortable and it's easy to forget that the sexual side requires making an active effort.

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