His and Her Health

Help! I lost the ability to have an orgasm! Is it my birth control pills, or a residual effect from antidepressants?<P>I am 33, in good health, no kids. I used to be able to have orgasms (not during intercourse, but from oral and manual stimulation) fairly regularly. Now, nothing. I have a strong libido, but I just can't seem to have an orgasm. Sensation is low, sometimes almost nil. My partner is patient and willing to try anything. <BR><p><BR>I can have orgasms with a vibrator, usually, but only after a lot of time, and to the point where I'm basically hurting myself as much as I'm helping myself.<BR><p><BR>I have been on Ortho Cyclen for about two years, and have had this problem for approximately that amount of time. I have taken other varieties of BC pills consistently for the past 12 years. <BR><p><BR>I was on antidepressants for about two years, ending about two years ago. I haven't taken any psycho-pharmaceuticals since then.<BR><p><BR>Any ideas what the problem is? I've read about libido issues with birth control pills, but not sensation problems.

I only have time for a short post...<P> <BLOCKQUOTE><font size="1" face="Verdana, Arial">quote:</font><HR><font face="Verdana, Arial" size="2"><BR>Another problem that is often seen is one caused by liver first pass metabolism of estrogens. As estrogen is processed by the liver it causes a rise in another hormone called sex hormone binding globulen or SHBG. SHBG is a naturally occurring hormone. But when it is produced in excess, it can cause problems. Here's why.<P>If you were to go get a hormone test to measure how much testosterone you have, there would be several options. There are tests to measure total testosterone, and others to measure free or bio-available testosterone. In combination, you may have your levels of SHBG tested. Here's how the three things are related.<P>SHBG binds to both estrogen and testosterone. However, it binds to testosterone much more easily and strongly. Any testosterone that is bound to SHBG is unavailable for use by the body. In essence, it's inert, useless. Since testosterone is incredibly valuable in the right amounts for the proper sexual functioning, a significant loss of bio-available testosterone. <P>The SHBG levels also appear to continue to rise over time. One study found that even at two years, the SHBG levels continued to rise as long as the oral estrogen was in use. So, you may not start out with problems, but find that these problems appear later, or get more dramatic.<P>Low testosterone levels can come from numerous causes:<BR>· Aging, and the natural decline in testosterone levels.<BR>· Production mechanisms that are not producing enough testosterone. E.g. Ovaries, Adrenals.<BR>· Control systems that are not properly regulating the amount of testosterone produced. (This can produce too much or too little.)<BR>· External factors that raise SHBG levels and thus decrease bio-available free testosterone, such as oral use of estrogens in hormonal birth control or hormone replacement therapy.<P>Testosterone is known to play a important factor in many sexual function areas such as:<BR>· Mood (Depression, blunted motivation, low energy, general malaise)<BR>· Libido or desire<BR>· Sensation (Loss of sensation in nipples and/or genetalia)<BR>· Orgasm (Loss of intensity in orgasm, amount of time and/or effort required to reach orgasm, or even total loss or absence of orgasm)<BR>· Minimal Lubrication or other arousal issues.<P>So, what can you do to avoid or stop these problems?<P>From the results of studies to date, it's generally believed that only oral estrogens cause these problems.<P>So, if you're on hormone replacement therapy or hormonal birth control, you could switch to a patch or vaginal delivery method. (Estring for HRT, Evra or Nuvaring for birth control.)<P>You could also stop taking the hormones all together. HRT is only really recommended for those with symptoms. Slowly decreasing your HRT over time will keep your body from reacting badly, and re-occurrence of night-sweats, insomnia etc. If you stop taking hormonal birth control, you can use an IUD, condoms, cervical cap, or diaphragms, or a completely natural method such as Fertility Awareness Method or FAM.<P></font><HR></BLOCKQUOTE><P>I've posted this in other threads, but the info may apply to your situation.<P>Low Testosterone *AND* low Estrogen can impact sensation dramatically. Pinky can elaborate how without T, touching her clitoris wasn't much different than touching her eyelid - that's nearly a direct quote I believe.<P>Our experience is similar, though our situation wasn't caused by oral contraceptives - but by low T levels in general. (The OC's didn't seem to exacerbate our situation.) Sensation is dramatically better.<P>It's difficult to speculate what your issues might be. It could be OC's or some other problem completely. I haven't heard of anti-depressants causing low sensation problems, but more often, low libido, and orgasm loss or difficulty - not exactly related to senstation though.<P>Have you considered getting a local doc to do some fairly comprehensive blood-work on you, and then perhaps seeing a specialist?<P>I'd be glad to elaborate more if you would like - just ask. There is more information about this topic on the website listed in my profile. We can discuss providers there, and follow up. Email me from my profile, if you can't find the info.<P>Best wishes,<BR>Greg<P>------------------<BR>See the icons at the top of this post for my profile and more information.<BR>Also note, I am *not* a doctor, and this is not intended as medical advice - Please talk to your doctor about your concerns.