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Question:
I'm a 33 yr old married female and for the past 1-2 yrs my orgasms have gone from very intense & pleasurable to almost nothing. I can still achieve orgasm, but the muscle contractions are extremely weak and cause virtually no pleasurable sensations at all. I've suffered no trauma (physical or mental) and I'm in general good health (other than allergies). The only thing I can link it to was a 6-month Accutane treatment (the drop in pleasure started soon after I stopped using Accutane, though I don't know if there is any connection). Please help! My sex life is awful because I just don't enjoy sex at all anymore. Any suggestions?
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Answer:
by Raven James: (01/23/2006)
Hello. Changes in the sexual response cycle can be caused by so many issues, it would be impossible to diagnose through this venue, but I can give you some information and ask some general questions about your situation that may help guide you to the next step in the process.
First of all, you have mentioned certain medications that you are/have taken. Accutane is taken for severe, cystic acne. It also appears there are many side effects from taking this medication, and although sexual dysfunction does not appear on the list, it is certainly possible there could be some affect on libido. Did your treatments clear up your acne? How do you perceive yourself as a sexual being? Often, body image can impact how we respond sexually to a partner. For some people, if they feel they are not attractive to their partner, this can affect the ability to orgasm.
Depression can also impact sexual function, and may occur for a number of reasons. Physical pain can also have a huge impact on sexual function. Not knowing the extent of your back pain, location, effect on nerves, actual physical positions, etc., I would also wonder whether this could be affecting you. Is the pain severe, chronic or debilitating? Hs it gotten worse? Does the pain or its affects cause you to be depressed?
Other areas that can be general to assess would include the relationship you have with your husband, or your life situation. Have there been any sudden, unexpected or major changes, such as a change in job or career, a death in the family, or event that could cause emotional or psychic distress? You may be able to link the change to an event or change, if this is the cause. In the light of not being able to provide a specific answer to your concern, I would suggest for you to re-visit your OB/GYN and mention the issue (as you did not when you got your check-up) as he/she may be able to help you better pinpoint the issues. Your health provider would have a much better handle on the ins and outs of your medications and physical history. If you are not comfortable with discussing sexual concerns with your doctor, it will be difficult for them to assist you. If you are not finding any answers you also may be able to locate a sex therapist that can assist you in finding a reason, but one of the things they will do first is take a physical and sexual history, along with baseline physical examinations and blood work, so I think your own doctor would be a wise place to start if you can't link it to any emotional events or changes.
It sounds like you are familiar with your own sexual response, but reading up on female orgasm may also provide some insight. Betty Dodson has authored several books on female orgasm, including "Sex for One" and "Orgasmic Women." She is also big on masturbation techniques and teaching people how to have and give themselves orgasms. Sometimes, learning more about our bodies can help with orgasming. Hope this helps and good luck. Write back if you have any other questions.Reviewed by: Patricia Fawver Ph.D. in Sexology
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