Dryness, insensitivity

Reduced vaginal lubrication and clitoral sensitivity may sometimes stem from the same cardiovascular problems that can cause erectile dysfunction. But more often those problems stem from declining estrogen levels after menopause.

Sildenafil (Viagra) and related drugs may improve sexual function in some women, including those who experience side effects from antidepressant drugs such as fluoxetine (Prozac and generic), paroxetine (Paxil and generic), and sertraline (Zoloft and generic), according to preliminary research. Supplemental estrogen can also help relieve that problem as well as vaginal dryness. But both treatments pose risks, so should be used cautiously.

What to do: In theory, reducing coronary risk factors may improve sexual function in women as it does in men. Extended foreplay and nonpetroleum lubricants like K-Y Jelly and Replens can usually provide sufficient moisture. Staying sexually active may also help keep the vagina moist and responsive. Those steps, combined if necessary with treatment of a partner's sexual problems or of issues that impair libido, may improve a woman's ability to achieve orgasm as well.

Women who want to try estrogen for dryness or possibly insensitivity can use creams (Estrace, Premarin) or vaginal inserts (Estring), which allow you to use smaller doses that are less likely to increase the risk of breast cancer and heart disease. If those don't help, consider short-term use of low-dose estrogen pills or patches, provided you're not at high risk of those diseases.

Women with antidepressant-related sexual problems should try other measures before talking with their doctor about possibly trying sildenafil. For example, they could try a lower dose or switch to generic bupropion, since some research suggests it's less likely to interfere with your sex life than are other antidepressants.