Q: I’ve heard that vaginal lubricants carry health risks. Should I worry if I use them?
A: Vaginal lubricants have been linked to fertility problems and vaginal infections, but this doesn’t necessarily mean that you’re at risk. If you’re trying to get pregnant, definitely steer clear because these products can render sperm immotile, which can decrease your chances of conception.

Not trying to get knocked up? Then it’s fine to use a water-based lubricant, but avoid the oil-based ones because they don’t wash away easily and can create a breeding ground for bacteria.

If you’re prone to yeast infections, don’t use any vaginal lubricant that contains glycerin (a sugar-based compound that can trigger or feed a yeast infection). Perfumed, flavored, and warming lubricants have also been shown to increase the risk of urinary tract and vaginal infections. Your best lubricant options are Liquid Silk, Maximus, and Slippery Stuff, which are all water-based and glycerin-free.

Q: Ever since I gave birth to my second baby two months ago, I haven’t been able to reach orgasm during sex. Am I doing something wrong? What’s going on?
A: There are several common physiological reasons why you may be experiencing postchildbirth-orgasm difficulties. Widening of the vagina during delivery and strain to the pelvic floor during pregnancy and childbirth can stretch the main sensory nerves to the genital area. As a result, many women have a temporary loss of sensation in this region during and after pregnancy. Also, enduring a prolonged or traumatic labor and/or delivering a large baby can damage the pelvic-floor muscles and nerves, causing numbness and feelings of vaginal looseness, both of which can affect the ability to have an orgasm.

For help restoring vaginal tone and sensation, try doing Kegel exercises; other remedies that might help include biofeedback (using sensors to monitor pelvic-floor-muscle contractions in order to zero in on the muscles that need to be worked on during Kegel exercises) and stimulation therapy (using electrical currents to contract pelvic-floor muscles so you can learn to duplicate the exercises on your own).

There’s another possible reason you may be having trouble reaching orgasm: low testosterone levels. This is quite common postpartum and can diminish libido and cause orgasmic difficulty. Testosterone-replacement therapy (prescribed in the form of a cream or gel patch applied to the skin, or given as a pill or injection) can be effective. However, because of the potential risks and side effects (and the impact that it can have on nursing) it’s important to thoroughly discuss this option with
your doctor.

Remember: It’s crucial to give yourself plenty of time to return to a comfortable sex life after having a baby. Every woman is different, so don’t feel like there’s a set time frame for when you’re supposed to be ready for sex again.

If your orgasm problems persist, speak to your gynecologist; she can have your hormone levels checked and recommend medical and alternative therapies that can help you get back on track.

Q: Lately, I have zero sex drive. Could it be my antidepressant? If so, what can I do about it without going off my meds completely?
A: This is a tricky one to call. Depression itself can dampen sexual desire, but so can some of the medications that are used to treat the condition. The biggest potential culprits are antidepressants in the selective serotonin reuptake inhibitor (SSRI) group, like Zoloft and Prozac, which can have an impact on two of the body’s primary arousal-related chemicals—nitric oxide and dopamine. By inhibiting the production of nitric oxide, SSRIs can hinder vaginal blood-flow and lubrication, decreasing arousal. These medications also reduce the body’s dopamine activity, which can lead to lower libido and orgasmic dysfunction.

But there’s no reason you should have to put up with a diminished sex drive. Talk to your doctor about any sexual symptoms you’re having and ask her about possible remedies that might work for you, including switching antidepressants, adjusting your current dosage, or periodically taking brief (one- to two-day) medication holidays.

 
Jennifer Berman, MD, is director of the Berman Women’s Wellness Center and author of For Women Only.

Find out more about Jennifer at Bermansexualhealth.com. And send your questions to AskHealth@health.com.