Topic: Problems with sexual function

[keruhi1]

I'm having some issues with sexual function since starting HRT.  I don't get erections like I used to, which is something I expected to happen, but the main issue is I can't seem to achieve orgasm anymore.

I have tried different things to no effect. I'm wondering if this is just some weird phase that I'll go through due to hormones and I'll eventually gain the ability to orgasm back?

I'm also concerned that it could be an issue due to my other medications.  I'm currently on Prozac and Risperdal for my bipolar disorder. I take trazadone to help with sleep. Other than that, I'm on Estradiol injections, Spironolactone, and Progesterone for HRT.

If anyone can help give me some insight into what is going on, I would really appreciate it. I'm hoping for a solution to this problem because it's been months now that I can't seem to achieve an orgasm. I'm getting a bit desperate here. I've only been on my current regime of HRT for about 3 months but prior to that, I was on estrogen patches and spiro for about a year but my testosterone levels were still too high.  The current doses I'm on have all my levels in the normal female ranges now.

[Maid Marion]

Both HRT and Prozac are likely to cause issues with sexual function.  The effect of HRT may be temporary.

https://www.healthline.com/health/erectile-dysfunction/antidepressant-sexual-side-effects#medications
I had a partner that had issues after taking SSRIs.  It is a very well known side effect.

I  found a study that suggested that the effect of HRT may be temporary.  It found that sexual desire comes back after a few years.  But, I don't have a link that I can post here.

Marion

[Northern Star Girl]

@keruhi1
Dear Keruhi1:
    Please know that I am not trying to hijack your thread but no doubt that you have seen other brand new members here get Official Welcome messages when they make their first posting.... now it is your turn!!!

    FIRST THINGS FIRST, you need to be Officially Welcomed and given important rules and information about the Susan's Place Forums.
    I am happy to see that you have signed up as a member of Susan's Place and have submitted your first posting. 

    As you post here on the forums you will be able to exchange thoughts and comments with others that are experiencing many of the same things that you wrote about.
 
    This is the right place for you to be to find out what others may have to say that may have been in your circumstances and with your questions and concerns.
    There are a lot of members here that will be able to identify with your situation as you continue to feel free to share it.
 
    I also want to warmly WELCOME you to Susan's Place. 
You will find this a safe and friendly place to share with others and to read about others similar trials, tribulations, and successes.

    As you are certainly aware you can share with others and involve yourself with some give and take with other like-minded members.  When frustrated or if you have successes you can share it here if you wish and receive support from others and offer support to others. ....
     ***There is a very good chance that you might find that you will make some new like-minded friends here. 

    Please come in and continue to be involved at your own pace.   Other members will be along shortly to give you their thoughts about your questions and concerns that you mentioned in your very first posting.
   
    There is information and important LINKS that I have included below.   You will find information about the site that will help you navigate around and best utilize the features here.   
Please look closely at the LINKS in RED, answers are there to many questions that new members ask.

Again, Welcome to Susan's Place.
Danielle

Here are some links to the site rules and stuff that all new members should be familiar with:
 

Things that you should read

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[Northern Star Girl]

@keruhi1
Dear Keruhi1:
OH.... one more thing.

Please feel free to stop by the Introductions Forum to tell more members about yourself!

Now I will let you and others have this thread back so your conversation can continue.

Wishing you well as you continue to be involved in the forums.
Danielle

[Rakel]

Dear keruhi1,

What you are experiencing are well known side effects of cross hormone therapy and certain psychotropic medications. Every medication has side effects that may or may not be undesirable.

I am a late transitioner, having transitioned in my mid 60's. I welcomed the reduction in sexual function. This wasn't my primary goal, but it was, for me, a gender confirming effect. Male sex drive is much stronger than the female sex drive. When my sex drive diminished, this just made me feel more female than before. I liked this feeling very much.

Many MTF people report decreased sexual drive when taking Estrogens. This is what I expected, so it was no surprise to me when it happened.

However, my experience is different from yours. Exactly what are your goals for taking hormone therapy? We do not discuss dosages here at Susan's Place, but a few people have reported improvement in this area with reducing the dose of their Estrogens. Of course, this will slow down any progress in your transition, if that is your ultimate goal. This is something to discuss with your doctor.

Also, I can recommend that you discuss with your doctor about prescribing something different for your psychological issues. Not all psychotropic medications have this side effect.

I hope things work out for you.

Take care. 

[Devlyn]

I'm having some issues with sexual function since starting HRT.  I don't get erections like I used to, which is something I expected to happen, but the main issue is I can't seem to achieve orgasm anymore.

I have tried different things to no effect. I'm wondering if this is just some weird phase that I'll go through due to hormones and I'll eventually gain the ability to orgasm back?

I'm also concerned that it could be an issue due to my other medications.  I'm currently on Prozac and Risperdal for my bipolar disorder. I take trazadone to help with sleep. Other than that, I'm on Estradiol injections, Spironolactone, and Progesterone for HRT.

If anyone can help give me some insight into what is going on, I would really appreciate it. I'm hoping for a solution to this problem because it's been months now that I can't seem to achieve an orgasm. I'm getting a bit desperate here. I've only been on my current regime of HRT for about 3 months but prior to that, I was on estrogen patches and spiro for about a year but my testosterone levels were still too high.  The current doses I'm on have all my levels in the normal female ranges now.

Hi keruhi 1, welcome to Susan's Place!

You've already gotten great advice, but can I ask what your levels are? You stated "normal female ranges" but it's surprising how many people here think a reading of "undetectable" or extremely low testosterone is a normal reading for a woman. Low T will definitely inhibit libido.

My personal experience was a lowering of libido and sexual function on a regimen of estradiol and spironolactone, followed by a resurgence of ability; seemingly as I switched to a "female" hormone profile. Following an orchiectomy,  my E level is 196, and my T is 53 (US units). I have very limited drive and performance, which I can partially remedy with Viagra, suggested by my doctor.

Your prescriber should have, and probably did, explain all the side effects to you beforehand, but it's a lot of information to take onboard.

See you around the site!

Hugs, Devlyn

[keruhi1]

Hi keruhi 1, welcome to Susan's Place!

You've already gotten great advice, but can I ask what your levels are? You stated "normal female ranges" but it's surprising how many people here think a reading of "undetectable" or extremely low testosterone is a normal reading for a woman. Low T will definitely inhibit libido.

My personal experience was a lowering of libido and sexual function on a regimen of estradiol and spironolactone, followed by a resurgence of ability; seemingly as I switched to a "female" hormone profile. Following an orchiectomy,  my E level is 196, and my T is 53 (US units). I have very limited drive and performance, which I can partially remedy with Viagra, suggested by my doctor.

Your prescriber should have, and probably did, explain all the side effects to you beforehand, but it's a lot of information to take onboard.

See you around the site!

Hugs, Devlyn

My doctor never actually showed me the results of my lab results but I was able to look them up online. My T is 7 and my estradiol is 72.  I hope this helps.

[Devlyn]

What’s a standard testosterone level for women?

Levels of testosterone and other androgens can be measured with a blood test. In women, normal testosterone levels range from 15 to 70 nanograms per deciliter (ng/dL) of blood.

Testosterone levels lower than 15 ng/dL may cause:

changes in breast tissue
fertility problems
low sex drive
missed or irregular menstrual periods
osteoporosis
vaginal dryness

https://www.healthline.com/health/womens-health/do-women-have-testosterone#normal-levels

[Maid Marion]

I looked up my lab results before I went in to the office for my physical.  You may find it easier to discuss issues with your doctor if you know the relevant lab numbers.

Marion

[Rakel]

My doctor never actually showed me the results of my lab results but I was able to look them up online. My T is 7 and my estradiol is 72.  I hope this helps.

Numbers without units are meaningless. Estradiol can be measured in pg/ml or pmol/L

Total Testosterone is measured in ng/dl and Free Testosterone is measured in pg/ml.

[Battle Goddess]

Hi, Keruhi

This is a great question to take to your endo. Risperidone can mess with your prolactin levels and has all manner of sexual side effects, among which anorgasmia.

Never thought to ask my endo or pdoc what they know about interactions between HRT and risperidone. Time to try to inform myself better.

[Rachel]

Hi,

Many things depend or what your goals are. I am post op and am supposed to take a dab of T each day. I forget 1/2 of the time to take the T. I am on high E.

It takes time to master the female sexual response. I have learned how to master the female sexual response
extremely well. It is not the male sexual response; it is sooooo much better.

There is a large learning curve and it helps heaps to post what is happening and make sure all is well and on track.

Rachel

[LaRae]

I went through this myself. For me, it was that my triggers completely changed. With T, it was "I'm tense & uncomfortable, let's get this over with". Pretty much perpetually ready to go, annoyingly so.

I found that, after starting HRT, I had to be invested to get aroused, it required imagination. Far more internal than external, as it was before. And, if I don't invest the mental effort to get my arousal up, even orgasm can be a very unsatisfactory & frustrating experience.

Hopefully this can help you a bit, too. Just keep experimenting with it, your triggers may have entirely switched without your realizing it.