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Dear Dr. Betty,

I am a healthy 28-year-old female, and I have been suffering from an undiagnosed sexual dysfunction for about six or seven years now. I began a very satisfying masturbation career at the age of about 18. My clitoris was too sensitive, and I've always preferred to stimulate my labia. Sometime in my early twenties, I'd found that I'd lost most of the sensation in my labia, and that persisted until a couple of months ago, when a small amount returned. I still cannot feel enough to orgasm the way I used to (and greatly prefer to), and so, as I'd done for the past several years, I've had to resort to clitoral stimulation.

Because of the sensitivity of my clitoris, the orgasms are so uncomfortable as to be almost painful; they also do not last as long as prior orgasms did and feel...very superficial (as opposed to the deeper climaxes I had before). My arousal level has also declined some, especially since I feel that something is wrong with my body, but, mainly, it feels like the blood flow is just not what is used to be. My vibrator has not helped; in fact, it seemed to dull what little sensation I did have.

I would like your input as to what I can do to get things back the way they were. The problem started around the time I had a falling out with a family member and was taking prescribed antidepressants, but, aside from a little stress from school and chronic loneliness, I am relatively psychologically healthy now. I eat right, I like my body for the most part, and I don't have any sexual hangups that I'm aware of that would impact my solo sex life. I have only had one real sexual partner in my life, and that was a couple of years ago, so I don't have much of a basis for comparison. In other words, I don't know what I need to fix.

Dear H,

You are a late bloomer with masturbation, but I wouldn't go so far as to describe you as having "an undiagnosed sexual dysfunction." You have answered your own question: "The problem started around the time I had a falling out with a family member and was taking prescribed antidepressants." Voila!' All anti depressants interfere with sexual functioning, especially orgasm. The med and stress will knock anyone off their game.

Also, your early masturbation technique of indirect clit stim by manipulating your labia was bound to change once your vulva got used to it. Read First Orgasm on the website. Even though you've had orgasms in the past, go through this process step by step. Following my suggestions might help you to control the intensity of your clitoral stimulation so it become pleasurable instead of "too intense." Also vaginal penetration and using your pelvic floor muscle often enhances clitoral sensations. But don't compare now with what used to be. Our arousal patterns change as we mature. If not, it's a sign we are stuck in a rut and it's time for a change. I'd check out the potential of using an electric vibrator correctly by softening the vibes layering a cloth and building up very slowly. Get out of your head, trust your body and enjoy yourself with a new love affair.

Dr. Betty