Got questions about sex? GeorgAnna's got your answers. She has 20+ years experience blending medical and natural healthcare and is a provider at Rebirth Holistic Women’s Health, offering primary care and gynecology with a focus on healing from trauma. Here, she answers questions submitted by readers. Got a question for GeorgAnna? Email us at and we'll pass it along.  

I’m curious about orgasms in regards to antidepressants, stress, and lack of libido. Is it due to neurotransmitters or hormones being out of whack?

SSRIs commonly prescribed for anxiety and depression often cause anorgasmia, or difficulty orgasming. Zoloft is one of the worst, but it doesn’t happen to everyone. These meds can reduce libido, but stress is a huge player as well.

Many providers prescribe pills without recommending counseling, lifestyle changes (diet/exercise), or mindfulness practices, and when medications don’t work they just increase the dose. If you test neurotransmitters, often serotonin is high but dopamine or another neurotransmitter is low and the culprit of mood issues, which can be helped with lifestyle changes and supplements rather than upping their meds. So it’s worth addressing neurotransmitters, diet, exercise, and mental healthcare. Checking your thyroid can also be helpful in getting to the root.

Masturbation can potentiate arousal, orgasms release oxytocin and feel-good hormones, so pleasing yourself can be a wonderful DIY treatment for stress, overwhelm, and to boost mood. You can also get oxytocin from petting a cat, snuggling a child, hugging anyone, anything that increases connection using the “tend and befriend” female response (women respond to stress differently from the male “fight or flight” response) to stress to soothe your brain.

Women tend to find arousal is linked to mental states, so doing things to put yourself in the mood such as scheduling or initiating sex can help when intimacy stagnates, you’re tired, touched out from kids, etc. Sometimes hormones are out of balance, especially due to perimenopause, breastfeeding, and PCOS. Many women benefit from bioidentical progesterone (not the same as synthetic birth control) which is often low in women who have a lot of chronic stress or are estrogen dominant. Reducing caffeine, exercising, drinking water, and eating more vegetables (like your mom told you) is always good.

What lubes are safe for vaginal health, and what's safe for toys?

Sex toys that are soft and squishy gel or latex advertised as “for entertainment purposes” are not made for internal use like silicone, metal, or glass are. The plastics are toxic, easily broken down and absorbed in the acidic vagina, so go for higher quality toys.

As for lubricants, if it tastes sweet, or is “tingly,” then it can feed yeast in your body and cause a reaction. Many women also react to spermicides, which are a form of pesticide. Plain lubricated spermicide free condoms work just as well, and the same cheap condom brands are tested to the same quality standards as expensive ones. For lube, consider coconut oil or other edible oils. Water-based work best with condoms, but may not taste as good.

Do genital piercings increase pleasure for women?

Genital piercings on women can be used to enhance orgasmic potential and pleasure, or just be decorative. The most popular female genital piercings are hood rings, which can be vertical or horizontal, resting on the clitoris for more direct stimulation. Others include clitoris piercings, triangle piercings which go behind the clitoris so it presses against the ring from behind your clitoris.

Inner or outer labia rings are decorative and don’t generally increase sexual stimulation for the woman, but may be aesthetically pleasing to either partner.

Male genital piercings can also be used to increase stimulation for partners – piercings along the shaft can stimulate the G spot, Prince Alberts can stimulate the cervix which many women enjoy yet some find too much stimulation, so ask her what feels good.

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