By Tori Hudson, ND

Q: Is there anything I can do to improve my sexual response? My libido seems to be okay, but I’m not as orgasmic as I used to be, and I’m a lot drier, too.

A: The first thing you’ll want to treat is your vaginal dryness since once the tissue is restored, sexual response tends to improve. I suggest using estrogen creams. I prefer estriol, a natural hormone derived from constituents in plants, which has to be mixed up by a pharmacy that can make compound and natural hormones.

Other creams—also available by prescription only—include an estradiol cream (Estrace), an estradiol suppository (Estring), an estradiol tablet (Vagifem), and an equine estrogen cream (Premarin).

If your orgasmic response doesn’t improve, you might want to try a natural testosterone cream, also from a compounding pharmacy and available by prescription. Another helpful option may be one of the newer, over-the-counter creams made with L-arginine, an amino acid that is applied topically to the genital area and that enhances blood flow and engorgement, and therefore sexual response. You can buy these creams in any natural food store that also sells supplements.

If that fails, you might want to consider other factors. Libido and sexual response can be influenced by many things, including the state of your general health, your hormone levels, and whether you’re on medication (and which ones). Add to that relationship issues, self-esteem and body image, and actual physical factors and it gets pretty complicated. Because of this, a physician is in the best position to evaluate the situation and determine the underlying cause.