Thank you for asking this brave question. Many women struggle with lubrication or orgasm difficulty. You deserve answers and solutions. Difficulty “getting wet” or achieving orgasm can result from hormones, medications, stress, nerve sensitivity, blood flow, anatomy… or a mix of some or all of the above. The first step is identifying what’s contributing to your symptoms. Some treatments aim to improve blood flow and tissue sensitivity. PRP-based procedures, like the O-Shot, can often enhance vaginal tissue health, lubrication and orgasmic response. In some cases, excess clitoral hood tissue may limit stimulation. A clitoral hood reduction or labiaplasty could improve comfort and sexual function for some patients. One of my favorite treatments for this issue is Viveve, our number-one procedure to improve natural moisture production. This fast, non-invasive, no-downtime treatment tones and tightens intimate tissue, helping the body produce more of its own lubrication. The safest next step is an evaluation with a surgeon who specializes in vaginal rejuvenation. Together, you can identify the factors affecting your sexual function and determine which treatments may help you feel more confident, comfortable and satisfied. Best Wishes, ~Dr. Courtenay Poucher