### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi. I am a 33 year old female who has bipolar. I take a few medications to keep my mood stable which include tegretol, seroquel xr, seroquel, lithium and lamictal. I have a good relationship with my psychiatrist and am responsible about my health. I had been on trileptal which did well for a few years but then I went high and needed something stronger. My doctor put me on tegretol and it has helped with my moods. However for months I wasn t able to experience an orgasm. Then I felt almost over sensitised and sore in the outer genital area and still orgasms really weren t and aren t to this day possible. Might this change? Is there any herb that might help? I have tried many meds over the years and it is best that I stay on Tegretol as others I have tried (apart from the ones I am on now) had side effects that were intolerable or were in some way not a fit. If anyone could shed any light on this it would be great. Thank you for your time and care. Sorcha

### output:

Hi, Tegretol has only rarely been known to cause orgasmic. In my opinion, you should first get your blood tested for serum prolactin levels to rule out hyperprolactinemia which is common in people on psychotropic medicines and causes inhibited orgasms. If you are found to have hyperprolactinemia, then the more likely causes would be antipsychotics like Seroquel. It can be treated with medicines and would not be a problem if you do not wish to change your treatment regimen. If there is no hyperprolactinemia, you will have to try reducing the dose of your medicines one at a time to identify the offending agent. Once you are sure that this is due to Regret or any other agent, you can consider changing it. Hope this helps you. Best wishes.