<s>[INST] I am a 28 year old female with a number of autoimmune disorders - fibromyalgia the most recently diagnosed. I am currently on Lexapro, Zegrid OTC, Flexeril, Singulair, proventil inhaler, claritin, 25mcg synthroid, and I also take vit b complex, c, and d daily as well as a kids multivite. My question is that in the past several months, I have been unable to achieve orgasm without great difficulty (by myself even - and I used to be able to do that incredibly quickly without any problems. When I do orgasm, my legs and arms go numb and very painful, and my heart beats out of my chest, and I feel like I can t breathe. I had an EKG in november that was normal, but I have had several incidences of tachycardia including when I was woken up from general anesthesia after ovarian surgery. Could this be a heart problem even with a normal EKG? [/INST] Hello, I passed carefully through your question and would explain that your problems with orgasm could be related to Learn adverse effects.  For this reason, I recommend discussing with your psychiatrist on this issue.  Your symptoms do not seem to be related to the heart. Anyway, I would recommend performing an ambulatory 24-48 hours ECG monitoring in order to investigate for possible cardiac arrhythmia.  Some blood lab tests (complete blood count, thyroid hormone levels, blood electrolytes) are also necessary in order to exclude possible metabolic disorders, which can mimic this clinical scenario.  Hope I have answered your query. Let me know if I can assist you further.  </s>