Medications like selective serotonin reuptake inhibitors (SSRIs) can be an important part of treating mental health conditions like depression and anxiety. But some people find antidepressants can impact their sex life with side effects like erectile dysfunction, low libido, delayed orgasm or no orgasm at all (also known as anorgasmia). When it feels like the fog is lifting and other parts of your life are improving, these impacts on your sex life can be frustrating and upsetting. But you do have options.
Here’s what you need to know about SSRIs, sexual dysfunction and what you can do about it.
What are selective serotonin reuptake inhibitors?
SSRIs work by increasing levels of serotonin in the brain. Serotonin is a neurotransmitter (a chemical made by the body that carries signals between nerve cells) and it plays a critical role in regulating your mood.
They’re commonly used to treat depression but are also used for anxiety disorders, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), eating disorders, chronic pain conditions, migraines, sleep disorders and premature ejaculation.
Serotonin and norepinephrine reuptake inhibitors (SNRIs) are another class of antidepressants and they can also come with side effects like sexual dysfunction.
SSRIs and sexual dysfunction
There’s pretty extensive evidence that antidepressants can cause sexual dysfunction. It’s difficult to estimate the exact prevalence but research suggests anywhere between 10% to 80% of users are impacted, depending on the type of SSRI they take.
“SSRIs can cause different types of sexual dysfunction in different people – some might ejaculate too quickly, while others might not be able to ejaculate at all,” says psychosexual therapist Christopher Brett-Renes. “For some, achieving an erection might be difficult even when they are in the mood, while others might get an erection but not be interested in sex. Each type of dysfunction can have different impacts on the individual, their depression or anxiety, and their relationships.
SSRI-induced sexual dysfunction can impact your relationships, self-esteem and quality of life, and can make depressive symptoms worse. It can also lead to people stopping medication.
“I have worked with young male service users who were experiencing significant suicidality due to sexual dysfunction,” says Brett-Renes. However, Brett-Renes stresses that if you are experiencing sexual dysfunction as a result of your medication, do not stop taking it. “Abruptly stopping your medication can cause antidepressant discontinuation syndrome. So, before taking these steps, it is important to talk to your prescribing doctor to see what options there may be.”
Depression and sexual dysfunction
It’s important to note that many people with depression experience sexual dysfunction — particularly low sex drive — before treatment. In some cases, sexual dysfunction may stem not from the SSRI, but rather from the underlying depression. Treating depression may also improve sexual function in some people.
What can you do if antidepressants are affecting your sex life?
If you’re experiencing side effects from SSRI medication, do not stop taking the medication until you have spoken with your doctor first. They can discuss your options for managing mental health conditions while reducing side effects.
These strategies must be discussed with your doctor before starting them.
When it comes to managing sexual dysfunction, Brett-Renes has some more advice.
Educate yourself
“By asking your doctor questions about how the SSRIs may impact your sex life, or through talking to a mental health professional, you can plan how to handle those challenges if they do occur.”
Set time aside for each other
“It is important to set any time we can for connection. In the mists of depression, you might feel like you have nothing to talk about, and that’s ok.”
Learn love languages
“Sex is not the only things that can foster a healthy relationship. I use Gary Chapman’s Five Love Languages a lot with my clients. The book looks at how we like to express as well as receive love, and includes touch, words of affirmation, quality time, gifts, and acts of service. Colleagues of mine also include cooking for others as an additional love language.”
Irreversible post-SSRI sexual dysfunction
Some people continue to experience sexual dysfunction after stopping medication and this condition is called post-SSRI sexual dysfunction (PSSD). PSSD symptoms include decreased sex drive, loss of genital sensation, pleasureless orgasm and erectile dysfunction. Some people experience PSSD for several months and for some, it can persist indefinitely, even when depression and anxiety have resolved. It’s rare, but it could also be underreported.
If you have concerns about PSSD, chat with your doctor.
People also ask
What are the antidepressants without sexual side effects?
Mirtazapine (Remeron) comes with fewer sexual side effects.
What is the best antidepressant in Australia?
The best antidepressant is the one that works for you.
How long does SSRI erectile dysfunction last?
Sexual side effects sometimes subside with time, but it’s best to chat with your doctor about how you can treat erectile dysfunction and your mental health. There may be solutions that resolve the problem.
