SSRIs and Your Sex Life

A significant number of people are taking medications for depression or anxiety and they are not always aware of the possible side effects to their sexual health. Truthfully, even if the usual side effects are listed for you, the ones dealing with your sex life are often left off that list.

Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed type of antidepressant and the 3rd most often prescribed medication in the United States. They are also prescribed to treat anxiety disorders. While not every person on SSRIs experiences side effects, these types of medication are known to have a potential impact on your sexual health. Studies indicate that these side effects may occur after a few doses, show up years afterward and can possibly persist for decades after use.

Medication Examples include: Prozac, Celexa, Zoloft, Paxil, Lexapro, Luvox

Possible secondary sexual problems caused by these medications are:

• Less interest in sex

• Difficulty becoming aroused

• Sustaining arousal

• Issues reaching orgasm

• Delayed ejaculation

• Erectile problems

• Genital anesthesia

• Nipple insensitivity

• Decreased lubrication of the vagina

• Diminished capacity to experience sexual pleasure

• Pleasureless orgasms

Helpful considerations:

• Keep in mind that depression & anxiety itself may be the underlying cause of some sexual difficulties and this must be taken into account when troubleshooting if what you are experiencing is related to a medication or a mental health condition.

• The majority of side effects are overlapping except for the following that have been found specific to SSRIs: genital anesthesia, nipple or glans insensitivity, and pleasureless orgasms.

• Talk to your medical provider about the side effects you are experiencing. Discuss the possibility of adjusting dosage, or another medication that is known to be sexually sparing, or having less sexual side effects. (tips for talking with your healthcare provider)

• Talk openly with your partner about what you are experiencing. Have an honest conversation about the changes or issues and how the two of you might adapt or work with them together. Revisit this conversation often.

• Notice what time of day you have the least amount of side effects and schedule sex for that time. Try morning sex instead of late at night.

• Consider using a vibrator as a tool for a quicker arousal and warming up with potential to reach orgasm.

• Bring a lube into your sexual tool kit to decrease friction and increase pleasure.

• Try exercising before sex, to increase blood flow to your genitals.

• Work with a trained therapist to talk through issues, problems, and possible solutions.

*photo courtesy of Kristin Scharkey

Talking About Sexual Health With Your Medical Provider

Sexual health is part of your overall health.
Many people find it uncomfortable to talk about sex and sexuality.
Talking about it with a medical provider can feel scary enough to keep you silent.

It can be intimidating, but your sexual health matters.

As a longtime nurse and patient advocate, one of the easiest tools I encourage clients to use is this:
write out a script or questions on a small card or in your phone and take with you to medical appointments. When a health care provider sees that you have specific questions or concerns written down, it helps them to pause, listen and address your concerns. It also helps you to remember what you want to ask or what you want to talk about.

Here are some talking points to get you started:

• I would like to discuss my sexual health or I would like to discuss sex.

• Something is not working correctly or ___ is happening.

• ____ is interfering with my sexual desire/arousal/orgasms/genitals/pleasure.

• What I think might be going on is ___.

• I can’t figure out what is going on.

• What can we do to figure this out? Are there tests we can do?

• If you cannot help me, who can you refer me to?

• Will you please give me that referral before I leave today?