Zara,sex thú m?i nh?t a 27-year-old woman living in London who asked to have her name changed, has been on antidepressants for around five years. She takes Sertraline to treat obsessive compulsive disorder (OCD) and anxiety. She says that the medication has significantly reduced her desire to have sex.
Sertraline is a type of serotonin reuptake inhibitor (SSRI) — a type of antidepressants that doctors often prescribe in the start for many patients. Noted side effects include loss of libido and difficulty in reaching orgasm during sex or masturbation.
"I'm really struggling with [the medication] as I used to be a really confident and sexual person," she tells Mashable. "It's really frustrating for something that was a big part of your life to be cut off or taken away from you."
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Zara describes a feeling of disconnect and also explains the impact of antidepressants on her sex life with her partner, saying she "rarely" finds herself "making the first move".
Her story isn't an isolated one. Taking medication to treat depression or anxiety is a brave and often important step in the journey to healing. Still, SSRIs and other types of antidepressants aren't a one-size-fits-all treatment that works for everyone. They aren't suitable for everyone; for instance, it isn't recommended to take SSRIs if you're pregnant, breastfeeding or under the age of 18. For some, the medication can have serious side effects. But for many, they can be crucial in lifting serotonin levels in the brain.
In the UK, an estimated 83.4 million antidepressants were prescribed in 2021 to 2022, accounting for about a 5 percent increase from the previous year. In the U.S., it's been noted that the number of Americans taking antidepressants rose by 65 percent in the fifteen-year period between 1999 and 2014.
It's been increasingly discussed that SSRIs have the ability to impact not only an individual's sex drive, but their ability to have an orgasm. Across the internet, people have written about how antidepressants have affected their sex lives, with some saying they were unable to have an orgasm at all.
Do antidepressants affect your sex drive?
In short, it's possible. SSRIs work by increasing serotonin levels in the brain. Serotonin is a neurotransmitter that positively influences a person's emotions, moods, and sleep. By increasing serotonin, people with depression or other mental health conditions (such as anxiety and OCD), are thought to respond well to treatments such as therapy.
That's why doctors often prescribe SSRIs in tandem with other forms of treatment. Popular SSRIs include paroxetine, citalopram, escitalopram, and sertraline (or Zoloft).
Madalaine Munro, a sexologist, says that antidepressants can have varied effects on a person's sex drive, often depending on "the type of antidepressant, dosage and constitution of the person".
Munro said it's also important to note that while medication can decrease libido, underlying depression may impact one's sex drive too. Harvard Health Publishing says that anywhere from 35 percent to 50 percent of people with "major depression" experience some sort of sexual dysfunction prior to treatment.
However, medication is still a source of a lower sex drive. A study by Drug Healthcare Patient Safetyfound that antidepressants affected "sexual function" for 40 percent of people taking them, also citing lower intensity of orgasm and duration of orgasm as potential consequences.
How do antidepressants impact orgasms?
This type of medication is designed to bring calmness and lessened anxiety to an individual – which, in turn, can lower libido, sometimes blocking the hormone receptors activated during sex. When an individual feels calmer, the hormones that make the body respond to sex can be blocked.
Zara, for example, found that taking Escitalopgram (or Cipralex), made her feel "numb emotionally, zoned out, and tired," causing her body to have almost no desire to have sex and negatively affecting her ability to "get turned on". She later switched to Sertraline, but those feelings haven't totally disappeared.
Tiffany Jones, Regional Clinical Director for mental health practiceThriveworks Counseling and sex and relationship expert, says SSRIs "are prescribed to increase the levels of active stimuli" and can therefore impact sexual libido.
For people of all genders, antidepressants "absolutely [have] the potential to impact the motivation for sex and arousal responses", says Jones. She says that "psychological and physiological arousal" go hand-in-hand, another reason why people can have their orgasms affected by antidepressants.
Jones says that people with vaginas may experience "delayed lubrication, discomfort and delayed or blocked orgasm", while people with penises can experience decreases in "their desire for sex and ability to get or maintain an erection".
Delayed lubrication, for example, can severely affect the ability to orgasm, and also make sex more painful. Natural arousal can be blocked in this manner, preventing orgasms from taking place.
How do I tell my partner that my antidepressants make it difficult to orgasm?
Zara found that her partner was understanding about her loss of libido, but also sensed frustration on his part, which caused "a few arguments". "It can get really upsetting to someone as they'll feel that their partner doesn't fancy them or have desire to have a connection with them," she says.
For partners, reduced sex drivein their significant other may leave them feeling undesired or confused. Jones suggests a conversation with "respect and openness": "talking to your partner about your sexuality, your desires, and your concerns is good for depression as it creates closeness."
The conversation isn't always easy, and it can be daunting. But it could be the first step in working together as a couple, figuring out solutions that both parties are comfortable with pursuing. "Choose a neutral moment and location to broach the desired topic," Jones suggests, adding it's best to avoid the conversation at especially vulnerable times such as during or immediately after an intimate situation.
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"Start the conversation by clarifying your issues ('I’m finding it difficult to orgasm'), specify your feelings ('it is making me feel frustrated and isolated') and work together for mutually satisfying solutions," Jones adds. She stresses that both people should "try to see things from the other’s point of view and to accept them".
Munro concurs, saying talking about antidepressants and mental health concerns will your partner is "a courageous step", says Munro, and one that should be celebrated. "If they know what is going on for you, they also know not to take it personally and how they can care and support you." This can be "a gift for your partner," she says, and can alleviate anxiety for both people. After all, "changes in the bedroom affect all people involved".
What are the next steps?
There are ways to foster both intimacy and compassion in this situation. Munro suggests that following an open conversation, consider practical steps to navigate your sex life. She recommends intimacy dates – scheduled time to spend with a partner without a goal in mind – or trying new things today, whether they involve intimacy or not.
When it comes to orgasming, she recommends pleasure mapping, or noting where your body feels pleasure. She also says to practice self-pleasure to discover what does or doesn't work for you, which can "can help transform your relationship to pleasure".
There are additional ways to help your wellbeing and regulate your nervous system, or in other words, bring a sense of calm back to your body. Munro says this is crucial. "Our nervous systems are ultimately responsible for different arousal and orgasmic states, so cultivating different practices to support nervous system regulation can help you reach more orgasmic states," she says. Approaching your well-being in a tailored way can support your mental health, going hand-in-hand with feeling sexual pleasure and desire.
You can also speak to your doctor about the right kind of medication for you, even considering whether a different sort of antidepressant may be better suited to you.
"Communication is of utmost importance, not just to your partner but also to your doctor," says dating expert Chris Pleines. "Ask your doctor for advice on how to address these symptoms. Never ever be afraid to try different alternatives until you find what works best for you."
Consulting sex therapists or counsellors can also be a route to consider, whether you do this alone or as a couple. Munro says "our libido is a deep and nuanced topic, and can required a layered approach," which experts can often guide.
"When we navigating changes in our sex lives, it can be triggering, feel destabilising and affect our self-esteem and self-worth," Munro says. "But it can also be a powerful time to revolutionise your relationship to sex and intimacy."