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Antidepressant medication and sexual problems

The most popular antidepressant medications belong to a drug class called SSRI’s – selective serotonin re-uptake inhibitors. Some of the brand names you may recognize include Prozac (fluoxetine), Paxil (paroxetine), Zoloft (sertraline), and Luvox (fluvoxamine). These medications are prescribed, to an ever-growing population of people, for a range of emotional symptoms and illnesses. SSRI’s have been associated with a range of sexual dysfunction symptoms - loss of desire, arousal difficulties, decreased orgasm and low libido. For men who are on SSRI’s, problems with premature ejaculation may actually subside because of the prolonged arousal side effect.

While sexual dysfunction is a recognized side effect of SSRI medication, the rate at which it occurs is somewhat controversial. When medications are in the approval process, study patients are asked to report symptoms or side effects. They may not be asked about specific symptoms, and low sex drive or arousal trouble, may be items that most are reluctant to offer. Some studies of SSRI medication indicate the rate of low sex drive is around 10-13%. Newer medications in this class are said to have markedly lower incidence of this problem.

In contrast , other studies that include physician interview (direct questioning) with regard to sexual health while on SSRI’s, find a much higher rate of sexual dysfunction, in over 50% of users. What isn’t clear, is the rate of pre-medication sexual problems. Emotional worries or problems often carry over in your sex life. So, what came first the sexual problems or the medication? Certainly, the drug effects should not be minimized. In one sample of patients who switched from an SSRI to another type of medication, more than 80% reported improved libido when asked directly. Were they just feeling better, was the emotional situation improved, was it the change in medication or would it have happened anyway –these are all things to consider.

While these are difficult issues to sift through, never hesitate to discuss your concerns with your women’s health care provider.