Sexual side effects of antidepressants

Reviewed by our clinical team

Sexual dysfunction in men is more common then you may think. Although it's sometimes difficult to talk about, it is estimated that 1 in 10 men in the UK have an issue related to sex. 

Sexual dysfunction can affect anyone, and at any age. So, you’re not alone. Sexual dysfunction and depression can feel surrounded by stigma - especially when it comes to talking about male mental health. But talking about it and understanding it are the first steps to getting the right treatment. And it can be treated. 

There are several underlying factors to sexual dysfunction. Sometimes, it can be a symptom of an underlying physical condition - for example diabetes. Sometimes it can be part of an emotional or psychological issue - such as depression. 

Here we’ll share the link between depression and sexual dysfunction, answering any questions you may have.

What is depression?

Everyone experiences sadness and feeling 'low' from time to time. That's totally normal. But, if those feelings persist, then you could be suffering from clinical depression. It can sometimes be hard to diagnose, partly due to a reluctance to seek help, and talk about it. 

Depression can stem from a specific trigger - bereavement, trauma, or a life-changing event. But it can also appear as if from nowhere, with no obvious origin. 

You don't need a 'reason' to be suffering with depression, and its symptoms can affect all areas of life. You may be feeling lost, hopeless, or anxious. You may experience physical symptoms - tiredness, lethargic, loss/increase of appetite, and perhaps lack of sex drive, or sexual dysfunction. 

If you think you may be suffering with depression, it is important to seek help. Depression can be treated, and there are a wide range of methods available. 

Does depression cause erectile dysfunction?

The symptoms and severity of depression vary from person to person. Stress and anxiety are common symptoms and can cause erectile dysfunction (ED). Sometimes, unhelpful ways of dealing with depression include alcohol overuse, or recreational drugs which can also contribute to ED.

Does depression cause a lack of sex drive?

Depression is a chemical imbalance in the brain. It can affect sex drive as well as sexual function. Depression symptoms such as stress, anxiety, poor sleep and low mood can affect libido (sexual desire). Depression can also affect relationships, which can lead to a lowered sex drive.

What are antidepressants? 

There is a wide range of treatments for depression. Antidepressants are just one of the treatments available, but they are perhaps the best known. 

For some people with moderate to severe depression, antidepressants can be effective. It's worth noting that they aren't suitable for everyone, because everybody's brain chemistry is different. So, it's really important to talk to your doctor about depression and discuss the best treatment for you. 

Antidepressants can help to relieve some depression symptoms, such as anxiety and stress. This can help you to feel more like yourself. But, they don't address the root cause of depression, so are usually combined with other treatments such as talking therapy. 

Do antidepressants have side effects?

Like most medications, there is a risk of side effects, which will be different for everyone. That's why it is so important to only use antidepressants with the guidance and support of your doctor. 

Side effects may include (but are not limited to): 

• Headaches 
• Drowsiness 
• Nausea
• Sleeplessness
• Increased agitation and anxiety
• Reduced sex drive/sexual dysfunction

Sexual side effects of antidepressants for men 

Depression can impact your sex life. This can include things like ED and a reduced sex drive (libido). But antidepressants can also sometimes impact these things too. If your sex drive or sexual function is (or becomes) an issue, be sure to discuss it with your doctor as your treatment progresses. 

Sexual side effects may include:

• Decreased libido 
• Difficulty getting/maintaining an erection 
• Delayed or blocked orgasm 
• Decreased sperm count 
• Sexual side effects of antidepressants for women 

It's important to note that antidepressants can also cause sexual side effects for women too, such as: 

• Delayed lubrication 
• Delayed or blocked orgasm 
• Lack of desire for sex 

Fertility and antidepressants 

Do antidepressants affect fertility? 

If you are a male trying to conceive, you may wish to consider that some antidepressants can reduce your sperm count. Also, a lack of desire or ED can impact on your intimate relationships, or ability to orgasm during sex. 

Can you get pregnant on antidepressants? 

If you are a female taking antidepressants, you can become pregnant. Some antidepressants are approved for use during pregnancy. If you plan to become pregnant or suspect you may be pregnant, it's important to tell your doctor, so that they can check the suitability of any antidepressant medication you're taking during pregnancy.  

It's vital to treat any mental health problems during pregnancy. Depression and anxiety can sometimes increase during pregnancy (perinatal depression), and after the baby is born (postnatal depression). Talk to your midwife and GP with any concerns. 

How to manage sexual side effects of antidepressants

If you are experiencing side effects from antidepressants, it's important to talk to your prescriber right away. Even though some side effects can be distressing, it’s not recommended to stop taking your medication without advice, as that may also create issues. Always seek guidance from a doctor.

Side effects can usually be managed or treated, depending on their type and severity. Adjustments can be made to:

• Dosage (how much you are taking)
• Timing (when in the day best suits your lifestyle)
• Type of antidepressant  

Another important element of dealing with sexual side effects is open conversation with a partner, if you have one. Keeping the lines of communication open with your partner, a trusted friend or family member, and of course your prescriber, is vital. This can help to monitor side effects such as: low mood, increased stress or anxiety, self-harming or suicidal thoughts. 

Which antidepressants are likely to cause sexual side effects? 

The possible side effects of antidepressants are by no means guaranteed - everyone will respond differently. However, there are a few types of antidepressants which are found to have more potential sexual side effects, such as:  

• SSRI’s (Selective serotonin reuptake inhibitors)
• SNRI’s (Serotonin and norepinephrine reuptake inhibitors) 
• MAOI’s (Monoamine oxidase inhibitors)
• Tricyclic and tetracyclic antidepressants

Which antidepressants have the least sexual side effects? 

Thankfully, there are many types of antidepressants available, so if one is producing unwelcome side-effects then it may simply be a case of switching the type. 

As above, each patient will respond differently. But, generally antidepressants known to have fewer sexual side effects include: 

• Bupropion (Wellbutrin XL, Wellbutrin SR, Aplenzin, and Forfivo XL)
• Mirtazapine (Remeron)
• Vilazodone (Viibryd)
• Vortioxetine (Trintellix)

Can you take Viagra on antidepressants?

Generally, Viagra can be used alongside antidepressants and can be an effective treatment if ED is being experienced as a side effect. 

Viagra is what’s known as a PDE5 inhibitor. Viagra is a brand name, the active ingredient is sildenafil citrate. Other PDE5 inhibitors may work in the same way, but they don’t have the same active ingredient, for example Tadalafil or Vardenafil.  

Other erectile dysfunction treatment options 

There are other treatments for ED, which may vary depending on the root cause of the ED. There are several medications and PDE5 inhibitors available, as well as topical treatment.

Vitaros (Alprostadil) cream

One such alternative to PDE5 inhibitors is Vitaros. This is a prescription cream that is applied to the tip of the penis. This stimulates blood flow, and causes an erection. 

Get talking

The effect of ED on men suffering with depression can be devastating. It can affect relationships, wellbeing, and confidence. If antidepressants are causing unwelcome sexual side effects this can result in a negative spiral for your emotional and mental health. 

That's why it is important to remember that both depression and ED are very treatable. And they are both far more common than people realise. With the right treatment, more and more men can lead healthy sex lives - and treat depression. 

Talk to your doctor, and get specialist advice. 

You can use our online ED service to request treatment without the need for a face-to-face appointment. 

References

https://www.echoclinics.nhs.uk/mens-health/sexual-dysfunction/
https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/medicines-and-psychiatry/antidepressants/overview/ 
https://www.nhs.uk/mental-health/conditions/clinical-depression/treatment/
https://www.nhs.uk/medicines/sertraline/pregnancy-breastfeeding-and-fertility-while-taking-sertraline/