Sexual Dysfunction From Medication: Let’s Talk About it

There are many medical conditions as well as treatments that contribute to sexual dysfunction in both men and women. Some medication categories, such as antidepressants and antipsychotics, are known for drug-induced sexual problems. Sexual dysfunction can be an incredibly distressing experience with negative effects on a person’s quality of life, quality of relationships, and personal self-esteem. Most commonly, experiencing adverse reactions from medications such as sexual dysfunction can lead to noncompliance with treatment, increasing the potential for relapse. With understanding the potential for these sexual problems and other negative impacts that a medication may have, it may be easier to work together with your clinician to create a better treatment plan or try other medications. 

Sexual function consists of phases or symptoms of sexual desire, including arousal as well as orgasm. Both men and women can experience sexual dysfunction which may include: 

  • Decreased or lack of sex drive

  • Inability to orgasm

  • Inability to reach orgasm despite sexual stimulation (anorgasmia)

  • Lack of swelling and/or lubrication in women

  • Erectile dysfunction in men

  • Premature or absent ejaculation

  • Painful sex

The severity of sexual side effects depends on a range of factors including the individual’s biological makeup, and specific medication and dose. For some, side effects may only be an issue when easing into a new medication, but for others, sexual side effects are persisting issues. It is crucial that we address this topic to spread education and awareness of possible side effects, as well as providing solutions for sexual dysfunction experiences. 

Antidepressants And Sexual Dysfunction

With 1 in 6 women in the United States taking antidepressant medication, it is essential that we acknowledge the facts and solutions to sexual dysfunction that is commonly experienced with antidepressant medication. Adverse effects from prescription medications are complex issues to address because there are many overlapping factors that can contribute to such effects, including sexual dysfunction experienced with mood disorders. 

The following antidepressants have been reported problematic in relation to sexual functioning: 

  • Citalopram (Celexa)

  • Duloxetine (Cymbalta)

  • Escitalopram (Lexapro)

  • Paroxetine (Paxil)

  • Fluoxetine (Prozac)

  • Sertraline (Zoloft)

Antidepressant medications are classified as selective serotonin reuptake inhibitors (SSRI’s). These drugs raise levels of serotonin in the body, which allows the user to feel calm and less anxious. In turn, the sensation of stability can lower sex drive because it prevents hormones in the body to respond to sex. Other side effects of antidepressant medications can include weight gain, nausea, dizziness, and drowsiness. 

Prior to treatment or trial of medications, it is important to identify any sexual dysfunction symptoms you may already be experiencing. If there is no preexisting dysfunction, you will be better able to recognize sexual dysfunction as the cause of any medications you may be prescribed and try. 

Treatment of adverse sexual effects experienced from antidepressants may include reducing the dose of medication, drug discontinuation, or using other medications with fewer adverse effects. There are also behavioral treatments that may help, such as exercising before sexual activity or prioritizing sexual experience, or more holistic modalities such as acupuncture techniques. 

Antipsychotics and Sexual Dysfunction

Sexual dysfunction is known as one of the most distressing side effects of antipsychotic medications and contributes majorly to poor quality of life. Rates of sexual dysfunction are higher in patients with schizophrenia compared to the general population or individuals with other psychiatric disorders. There is a researched correlation between the severity of symptoms and reported severity of dysfunction. Antipsychotic medications block dopamine receptors in the body that indirectly decrease libido, impair arousal, and impair orgasm through the elevation of prolactin levels. 

Although medication itself can be the cause of sexual dysfunction, psychiatric disorders already have contributing factors that can affect sexual dysfunction. Factors include performance anxiety, social anxiety, comorbid diseases, and co-occurring disorders. When identifying solutions, there are many caveats to consider. Reducing the dose of medications or switching medications can increase the risk of relapse with psychotic symptoms and distress. Adding a reversal agent medication may aggravate psychosis or add additional side effects. Always consult with your doctor before reducing your dose of medication or before you try to quit the medication entirely. 

Other Things To Know (Tips and Treatment Options)

Medication-induced sexual side effects are not permanent, as there are many treatment solutions. The first and most important thing to note is you should not stop taking your medication without contacting your primary care provider. Doing so may contribute to even greater adverse effects as well as potential relapse. To prevent sexual dysfunction you may want to consider:

  • Losing weight if you are overweight

  • Smoking cessation  

  • Stop using illicit substances 

  • Increasing exercise

  • Cut back on drinking alcohol

  • Reduce stress by remaining active in mindfulness or meditation

When it comes to mental health conditions and diagnoses, trial and error of medications are common. Prescription medications for treating anxiety and psychosis often have adverse sexual side effects. It is important to recognize these side effects as well as identify possible solutions when such issues arise. Antidepressant medications and other SSRI medications raise the amount of serotonin in the body, producing feelings of wellbeing and calmness. When our serotonin is increased, our libido (sex drive) may be reduced because the medication prevents hormones in the body to respond to sex. At SokyaHealth, we provide treatment to those in the Alaska, Oregon, and California regions. In addition to in-person services, we also offer treatment via telemedicine, including individual and group therapy, counseling, psychotherapy, crisis intervention, medication management, and life coaching. For more information about solutions and treatments for sexual dysfunction, call us at 866-932-1767. We would love to speak with you!

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