Antidepressants Dulled Your Sex Life?What Research Shows Helps Women
Intimate HealthArticleLow desire, trouble with arousal or orgasm are common side effects of SSRI and SNRI antidepressants, and they lead many people to stop treatment. A Cochrane review found adding higher-dose bupropion was the most promising approach for women. Sildenafil helped in one trial of younger women, though the overall evidence for women is uncertain.
Sexual side effects of antidepressants are common, and they’re a frequent reason people stop treatment too early.1 If your mood has improved but desire, arousal or orgasm hasn’t, here’s what research has tested.
What a Cochrane review found
The review looked at 23 trials with about 1,900 people, most testing an added medicine.2 Most options were studied only once, so the evidence is limited.2
- Bupropion added at a higher dose (150 mg twice daily) showed benefit over placebo in men and women; a once-daily dose didn’t show a clear benefit.2 The reviewers called higher-dose bupropion the most promising approach for women so far.2
- Sildenafil for women: uncertain overall.2
- Other add-on medicines didn’t show significant improvement.2
- Switching antidepressants or taking “drug holidays” hasn’t been tested in good trials with today’s medicines.2
- None of the tested strategies worsened depression in the trials, though numbers were small.2
The sildenafil trial
In one U.S. trial, 98 women (average age 37, before menopause) whose depression had improved on SSRI-type medicines took sildenafil or placebo before sex for 8 weeks.1 Sexual side effects improved more with sildenafil, and depression stayed in remission.1 Headache, flushing and indigestion were common.1 Whether results apply after menopause wasn’t tested.
What this means for you
- Tell your prescriber. These side effects are common and worth addressing.
- Ask about options such as adding bupropion, adjusting the dose or timing, or switching, and the trade-offs of each.
- Check menopause factors too, like vaginal dryness, which may add to the problem. See vaginal moisturizers and lubricants and flibanserin for low desire.
Our guides to antidepressant sweating and low mood in menopause cover related concerns.
Try: “My antidepressant is helping my mood, but my sex drive and orgasms are gone. What are my options without risking a relapse?”
Down There, Decoded includes a Down-There Log and a See script for appointments. Use them to note when sexual changes started relative to your medicine and dose changes. Explore the intimate-health playbook.
This article is for general educational purposes only and is not medical advice. It isn't a substitute for diagnosis or treatment from a qualified healthcare professional who knows your health history. Please don't stop, skip or change an antidepressant on your own, since stopping suddenly can cause withdrawal symptoms or a return of depression. Sildenafil can interact dangerously with nitrate heart medicines. If you have thoughts of harming yourself, call or text 988 in the U.S., or call 911 or your local emergency number right away. This article discusses published research. Girl Playbook does not endorse any specific product, test, or provider.
Girl Playbook sells this book. It provides education and worksheets, not individualized medical care.
Sources
The research behind this article, in the order it’s cited. How we source our articles.
- JAMA (abstract via PubMed), 2008Sildenafil treatment of women with antidepressant-associated sexual dysfunction: a randomized controlled trial (opens in a new tab)abcd
- Cochrane Database of Systematic Reviews (full text via PubMed Central), 2013Strategies for managing sexual dysfunction induced by antidepressant medication (opens in a new tab)abcdefgh
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