How does depression affect sexuality?

The brain is the body’s most sensitive "sex organ." Sexual desire starts in the brain and works its way down. Chemicals in the brain called neurotransmitters help brain cells communicate with each other in order to stimulate blood flow to the sex organs. In a person with depression, these chemicals are out of balance. As a result, sexual desire is low or nonexistent. In addition, low levels of some of these chemicals can dull pleasurable feelings. The strain that depression places on relationships can further interfere with sexual function and pleasure.

It is estimated that 35 percent to 47 percent of people with depression experience some sexual problems. The severity of the problem depends on the severity of the depression and the presence of anxiety. For those with more severe depression, 61 percent have sexual problems.

How do antidepressant medicines cause sexual problems?

Although antidepressant medicines are highly effective in helping you feel normal again, many of these drugs, such as SSRIs, have undesirable side effects, including causing sexual problems. For both men and women, this means being unable to initiate, participate fully in or enjoy sex—and that can lead to a crippling loss of self-confidence that can, in turn, undermine depression recovery.

It’s estimated that a third of people taking antidepressants experience decreased desire and difficulty achieving orgasm. Some antidepressants may make it difficult for a man to have an erection. These side effects tend to increase with higher doses of antidepressants.

Antidepressant medicines work by restoring the normal balance of chemicals in the brain, which—in turn—improves communication between brain cells, reducing depression symptoms. Unfortunately, altering these chemicals can also cause sexual problems.

What can be done to treat sexual problems?

There are ways to help manage the sexual side effects associated with many antidepressant medicines without compromising treatment. These include switching to drugs that have less effect on sexual function. Some newer antidepressant medicines—such as Survector^® (not available in the United States), Wellbutrin^®, Remeron^®, and Serzone^®—cause fewer or no sexual side effects.

To better cope with the debilitating effects of depression, as well as the sexual side effects of treatment, you should be open and honest with your doctor and your sexual partner. Most people choose to continue treatment once they realize that the sexual problems they are experiencing are associated with the medicines and can be overcome.

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