One of the most significant symptoms of antidepressants is also the least talked about: sexual side effects. At least a quarter of antidepressant users are estimated to experience sexual issues, such as decreased libido, delayed lubrication, and difficulty reaching orgasm. Frustratingly, these side effects are often not mentioned or properly addressed by health care providers.

We talked to 8 women about how antidepressants affected their sex life, and how they dealt with it. 

1. Amy Norton

I was taking Citalopram. I didn’t notice a huge decrease in my desire for sex (I've always had a very high sex drive), but after taking the medication for a few days, I totally lost my ability to orgasm. This anorgasmia continued for about a month. After that, I was on the medication for six and a half years in total and problems with orgasm were present for pretty much that entire time. I COULD come, but it took a long time and a high-powered toy, and often felt like “more effort than it was worth.” 

I knew it was possible I would lose my sex drive, as I'd briefly been on Prozac when I was 18 and that completely killed…well, everything. My desire for sex, my appetite, my energy levels. I did not know that anorgasmia was a potential side-effect.

I did talk to my doctor and they were worse than useless. They pretty much told me I could either have orgasms or not be depressed. They made me feel broken and weird for even caring about the sexual side effects. Our society so often forgets that people with disabilities, chronic illnesses or mental health conditions are still people, and most of us want and enjoy sex. Sex isn't an optional extra that can be scrapped if medication happens to mess with it! Eventually, I just kept experimenting with different types of touch by myself and with my partner until my ability to orgasm returned, and accepted long-term orgasm difficulties as my new normal. 

Sexual side effects are real and they matter! They’re not just something you have to put up with in order to access medication. Talk to your doctor, and insist that they take these issues seriously. Advocate for yourself. There's no shame in taking medication — seeking help is the most awesome thing you can do!

2. Jayne Renault

I was prescribed Citalopram, as well as occasional, albeit high doses of benzodiazepines to counteract the anxiety that was exacerbated by the antidepressants. It reduced the frequency and intensity of my desire to engage in sex (partnered or masturbation). For the first time in my life, I had to choose to work on getting excited about the possibility sex. Suddenly, engaging with a partner had become so much work and touching myself was a frustrating chore rather than a comforting release. It made it nearly impossible to orgasm. I’d been in touch with my sexuality and enjoyment of sexual pleasure from a very early age. I orgasmed easily and often by myself, and fairly consistently with others. But shortly after I went on antidepressants, I pretty much had to square off the possibility of partner orgasms completely because it took crazy amounts of concentration, intent, and effort to get there with myself, never mind someone else. With a new partner? Forget about it.

And it wasn’t just the sex drive. I lost my drive to do pretty much anything. I knew that I had to stabilize in order to start and sustain the complimentary cognitive therapy, but that necessary numbness was not the most enjoyable sensation. After a lifetime of extreme emotions and hypersexuality, I had a massive identity crisis. Like, who am I if I don’t emote or orgasm? Luckily, my doctor warned me of it right before I started taking them. I’m as certain as I can be that if I hadn’t known about that going in, I would have gone through even greater existential crises trying to figure out what was wrong with me. 

I didn’t engage very often in partnered sex for the couple of years that I spent working intensely on getting a handle on my mental illness. But I never let myself go too long without masturbating. I started to explore different styles and techniques — using my hands in different ways, new toys, different porn, etc. If it was going to take forever to get off even with the most tried and true method, why not find new ways to get there? 

I was on the medication for about 4 years before I started to wean off of them. It took a lot of work to adjust to the changes and acknowledge that it was for the greater good and long-term success. If I hadn’t had the support of an amazing therapist, it would have taken a lot more time and effort to get to that point of acceptance. And though it was part of the identity crisis, I think it also helps that my sexuality was such a significant part of me — I fought to get it back.

My sex drive has never really recovered. After I came off antidepressants, it didn’t really bounce back to what I remember it being. I would never have been able to conquer my depression if it hadn’t been for the antidepressants. But it’s taken a lot of ongoing conscious effort to adjust to what they took away from me.

3. Amelia Davis 

Antidepressants stifled my sex drive pretty much completely. I was taking a combination of Lexapro and Abilify for about four years. I thought it was just that I was new to sex but I hardly enjoyed sex at ALL and I didn't orgasm until after I stopped taking them regularly. When I wasn't taking them anymore my sex drive flew through the roof because I actually started enjoying sex. 

When I stopped taking them altogether I started craving sex way more and masturbating and having a way healthier relationship with sex that I actually enjoyed and really liberated me in a way. I was aware that sexual side effects could happen, but I was a virgin when I first started taking antidepressants so it wasn't a huge concern for me.

Antidepressants can be great if you find the right combination and know what works for you, but my least favorite thing about them is they made me so *dull.* I didn't have really low lows, but I didn't really enjoy things that much either. They really flattened me out. I wasn't so sad anymore, but I definitely wasn't so happy either.

4. Anne Stagg  

I’ve been on antidepressants for almost 20 years. I’ve struggled with depression and anxiety from an early age. I was prescribed Citalopram in 1999 for depression by my general practitioner. In retrospect (now that I’m a trained therapist) it’s infuriating to think that I sat in front of a medical professional, described symptoms of severe depression and PTSD and the doctor said, “Here’s a prescription for an antidepressant, try this out, in about two weeks you’ll feel better. Try to get more exercise.” No referral to therapy, no discussion of side effects, and definitely no mention of sex. I was out as bisexual (there wasn’t a word for pansexual at the time) and my doctor largely employed a great deal of side-eye and blushing when she brought up questions about sexual health. 

Despite not receiving any talk therapy, my symptoms did get a little better. After two months I was feeling more like myself and that is when I first noticed that my sex drive was gone. When I did do it (either with my girlfriend or on my own) I couldn’t get wet and I couldn’t come. It was awful. 

I stayed on Citalopram until 2004 when it became clear the antidepressant wasn’t working. By that point I had found a doctor who was worth a shit and a psychologist. They prescribed me Lexapro, and indicated that sexual side effects were linked to this medication as well, but were less so than Citalopram. I’ve been on Lexapro since August of 2004.

I spent a year focusing on my recovery, and that included learning about how to relate to my body. Lexapro continued to deaden my experience of arousal and my ability to orgasm. It was so strange, because I wanted to express myself sexually. Intellectually I desired sex and fantasized about it, and I experienced glimmers of arousal, but my body still couldn’t come. My doctors and my psychologist and I started to plan for me to come off the antidepressant, because I didn’t want to sacrifice that part of myself any longer. But in October of 2005 I was diagnosed with Systemic Lupus Erythematosus. We made the decision that staying on Lexapro was critical as I was now going to have to live with a potentially life-limiting, chronic illness. 

Through therapeutic work and my own internet research I started to explore mind/body connection. Talking it over with my psychologist, I started using the tools that helped me re-ground during my PTSD flashbacks to stay present and focus on my pleasure when I masturbated. I bought myself a dildo, a vibrator, and a lot of lube and became my lover. It was a life-changing experience. 

Let’s face it, having a chronic illness sucks, and I need the additional biochemical support because depression and chronic illness are too much for anyone. It takes time and patience, but I can experience physical arousal and desire again. The first time I managed to get wet on my own I wanted to throw a goddamn party.

5. Anouszka Tate

I was put on amitriptyline in the summer of 2016. Despite a long history with depression — which I’ve always dealt with without medication — I initially wasn’t actually put on amitriptyline for my mental health. I was paralysed by a freak autoimmune syndrome and, amongst a lot of other heavy-duty medication, was given amitriptyline predominantly as a painkiller and sedative to help me sleep through the pain at night. 

At the beginning of 2018 I managed to wean myself off all my medication. However, both because amitriptyline is highly addictive and because of my existing mental health issues, I struggled to stop taking that pill, and will likely be on it for a long time now. It was at this point that I had the time and brain space to stop and think about why on earth I didn’t feel bothered about having sex anymore. Sex had always been such a huge part of my life, it was vitally important to me in relationships, it was how I connected and showed affection. The lure of it was just as important to me when I was single, I loved the excitement and butterflies leading up to sleeping with someone for the first time. Those things are huge parts of who I consider myself to be.

I was taking amitriptyline to dull both mental and physical pain…and the only way I can describe my loss of interest in sex is in the same way — it was dull, it was numb, it was subdued, it was suppressed. It wasn’t that I was repulsed by sex; I had no emotions towards it whatsoever.

I did know that sexual side effects were a possible symptom, which is partly why for a decade I chose to work through my mental health issues without mediation. Knowing how much sex played a part in who I feel I am as a woman meant sacrificing that felt like too big a cost. However, it took me a long time to make the connection in this case because I wasn’t actually taking amitriptyline for my mental health, so I wasn’t thinking about it as an antidepressant!  

As soon as I made the connection between taking antidepressants and my loss of desire I decided I had to manually override it! Even though at first I absolutely didn’t feel like it, I actively made myself go on dates, meet new people, in the hope that any tiny flame of my former self would be reignited…and it has been! Putting myself back in sexy situations has brought memories of how much I love that skin on skin contact back at the forefront of my mind, so I’m naturally craving it more now.

6. Rachel Woe  

I fell into a deep depression my senior year of college. I’ve struggled with social anxiety and depression since I was a child. The nurse practitioner at the university medical center convinced me to try Prozac. I was reluctant because I knew antidepressants could make it difficult or even impossible to orgasm, but it was my last semester and I could tell things weren’t going to improve on their own. I took Prozac for three days and then had to quit. I couldn’t stay awake. I was accustomed to masturbating once a day or every other day, but that desire vanished. I felt like a libido-less zombie. 

Fast forward four years. I was still depressed and anxious and living a very small, insular life. After seeing how antidepressants had improved things for one of my closest friends, I decided to ask my doctor if I could try Zoloft. I’m still taking it. My doctor told me there would probably be sexual side effects, but that they would likely improve with time. This has been the case for me, though I wouldn’t say things have gone back to “normal.” Prior to taking Zoloft, I was the sort of person who could have five, seven, even ten orgasms in one masturbation session if I kept at it. For the first three months, I found it difficult to achieve even one orgasm, let alone two. I also found I wasn’t very interested in sex or masturbation. Seeing as how I’m an erotica writer, that was bad for business.  

I haven’t been sexually active with a partner since I started taking Zoloft a little over a year ago. However, my sex life with myself is back to being quite active. I can’t come as frequently as I once did, but my orgasms are longer and way more intense. Nowadays I’m able to achieve orgasm by myself with ease, though it takes a bit longer, and two is my upper limit unless I wait around for twenty or thirty minutes between stints. I do miss being able to spend an entire afternoon with my hand between my legs, and I’ve had to get better at pacing myself. But overall, I’d say the changes to my sex drive have been beneficial. Especially when paired with the overall mental and emotional benefits.

7. Jamie Jenkins   

I have a pretty high sex drive naturally. I am not sure if this is due to hormonal issues — I have polycystic ovarian system, which causes increased testosterone in women. When taking Prozac I had zero sex drive. When I took Trintellix, this exacerbated my already high sex drive. There were times while taking this that I felt hypersexual, and almost could not control my urges or needs for sex. The two years I have been on Trintellix I have had almost 30 different partners. The maximum time I think I had gone without sex during this time was three weeks and it was a struggle. I still had to masturbate daily. Sex was all I could think about, and it became almost impossible to focus on anything else, including my own mental health, my job, my happiness, my friendships. This caused me to engage in a lot of unhealthy relationships, and sometimes very unhealthy sexual behavior. This unfortunately just perpetuated my depression and anxiety. This was a scary time for me. I felt very overwhelmed mentally, physically, like I didn’t have control over my own body. I’d even go as far as to say I felt like my body was turning on me. Last but definitely not least, I noticed decreased sensation in my clitoris and had a harder time to orgasm from clitoral stimulation. It had been much easier for me prior to that. It WAS possible, just very hard to achieve and required a lot of build up and foreplay. 

Taking antidepressants should not be stigmatized and there is 100% no shame in talking about your medication and your efforts to improve your mental health. I recently have started just openly telling my friends about my depression/anxiety and about my antidepressants. It feels good to just say things like “my depression” or sharing about the medication I am on. For me being open about it helps. You can still enjoy sex while taking antidepressants! Even though things have changed in your body there are ways to still feel pleasure or reach orgasm. 

8. Ally Masterson 

I’ve been on many antidepressants. But Prozac was the worst for me in a lot of ways. I lost all my libido first, but then I also lost all appetite and was nauseous almost half of every day. I lost sooo much weight in a short time that I didn’t need to lose. I also experienced emotional numbness, so I didn’t feel depressed anymore, but I also didn’t feel happy. I felt nothing. 

Sexual side effects were never mentioned by my doctor, but online research had loss of libido as a side effect along with a long list of others, so for me it was sort of overlooked. When I told my doctor he suggested giving the drugs a few more weeks. I just couldn’t. I’m a person who loves sex, has a high sex drive, and it was like I lost part of my identity that I enjoyed. I also hated feeling nauseous and not having an appetite. So I just stopped taking them and forced him to move on with my medication plan. 

Antidepressants work differently for everyone. You may have to try a few different kinds and different dosages for a period of time. It can be frustrating, but worth it when you find the right one. Make sure you trust your psychiatrist, or general practitioner, and feel that you can be totally open with them. 

/Shutterstock.com