Will Anxiety Meds Hurt My Sex Life?

If your anxiety is so intense it seems tangible, or your depression dips too deep, you’re likely to be prescribed SSRIs, a family of medications that ease either or both conditions.

Some women, however, find their libido might decrease or they struggle to orgasm.

If you are struggling with these issues, don’t give up on SSRIs quickly if they’re easing your depression or anxiety.

The dip in arousal is often temporary. In some cases, your sexual health will readjust once your body gets used to the new prescription.

What Do SSRIs Have To Do with Sex Drive and Function?

SSRIs are commonly used to treat depression and anxiety but, like most medications, they can lead to side effects.

One is low libido. Studies report that 20 percent to 70 percent of women who benefit from SSRIs have one or more of these sex-related side effects:

• Less interest in sex
• Less likely to become aroused
• More difficult to remain aroused
• Trouble reaching orgasm

SSRI stands for “selective serotonin reuptake inhibitors.” That second “S” is the key: It stands for serotonin, which is one of the human neurotransmitters. Serotonin sends messages to your brain about all kinds of things, including mood, muscle stimulation, appetite and sleep. Libido, too.

Too little serotonin can lead to depression and/or anxiety. SSRIs such as sertraline, paroxetine and fluoxetine essentially adjust your serotonin levels to behave as if they’re not too low.

That, in turn, can affect other neurotransmitters such as dopamine, a neurotransmitter related to areas like pleasure, among other areas. Everything in the body works in concert, so when one element, such as serotonin, is off, others are affected, too.

How To Get Your Sex Drive Back on SSRIs

Depending on you and your relationship status, you might not mind feeling less sexual. Or, you might find it’s worth the price not to be depressed or exceedingly anxious.

Note that other factors tie in. For example, the older you are, the more likely you’ll feel less sexual anyway. Libido often wanes with age.

However, if your level of desire or ability to orgasm fizzles on SSRIs and stays that way, and that’s not OK with you, try a workaround — always under a doctor’s care.

• Lower the dose. If your sex drive remains dormant after two to eight weeks, talk to your doctor about decreasing the amount you take every day.
• Add another drug. Some medications boost libido. Ask about supplementing or replacing your SSRI with bupropion or buspirone, which are also used to ease depression or anxiety but can increase desire.
• Consider libido-boosting meds. The FDA has approved two drugs designed to lift the libido —  bremelanotide and flibanserine, known as “the pink pill.” Studies warn against adding these into a mix with SSRIs, so look into trying a different type of antidepressant or anti-anxiety substance instead.
• Talk about testosterone. Ask your OB/GYN about testosterone therapy. Some studies show that it can help post-menopausal women feel more sexual.
• Take a drug holiday. In some cases, your medical provider can ease you off an SSRI for a break, then ease you back on.
• Examine your relationship. Your lack of enthusiasm for intimate relations might be more about how you and your partner interact than about the chemicals in your brain.
• Talk it out. Talk to a therapist, and make lifestyle changes based on what you learn. The joint actions might help you conquer issues that affect your desire.
• Consider other bodily changes.  As women age, they tend to self-lubricate less during sex. That can lead to discomfort during intercourse and ultimately less interest in sex. That and other physiological developments curb your enthusiasm for sex.

Before taking action, assess your situation to see if tinkering is worth the risk. If your depression or anxiety is severe, especially if you’re suicidal yet well-controlled on an SSRI, put your mental health first.

Give the SSRI time. After a couple of months, talk to your doctor about altering the dosage, adding another drug, adding toys to your sexual relations -- whatever you can try without tinkering with an effective medication. Every case is different, so be patient as you and your doctor attempt different possible solutions.