Sexual side effects: A silent epidemic?
March 10th, 2011
11:18 AM ET

Sexual side effects: A silent epidemic?

Ian Kerner, a sexuality counselor and New York Times best-selling author, blogs about sex on Thursdays on The Chart. Read more from him at his website, GoodInBed.

Are meds zapping your mojo? Is a prescription inhibiting your passion? If so, you’re far from alone. More than 27 million Americans  take antidepressant drugs and research suggests that 37 percent of those people experience sexual side effects. And that’s just in the category of antidepressants! When you consider that millions of drugs are prescribed for common medical conditions, such as high blood pressure, and that many of those drugs can lead to sexual dysfunction of some sort, it’s no wonder that nearly 40 million Americans describe themselves as being stuck in sexless marriages.  Many of us may be grappling with a sexual problem and not even realize that a drug or drug combination could be the underlying cause. In this sense, sexual side effects could be a silent epidemic.

But for many people going off their medications simply isn’t an option. In the case of antidepressants, most people who take them are actually happier than they were before they went on the drugs, and while they may be dealing with sexual side effects such as erectile disorder or loss of desire, they weren’t necessarily interested in sex before the medication either. “After addressing your depression, anxiety, or other mental health concern, you're interested in sex again—enough to worry about how the medication is affecting your sex life,” explains my Good in Bed colleague, psychiatrist Dr. Ed Ratush. “You may be bothered by what you think is a lower sex drive, but consider how you felt before. In a way, your libido has actually increased!”

Sexual side effects don’t have to destroy your sex life, but they may mean that you have to change your approach to sex. In the case of low desire (a very common sexual side effect), you may have to put your body through the motions in order to get your mind to follow. Or you may have to spend a lot more time on foreplay and getting yourself physiologically aroused. Ratush suggests trying a sexual warm-up, a technique that helps generate arousal but intentionally does not lead to climax or ejaculation. “The idea is that the process of getting aroused will increase the person's ability to generate more of the sex hormone testosterone later in the day or later in the week,” he says.

And remember that mental stimulation plays a big role in sexual arousal, so you may have to try some new things and develop some new routines.

What are some other things you can do?

  • Talk to your doctor. Sounds simple enough, but many people are uncomfortable talking about sex with their doctors and, believe it or not, many doctors are uncomfortable as well. Not all doctors are adequately trained in human sexuality, and many don’t take the time to discuss all of a patient’s needs. It can be challenging to start a conversation about sex, but it’s worth it: Your doctor may be able to switch you to a similar medication with fewer side effects. Some people find that switching from Celexa to Lexapro, for example, helps treat their depression without affecting their sex life.
  • Reduce your dose. It’s possible that you can still achieve benefits of medication, but at a lower dose that may not induce sexual side effects.
  • Have sex at a different time. Sexual dysfunction may be significantly higher two hours after a dose of medication and may be less problematic two hours before the next scheduled dose, so time your rendezvous accordingly. Or have morning sex: Testosterone levels are generally highest in the morning and decline throughout the day.
  • Add a sexual enhancer. Some medications can improve excitement by increasing either desire or blood flow.  In the case of erectile disorder, for example, a physician may prescribe a medication such as Viagra, or in the case of low desire he or she may recommend a drug like Wellbutrin. It may sound a little strange to deal with the sexual side effects of one drug by adding another, but under the supervision of a physician who is familiar with your medical history, drugs can be combined in creative ways.
  • Focus on diet and exercise. Your lifestyle and overall fitness plays a big role in your sexual health. For example, many people end up gaining weight once they go on an SSRI antidepressant, which also contributes to low libido and erectile disorder.

Dealing with sexual side effects can be tricky and frustrating, but the point is to not just give up. Go on the web and do some research. Be proactive in communicating with your doctor and your partner. Try new things in the bedroom. When you have to say “yes” to drugs, don’t say “no” to sex.

soundoff (59 Responses)
  1. jim

    Waking up to the same person everyday is enough to cause ED in any man. Yuk.

    March 10, 2011 at 11:45 | Report abuse | Reply
    • Sarah

      Haha. You can't get an attractive girlfriend/wife.

      March 10, 2011 at 12:03 | Report abuse |
    • Patrick

      Sounds like someone's blaming others for his "growing problems".

      March 10, 2011 at 12:36 | Report abuse |
    • Valerie

      That works both ways, just so you know.....women are not all that different then men, in that regard......sorry if that hurts your little ego, but it's true............

      March 10, 2011 at 13:12 | Report abuse |
    • naomipriester

      Are you the reason your wife's on anti-depressants?

      March 10, 2011 at 14:05 | Report abuse |
    • Bubba

      Are you kidding? The last thing I see at night and the first thing in the morning is my true love's face. I bet you don't even have a dog.

      March 10, 2011 at 14:59 | Report abuse |
    • druid dude

      while i suspect you're being a jerk because you're unhappily married, what you say is true and goes for both genders and equally so, no doubt. one of the scariest truths for people in this life is that, except in very rare instances, all love is temporary.

      March 10, 2011 at 20:25 | Report abuse |
    • RHinWI

      You sound like a real "winner".

      March 11, 2011 at 08:23 | Report abuse |
    • DavidP

      Any discussion of erectile dysfunction is incomplete without mentioning a common form of erectile dysfunction known as Peyronies Disease (PD). This disease, for which there is no satisfactory treatment, results from formation of penile scar tissue, makes erectile functioning difficult or impossible and is often accompanied by excruciating pain. Approximately 6% of middle age men have this condition. According to Medical News Today, July 2008, almost 20% of men who undergo prostate cancer surgery develop this condition.

      When I developed this condition, I was unaware that a disease like this even existed. In frustration, I started an informational website, http://www.curepeyronies.net Every email I get describes a man in a desperate situation with nowhere to turn. Urologists must do a better job of informing patients about this disorder and there should be additional research efforts to find an effective treatment.

      March 12, 2011 at 07:02 | Report abuse |
    • wsj

      Well jim, that is what happens when you marry your sister.

      March 31, 2011 at 12:27 | Report abuse |
    • Barbara

      You ought to try picking up the same guy's dirty socks and cleaning his toilet. This is real life, not Disney.
      But a lot of people need to understand that real life isn't pretty. There are hard times in all people's life. And there are much better coping mechanisms than drugs.

      April 4, 2011 at 07:13 | Report abuse |
    • Brad

      I disagree, if she is slamming hot and not too dirty! I would give it a go!

      April 7, 2011 at 14:09 | Report abuse |
  2. Linderman

    Must be the Charlie Sheen affect on our labidos.

    March 10, 2011 at 11:55 | Report abuse | Reply
    • Charlie Sheen


      March 11, 2011 at 07:13 | Report abuse |
  3. Jack

    Does anyone find it ironic that there is a Cymbalta advertisement in the top right corner?

    March 10, 2011 at 12:19 | Report abuse | Reply
    • Charlie Sheen

      It's called targeted advertising

      March 11, 2011 at 07:13 | Report abuse |
  4. Sam

    Don't take ssri's.

    March 10, 2011 at 12:22 | Report abuse | Reply
    • FireSunset

      They might be the only thing that helps someone with their severe depression, though. When it's truly severe, people often don't have a choice. They need to get those neurotransmitters rebalanced!

      March 10, 2011 at 16:52 | Report abuse |
    • Sam

      They can potentially cause long-term to permanent dysfunction.

      March 10, 2011 at 17:04 | Report abuse |
    • Sam

      In very severe depression ssri's may be warranted. However, a recent meta analysis concluded they do not work for 80% of depressed patients. They are WAY overprescribed and this is very scary given their serious short-term and long-term side effects. Also, the whole neurotransmitter thing is not conclusive. Psychiatry has a horrible track record with practices like insulin shock therapy, ECT, and lobotomy. One last thing, antipsychotics like Abilify shrink your brain.

      March 10, 2011 at 17:22 | Report abuse |
    • Belinda

      Someone had to say it. I made the mistake of taking SSRIs, worst decision I ever made. And they didn't work anyway.

      March 11, 2011 at 01:45 | Report abuse |
    • FireSunset

      Well, one of them worked well for me, so I advocate them for serious depression, but at the same time, I haven't taken them in years, due to side effects (weight gain, digestive issues, poor sleep) and now deal with milder depression on my own. I fully understand both sides of the issue. Wish they'd come out with something better.

      March 11, 2011 at 04:56 | Report abuse |
    • DavidMichael

      Let me guess, you are a Scientologist

      March 11, 2011 at 17:20 | Report abuse |
  5. Ashley

    None of these articles ever deals with the female inability to climax, even though the desire and 'function' otherwise is there. Moreover, we still don't have a Viagra for women. Where's the equality?

    March 10, 2011 at 13:01 | Report abuse | Reply
    • whatthef

      Its not about equality. A man is usually easier to fix. Just get some blood flowing and he's game. A female's lack of drive isn't quite so easy to fix. Some women suffer from the same blood flow issues but more often than not its mental, hormonal, or some combination of all the above.

      March 10, 2011 at 14:12 | Report abuse |
    • mike

      Try PT-141 or melanotan II. Both are readily available on the web and reportedly work for women as well as men. Viagra isn't the answer, especially for lack of desire.

      March 10, 2011 at 14:13 | Report abuse |
    • ali

      Usually it takes more for a woman to climax than simply having intercourse. If you can achieve an orgasm on your own, bring those techniques to the party. Plus, we get the benefit of multiples... Enough said!

      March 10, 2011 at 14:53 | Report abuse |
    • Meh

      Eat her until it happens...works every time for me

      March 10, 2011 at 15:35 | Report abuse |
    • MikeG

      Viagra doesn't increase a man's libido or his ability to climax.

      March 11, 2011 at 01:41 | Report abuse |
    • JEFF

      You are welcome to start a discussion on the issue. I have been very successful in obtaining this goal through various manual methods

      March 24, 2011 at 18:17 | Report abuse |
  6. equality

    Ashley, the only reliable Viagra for Women is a well versed man. Buy your partner the book; "The Sensual Man" Or, Call Me.. Joel.

    March 10, 2011 at 13:22 | Report abuse | Reply
  7. me

    bad drugs

    March 10, 2011 at 13:42 | Report abuse | Reply
  8. mike

    I've been dealing with this for years. A combination of testosterone and proviron work great. Both are readily available on the internet black market. Just do your research before you start pinning yourself.

    March 10, 2011 at 14:16 | Report abuse | Reply
  9. Glen

    I had the same issue. Turns out, I was on an outdated blood pressure medication. My cardiologist changed the medication my regular doctor was using for my blood pressure, and in about 3 weeks after being on the new medication, all of the other problems were gone. No more magic V pills any more!! Very happy now. No more planning 1 hour ahead for the V to do it's work.

    March 10, 2011 at 15:01 | Report abuse | Reply
    • KL

      Glen ..what was the med you were on?

      March 27, 2011 at 18:27 | Report abuse |
  10. Bubba

    I've been mixing drugs and s ex for years. I use rock-n-roll for the side effects.

    March 10, 2011 at 15:40 | Report abuse | Reply
  11. Denise

    Beware of the SSRIs. My problems got worse after stopping them. I had a reduced libido and function while on them and 2 years after stopping I no longer have any function or libido. Prior to SSRIs I was fine. There are more than 2500 people on record who have encountered the same problem and unfortunately there's not a known cure. They don't tell you about this happening when they prescribe the stuff.

    March 10, 2011 at 16:19 | Report abuse | Reply
    • FireSunset

      I agree with you. I believe that the real percentage is probably more than the 37% mentioned in the article, especially those who were on these medications long-term, or had to try a few different ones. It may be "worth it" for severe depression, but it is a VERY SAD side effect.

      March 10, 2011 at 16:55 | Report abuse |
  12. kevin

    pills making you feel bad? just take more pills !!!

    March 10, 2011 at 18:00 | Report abuse | Reply
    • MikeG

      Haha! Yeah, I love that. Oh, having a problem because you're taking this medication? Maybe this other one will help with that problem. And then when you experience issues with that new drug, we have a drug for that side effect, too!

      March 11, 2011 at 01:44 | Report abuse |
  13. Roz

    Sam, Please explain your remark about Abiify... Thank You

    March 10, 2011 at 18:12 | Report abuse | Reply
    • Steve

      Pleasure to oblige Roz! There has been a recent study that showed rather conclusively that antipsychotic meds like Abilify shrink brain tissue up to 1% a year. Yes, you read that right. The same drug that's being marketed as a "helper" drug on those fluffy commercials that say "abilify may be for you if your antidepressant isn't enough" has been shown to shrink the brain. I don't think I can post links here, so I'll tell you that if you type in "Robert Whitaker bombshell" into google you'll find commentary on the study by Robert Whitaker, whose ANATOMY OF AN EPIDEMIC is the defining book that explodes the myth of psych meds and proves with chilling clarity how these meds make people sicker in the long run.

      March 10, 2011 at 19:52 | Report abuse |
  14. Roz

    Men are fortunate enough to have such drugs as viagra... women suffer in silence. Loss of mojo due to drug s for mental illness is a HUGE problem for women.

    March 10, 2011 at 18:14 | Report abuse | Reply
    • MikeG

      Viagra does not help with a man's "mojo". It does not increase libido at all. In fact, if a man isn't feeling anything viagra may do nothing more than give him a headache and blurred vision.

      March 11, 2011 at 01:42 | Report abuse |
  15. kim

    We be doing it and doing it well me and mines be doing it and doing it well without drugs!

    March 10, 2011 at 19:38 | Report abuse | Reply
  16. Joan

    My libido soared since I've been on Paxil so maybe that's the right SSRI to use:) I have been on it for 7 years now and no complaints other than a bit of weight gain. I would never want to experience the severe anxiety and deep, dark place I went to 7 summers ago, all very suddenly. I resisted taking any meds because I was against the whole idea but I can tell you first handed that my brain chemistry when beserk for no apparent reason. I tried "natural" things first such as hypnosis, deep breathing, talk therapy, SAME, exercise, but I was weeping and having constant anxiety attacks. So, please don't judge anyone who needs to take meds for various problems. A diabetic would never be judged for taking insulin..............

    March 10, 2011 at 21:57 | Report abuse | Reply
    • MikeG

      It's great that it is working for you. But be careful when you decide to come off of it. Do so very slowly over a long period of time. Lots of people have severe persistent side effects from Paxil, too. Just do a search for paxilprogress to see.

      March 11, 2011 at 01:39 | Report abuse |
  17. steve

    is "familiarity" a drug they are referring to?

    March 10, 2011 at 22:28 | Report abuse | Reply
  18. Linda Kay

    The so-called "antipsychotics", also known as neuroleptics, can cause numbness in this area too. I've experience permanent loss, even after being off neuroleptics for over 27 years now. Here is my story:


    March 11, 2011 at 11:34 | Report abuse | Reply
  19. survivor

    Why doesn't CNN tell the real story? There is no medical test for any mental illness. All psychiatric diagnosis are voted into existance by the APA. All thoughout history psychiatry has been a means of oppresion and brutal abuse. SSRI drugs have caused an estimated 70+ thousand suicides. 9 out of 10 mass murders in the last 20 years were committed by people on anti-depressant drugs or were withdrawing from them. Pharma co.'s as a course of doing business heavily rely upon covering up negative studies, and using ghost writen studies to get their drugs FDA approved. The list of crimes and curruption goes on and on... The people who read/hear these facts and respong by saying I/we are scientologists are pharma employees and control freak yuppy trash who have been trained to attack anyone that exposes their lies.
    C'mon CNN stop whitwashing and being deceptive on the issue. Get off your dumb lazy butts and do some real investigative reporting.

    March 11, 2011 at 21:34 | Report abuse | Reply
  20. thierryjtaule

    i can still have s3x but im just not as interested in doing it as much. i used to be way more s3xually active.

    March 31, 2011 at 15:41 | Report abuse | Reply
  21. 10377586

    I've been waking up to the same wonderful woman for 25 years............it takes effort from both to keep things interesting both in and out of the bedroom.............works for us.

    April 2, 2011 at 09:14 | Report abuse | Reply
  22. RodBinNC

    Yep..that's me and my right hand is very angry and depressed too.

    April 3, 2011 at 22:00 | Report abuse | Reply
  23. WOJO

    MIKE G'S comment that V does not help with mojo. If a man is not feeling anything, V may do nothing more than give him a headache, and blured vision. HOW TRUE ! After a concussion from a fall , i took Dilantin, which ate bone mass. Now, i am taking Boneva and Lamotrigine , My doctor gave green light to V . Massive headache and blured vision were the result !

    April 12, 2011 at 20:55 | Report abuse | Reply
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