What to Do If Your Antidepressants Are Killing Your Sex Drive

Antidepressants can be life-saving medications—and chances are, you know someone who has used them to reduce the symptoms of depression, anxiety, post-traumatic stress disorder, chronic pain, and other potentially debilitating conditions.¹ About 13% of adults in the United States reported taking antidepressants in the last month, according to the most recent data from the Centers for Disease Control and Prevention (CDC).² Due to the emotional weight of the pandemic, that number may continue to rise, research suggests.^3,4

Like any other medication, antidepressants come with potential downsides, namely in the form of side effects. This can include issues like headaches and nausea, but when it comes to selective serotonin reuptake inhibitors (SSRIs)—the most commonly prescribed antidepressants—one of the most prevalent and upsetting side effects is a low sex drive.¹

Megan, 35, started experiencing this when she began taking sertraline, a popular SSRI, three years ago. “It’s basically decimated my libido,” she tells SELF. “It’s pretty frustrating. I am currently single, but when your libido is at zero, it can be hard to muster up that extra incentive to go out on a date when you’d rather chill and stay home.”

Megan has “thought about trying to switch to different meds” but her current antidepressant has worked well for her beyond this side effect. “I was struggling with really terrible anxiety and depression when I first started taking it, and it honestly changed my life,” she says. “I don’t know if I want to go through the hassle of messing with other medications and risk feeling terrible again in order to regain my libido.”

This experience is all too common, and “it can cause people to stop taking their antidepressants,” Tamar Gur, MD, PhD, an assistant professor of psychiatry, neuroscience, and obstetrics and gynecology at the Ohio State University Wexner Medical Center, tells SELF.

Experts stress you shouldn’t quit taking antidepressants suddenly for any reason—low libido included. That doesn’t mean you don’t have options, though. Here’s what you should know if your meds are, well, killing the mood.

There’s a link between antidepressants and low libido, but the reason why is a bit unclear.

Research shows there’s an association between taking certain antidepressants and having a lowered sex drive, but this can be a little complicated to parse from person to person. “Depression in and of itself can cause sexual dysfunction,”⁵ Lauren Streicher, MD, a board-certified ob-gyn and the founder and medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause, tells SELF. “It’s always tricky to know: Is the sexual dysfunction because of the depression itself or the drug?”

Some research suggests that anywhere between 50 to 70% of people diagnosed with depression may also deal with sexual dysfunction—a medical term that refers to persistent and distressing issues with sexual response, desire, orgasm, or pain. People with vaginas are more likely to deal with this than people with penises, but it can affect anyone of any gender identity.⁶

Taking antidepressants may complicate things if your sex drive is already struggling, but the effects can vary. Some people notice a lower libido when taking the meds, while others may experience improvement in their sexual desire. More research is needed to understand this distinction, but it seems to depend on the type of antidepressant a person is taking, the dosage of the medication, and their individual response to it.⁶ Research even points to genetics as a potential factor.⁷

“It is not universal,” Mary Jane Minkin, MD, a clinical professor of obstetrics and gynecology and reproductive sciences at the Yale School of Medicine, tells SELF. “Some people will have zero problems, and some will be severely affected.”

For example, one 2014 meta-analysis of 63 studies that included more than 26,000 patients treated with antidepressants found that people who took bupropion (Wellbutrin)—a norepinephrine-dopamine reuptake inhibitor (NDRI)—had a “statistically significantly lower risk” of sexual dysfunction compared to placebo, while those who took escitalopram (Lexapro) and paroxetine (Paxil)—both SSRIs—had a “statistically significantly higher risk” of sexual dysfunction.⁸

Sexual arousal and function are pretty complicated because every human operates differently physically and emotionally, Dr. Gur notes, but the association between certain antidepressants and low libido seems to be related to serotonin, a neurotransmitter that acts as a mood stabilizer; that’s why it’s often referred to as a “feel-good” chemical. Low serotonin levels can set the stage for depression for some people—and SSRIs, in particular, work by boosting serotonin in the brain.⁹

Serotonin also plays a role in sex, Dr. Gur says. “It’s a very complex system, but the increase in serotonin from SSRIs may be related to sexual dysfunction,” she says. One possible reason why: Boosting serotonin may inhibit desire because it can interfere with your body’s ability to become aroused.¹⁰

What should you do if you believe your antidepressants are tanking your sex drive?

If you’re taking SSRIs for a mental health condition, odds are high that you’re already dealing with some tough symptoms. Tossing in a lowered sex drive doesn’t feel great for many people, Dr. Gur says, especially if it impacts the way you feel about your body or your relationships.

However, she stresses that the reaction to this side effect is also “not one-size-fits-all.” “I’ve had patients who tell me, ‘My sex drive is not the end-all-be-all [and] what’s important to me is that I’m able to get through my day with as positive of an attitude as possible, and that my partner and I have ways of getting around it,” she says. “I have other people who come to me and say, ‘If I don’t have my libido, no day is okay.”

If you have a lower sex drive and you suspect it is due to your antidepressant use and it’s not bothering you, then you don’t really need to change anything. But if your libido is suddenly much lower and it’s upsetting you, affecting your day-to-day life, or harming your relationships, Dr. Streicher says it’s time to talk to have an open conversation with your doctor. “This is not a DIY project,” she says. “You really need to work with the person who has prescribed it.”

Your doctor should go over your medical history first to get a sense of when you started taking the antidepressants, when you started noticing a change in your sex drive, and different factors that could potentially play a role in your low libido, like stressful life changes, underlying health conditions, or other medications or substances you’re taking, among others.

Once they have a better idea of all the pieces that could fit into this puzzle, here are a few steps they may recommend taking if the antidepressants feel like the likely culprit:

Give the medication more time first, if you’re open to it.

This won’t be doable for everyone, but if you feel like you can ride out certain side effects, including low libido, for a little longer, that’s an option worth considering—especially if the medication you’re taking has stabilized other concerning issues, like a really low mood or unpredictable panic attacks.

“Sometimes, it just gets better on its own,” Dr. Streicher says, adding that it can take time for your body to get “used to” a new medication. “When people have been taking medications for a while, their body can simply accommodate over time and sexual desire gets better.” This typically takes anywhere between two and six weeks after starting a new prescription, she notes. If you’re riding it out any longer than that and still working with a lackluster libido, it might be time to try another game plan.

Adjust the dose of your antidepressants.

If you’re on a high dose of an antidepressant, you may be more likely to experience a lowered sex drive, as well as other side effects, that you may not experience with a lower dose of the same antidepressant, Dr. Streicher says. This is a conversation to have with your doctor—and definitely shouldn’t be something you do on your own. Your doctor initially prescribed your specific dose for a reason, and lowering it on your own may lessen the effectiveness of your medication, she says.

Consider switching your antidepressants completely.

Remember, some SSRIs seem to have a lower risk of sexual side effects compared to others, but this will ultimately depend on the individual. “Just because someone has a reduced libido on one SSRI doesn’t mean they will have a reduced libido on all SSRIs or other antidepressants,” Dr. Streicher says.

All of the experts SELF spoke with say switching to bupropion—which is not an SSRI but still very effective as an antidepressant—is another option. Dr. Minkin says bupropion, in her professional experience, has been “the best antidepressant” to switch a patient to if they’re having libido issues.

Again, it’s in your best interest to be open with your prescribing doctor and follow their lead, given they know the ins and outs of your medical history. You should never suddenly stop taking your antidepressants—this can lead to intense anxiety, insomnia, headaches, flu-like symptoms, and a swift return of concerning depression symptoms, among other side effects. Work with your doctor to either adjust the dosage or create a plan to switch your meds safely.

Above all, Dr. Gur stresses that you shouldn’t just try to move on if having a lower libido truly bothers you and affects your life. “Absolutely advocate for yourself and talk to your doctor about it,” she says. “If it’s causing you distress and you’re not satisfied with your sex life because of a medication you’re on, it’s important to speak up. It’s really about you and what you want.”

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