Sexual dysfunction and low libido is one of the most common side effects of antidepressants. “Depression is one of the most prevalent conditions seen in primary care, and by far the most frequent reason women have sexual problems is the drugs we give them to treat depression,” says Leonard Derogatis, Ph.D., director of the Maryland Center for Sexual Health. (Weil, 2013)

There are several well-established reasons for this. First of all, SSRI antidepressants boost serotonin levels, and high serotonin tends to suppress dopamine. Dopamine is vital for both sexual drive and functioning, so when dopamine is suppressed, so is a person’s libido. This altered hormonal state also tends to blunt emotions in general, which makes it harder to get excited about much of anything. Third, serotonin influences vasoregulation, which is an important part of sexual function: It enables erections in men, and in women, the dilation of blood vessels around the vagina and pelvis, which spurs the production of lubricating mucus. SSRI antidepressants throw off this system. “These medications can similarly diminish blood flow in the pelvis, thereby blunting sexual responsiveness,” says Cat Bohannon, Ph.D. “Erectile dysfunction and its analogue in women are such common side effects of SSRIs that some doctors are now in the habit of prescribing a cocktail of antidepressants and Viagra.” (Bohannon, 2014, p. 54)

They can also cause problems on the reverse end when people try to quit the drugs, leading to an overcompensation and restless genital syndrome, or ReGS. “Many patients with ReGS link SSRIs to the start of their symptoms,” says Bohannon. “Goldmeier and Lieblum published a paper on the link between SSRIs and ReGS in 2008; more papers have followed. In most cases, symptoms seem to start after either reducing dosage or discontinuing SSRIs.” (ibid)

How common are sexual side effects from antidepressants?

Rates of sexual side effects from antidepressants can vary depending on the particular drug, but it’s clear they are quite common. “When Prozac first came on the market, in 1988, the package insert said 1.9 percent of people experienced sexual side effects,” says Anita H. Clayton, M.D., a professor of psychiatry and neurobehavioral science at the University of Virginia. But she and her colleagues began to notice that the prevalence of sexual side effects in the patients they treated seemed much higher than this. So she conducted her own study to better assess how common these side effects were. The results, which she published in 2002, showed more than a third of people on antidepressants suffer sexual dysfunction.

The consequences of low-libido and antidepressant-related sexual side-effects

“America and other nations are prescribing themselves a gradual but gigantic and deadly loss of libido. An ironic end to the Freudian century.”
– Jesse Ausubel, director of the Program for the Human Environment at Rockfeller University (ibid)

These sexual side effects can have profound and far reaching consequences on a person’s life. This is especially concerning when it comes to youth. Parents may not like to think of their children as sexual beings, but the reality is that they’ve been developing sexually since birth. A healthy libido is especially important for teens, who are at a crucial age in terms of sexual development. Adolescence is the time when you explore sexuality and find out who you are, but if your sexuality has been medically stunted, you’re going to pass through this phase without any development taking place. It’s not just a matter of modified hormones, it’s about how a child’s sexual circuitry is shaped for the future. Katherine Sharpe, author of Coming of Age on Zoloft, has documented these concerns. For her book she interviewed a number of her “Gen Rx” peers who grew up on libido-stunting mood-altering drugs. One woman told her, “When I was on those drugs, I had no sexuality. I didn’t even know if I was gay or straight.” (ibid)

Many youth are put on these drugs early in their adolescence and then stay on them throughout their teen years and into their 20s, often for no other reason than taking them has become a habit (and after such long-term use, withdrawal quite painful). The potential for irreparable damage here is huge. Such long-term use during such a developmentally important stage of life may set a child down a libido-less path that they never recover from–no sexual interest, no romance, no desire to date or marry. Although parents may neurotically think that no sex drive in their child is a good thing, they risk denying their child a huge aspect of life itself.

The ripple effects of antidepressant-related sexual side effects are something that many experts worry about. “When you lose your sex drive, it blunts emotions,” says anthropologist Helen Fisher. “If you meet a perfectly wonderful guy at a party that you might have fallen in love with and your emotions are blunted, he may give you his e-mail and you just let him pass.” (ibid)

These medications can also tank existing relationships. “I see a lot of women who are stressed, tired, and who want to be able to function at work and for their families,” says one woman on antidepressants, who is also struggling with low libido. “So they figure taking medication and not feeling sexual is better than being depressed. They end up living with their husbands as roommates.” The strain this has on marriages and relationships can be substantial. “I get a story every week,” says Fisher. “A guy says he had a great marriage for twelve years, and then his wife started taking antidepressants and the union fell apart.” (ibid)