Can Depression Cause ED?

Can depression cause ED? Here’s everything you need to know.

Research suggests there’s a bidirectional relationship between depression and erectile dysfunction (ED). If you have ED, your risk of having depression is higher. Similarly, battling with depression increases your risk of ED.

If you’re dealing with depression, you already know it can negatively impact many aspects of your life, maybe even your sex life. You may have a loss of interest in everyday activities or feel like your quality of life has decreased.

If you’re dealing with ED, you may feel like your self-esteem has taken a hit, or you feel reluctant to have sex because of what you’re managing inside your head.

If you’re battling with depression and also experiencing ED, keep reading to explore the connection between the two issues and find out what treatment options are available.

What’s the link between depression and ED?

Many factors can contribute to ED, like chronic health conditions or certain medications. ED can also have psychological causes like depression.

Research from 2018 on the connection between these two conditions evaluated several studies to find that depression is a risk factor for ED. Patients with depression had a 39 percent higher risk of erectile dysfunction. The review also found that patients with ED had an increased risk of developing depression.

Although the connection between depression and erectile dysfunction isn’t fully understood, researchers believe the causes of depression-induced ED could include reduced sexual desire or antidepressant treatment.

Severe Depression Decreases Sexual Desire

Depressive symptoms can include a low mood and negative thoughts, which could lead to low self-esteem or sexual performance anxiety, thus causing erectile dysfunction. Depression can also decrease your desire for sex.

Sexual Side Effects of Antidepressants

Antidepressant treatment is another possible cause of erectile dysfunction. There are several effective treatments for major depression; antidepressant medications are a common option these days.

Antidepressant drugs can treat disorders like depression and anxiety. They change the levels of certain natural chemicals (neurotransmitters) in your brain and body.

Common types of antidepressant drugs include:

• Selective serotonin reuptake inhibitors (SSRIs)

• Serotonin-norepinephrine reuptake inhibitors (SNRIs)

• Tricyclic antidepressants (TCAs)

• Monoamine oxidase inhibitors (MAOIs)

Many of these antidepressants cause sexual side effects. Sexual dysfunction is a common side effect of antidepressants, resulting in decreased libido and difficulties developing and maintaining an erection for men.

In addition to increasing your risk of erectile dysfunction and reducing sexual desire, certain antidepressants can also cause orgasmic dysfunction (an absent orgasm, delayed orgasm, or difficulty with ejaculation). For example, the active ingredient in Lexapro® may cause abnormal or delayed ejaculation.

Many antidepressants can cause sexual side effects — referred to as antidepressant-induced sexual dysfunction or SSRI-induced sexual dysfunction.

The medications associated with these types of side effects  include:

• Citalopram (Celexa®)

• Fluoxetine (Prozac®)

• Sertraline (Zoloft®)

• Duloxetine (Cymbalta®)

• Escitalopram (Lexapro)

Not everyone experiences the sexual side effects of antidepressants. However, a review of studies found that between 30 and 60 percent of people prescribed SSRIs experience some adverse sexual effects.

How do you know if you even have depression?

To understand how depression affects ED, you should know some key facts about this common mental health condition.

Despite the stigma surrounding mental health, depression is a common illness. An estimated 21 million adults in the U.S. experienced a period of depression in 2020.

Major depressive disorder — also known as clinical depression or simply depression — is a common mental health disorder. Depression can occur at the same time as other mental disorders like anxiety or medical conditions like heart disease, chronic pain, and cancer.

Symptoms of depression may not be as clear as other conditions — like the symptoms of a panic attack, which can include shaking, sweating, or chest pain.

Depressive symptoms typically include:

• A persistent feeling of sadness or emptiness

• Feeling hopeless or believing your situation won’t improve

• A pessimistic or helpless outlook

• Frequent feelings of irritability and annoyance

• Fatigue and generally decreased levels of energy

• Difficulty falling asleep or oversleeping

• Losing interest in hobbies and other activities you used to enjoy

• Suicidal thoughts and/or suicide attempts

Depressive symptoms can vary in severity, from mild to overwhelming and severe depression. They can also vary based on the type of depression. Those with bipolar disorder, for example, experience depressive episodes as well as manic episodes (periods of a high, elevated mood).

Just as depression can affect your mood and outlook on life, it can also affect your sexual health.

How do you know if you have ED?

If you’re having difficulty getting an erection or maintaining a firm enough erection to have sexual intercourse, you might have erectile dysfunction.

Signs of ED include:

• Inability to get an erection whenever you’d like to

• Ability to get an erection but unable to sustain it throughout sex

• Getting an erection only sometimes, despite a desire to have sex

Our guide on how to know if you have ED goes into more detail about common signs of being affected by erectile dysfunction.

While it might seem like you have to choose one or the other, you can treat both depression and erectile dysfunction. These treatments can include:

• Adjustments to your antidepressant regimen

• ED medications that increase blood flow

• Therapy

Adjustments to Your Antidepressant Regimen

If you’ve recently started using an antidepressant and are experiencing antidepressant-induced sexual dysfunction, you shouldn’t immediately stop taking the medication. This can cause withdrawal symptoms, known as antidepressant discontinuation syndrome, or cause your depression to worsen.

The first step is to talk to your healthcare provider about your symptoms. They may suggest switching to a different antidepressant, adjusting your drug dose, or going on a “drug holiday,” which is simply not taking your antidepressant or reducing the drug dose when you plan to have sex.

Your provider might suggest waiting to have sex until your treatment is done if you’ve been prescribed a short-term treatment.

ED Medications That Increase Blood Flow

Your healthcare provider may also recommend an ED medication that you take at the same time as your antidepressant. Sildenafil (the active ingredient in Viagra®) has been found to help improve erections and other aspects of sexual function for many men who use antidepressants.

Other common erectile dysfunction treatments can work with antidepressants and include drugs like tadalafil (Cialis®), vardenafil (Levitra®), and Hims Hard Mints, which feature the same active ingredients in Viagra and Cialis at different dosages.

Therapy

Another treatment option for depression and erectile dysfunction is psychotherapy or talk therapy. This can be especially helpful if the cause of your ED is related to psychological factors. One of the most effective types of therapy is cognitive behavioral therapy (CBT), which helps you recognize negative thought patterns and how they affect you.

Can depression cause erectile dysfunction? There’s a good chance your ED could be a symptom of depression. Remember:

• There’s a bidirectional relationship between depression and ED. It’s possible that depression can cause ED, and ED can cause depression.

• A sign of depression is no longer having an interest in your usual activities, including sexual activities. Other symptoms include negative thoughts, low self-esteem, and a lack of energy. All of these could certainly contribute to sexual function issues, such as a loss of libido or lowered sexual desire, and cause you to struggle with getting or maintaining an erection.

• Antidepressants can also affect your erections. If you’ve been taking antidepressants for your depression symptoms, you could be experiencing sexual side effects — like erectile dysfunction.

Fortunately, interventions for depression and erectile dysfunction don’t have to be an either-or situation. You can find relief from both issues through common erectile dysfunction medications, therapy, or both. Contact a healthcare provider to learn more.

Want to learn more about the connection between your mental health and ED? Explore the relationship between PTSD and erectile dysfunction and find out how stress contributes to ED.