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Can Depression Cause Erectile Dysfunction?

Katelyn Hagerty

Reviewed by Katelyn Hagerty, FNP

Written by Rachel Sacks

Published 04/15/2023

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

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

Depression can negatively impact many aspects of your life — from feeling unable to do everyday activities to affecting your overall quality of life. So if you’re dealing with depression and also experiencing erectile dysfunction (ED), you might wonder: Can depression cause erectile dysfunction?

We’ll explore the connection between depression and erectile dysfunction below, including ways to treat either condition

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Can depression cause erectile dysfunction? To answer this question, it’s helpful to know a few important details about depression.

Major depression — also known as clinical depression or simply depression — is a common mental health disorder. Major 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, such as 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 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, this mental condition can also have an effect on your sex life — which begs the question, can depression cause erectile dysfunction?

What’s the link between depression and your sex life?

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.

Erectile dysfunction can be caused by many things — chronic health conditions, certain medicines like blood pressure medication or health-related factors. Erectile function can also be affected by psychological causes like depression.

Research from 2018 on the connection between these two conditions evaluated several studies to find that patients with depression have a higher risk of erectile dysfunction. The review found that patients with depression had a 39 percent higher risk of erectile dysfunction.

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

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Severe Depression Decreases Sexual Desire

Depressive symptoms can include a low mood and negative thoughts, which could lead to low self-esteem or performance anxiety, thus causing erectile dysfunction. Depression could 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, with antidepressant drugs being a common option.

Antidepressant medications are used for disorders like depression and anxiety. They work by changing 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. A common side effect of antidepressants is sexual dysfunction, which results 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, orgasm delay and difficulty with ejaculation). For example, Lexapro may cause delayed or abnormal ejaculation.

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

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 negative sexual effects.

If you’ve been using antidepressants for depression or are noticing a loss of libido or sexual desire — either of which could be causing erectile dysfunction — you may be searching for a solution.

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While it might seem like you have to choose one or the other, you can have both depression and erectile dysfunction treatment.

It should be noted that 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.

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.

An ED medication may also be recommended to 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, which are covered more in-depth in this article.

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

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Can depression cause erectile dysfunction? There’s a good chance your ED could be due to depression.

A sign of depression is no longer having an interest in your usual activities, low self-esteem, negative thoughts or mood 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.

Or if you’ve been taking antidepressants for your depression symptoms, you could be experiencing sexual side effects — like erectile dysfunction.

Fortunately, depression and erectile dysfunction treatment don’t have to be an either-or situation. You can find relief from depression and erectile dysfunction through common erectile dysfunction medications, online mental health services or both.

Explore ED and depression options at Hims today.

14 Sources

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  2. NIMH » Depression. (n.d.). National Institute of Mental Health. Retrieved from https://www.nimh.nih.gov/health/publications/depression
  3. NIMH » Panic Disorder: When Fear Overwhelms. (n.d.). NIMH. Retrieved from https://www.nimh.nih.gov/health/publications/panic-disorder-when-fear-overwhelms
  4. NIMH » Bipolar Disorder. (n.d.). National Institute of Mental Health. Retrieved from https://www.nimh.nih.gov/health/topics/bipolar-disorder
  5. Symptoms & Causes of Erectile Dysfunction | NIDDK. (n.d.). National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved from https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/symptoms-causes
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  7. Depression & Sex: SSRI Side Effects, Depression & ED. (2020, December 11). Cleveland Clinic. Retrieved from https://my.clevelandclinic.org/health/diseases/9296-sexual-problems-and-depression-
  8. NIMH » Mental Health Medications. (n.d.). National Institute of Mental Health. Retrieved from https://www.nimh.nih.gov/health/topics/mental-health-medications#part_2359
  9. Higgins, A., Nash, M., & Lynch, A. M. (2009). Antidepressant-associated sexual dysfunction: Impact, effects, and treatment. Drug, healthcare and patient safety, 2, 141-150. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3108697/
  10. Gregorian, R. S., Golden, K. A., Bahce, A., Goodman, C., Kwong, W. J., & Khan, Z. M. (2002). Antidepressant-induced sexual dysfunction. The Annals of pharmacotherapy, 36(10), 1577–1589. Retrieved from https://pubmed.ncbi.nlm.nih.gov/12243609/
  11. Gabriel, M., & Sharma, V. (2017). Antidepressant discontinuation syndrome. CMAJ : Canadian Medical Association Journal, 189(21), E747. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5449237/
  12. Nurnberg, H.G., Hensley, P.L., Gelenberg, A.J., Fava, M., Lauriello, J., Paine, S. (2003). Treatment of Antidepressant-Associated Sexual Dysfunction With Sildenafil: A Randomized Controlled Trial. JAMA, 289 (1), 56–64. Retrieved from https://jamanetwork.com/journals/jama/fullarticle/195700
  13. Mark Ng, C. W., How, C. H., & Ng, Y. P. (2017). Managing depression in primary care. Singapore Medical Journal, 58(8), 459-466. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5563525/
  14. Bilal A, Abbasi NUH. (2020). Cognitive Behavioral Sex Therapy: An Emerging Treatment Option for Nonorganic Erectile Dysfunction in Young Men: A Feasibility Pilot Study. Sex Med. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7471093/
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