Antidepressants can help you chat up that girl, finish that screenplay and stop watching endless reruns of The Office every night before bed.
In short, they’re great for humankind. For some antidepressant users though, common side effects can ruin one of the happiest and most fulfilling parts of lives: intimacy (specifically, sex).
Research shows that between 25 and 73 percent of people who used antidepressants like Zoloft to treat depression, anxiety and other conditions experience sexual side effects. Basically, antidepressant problems in the bedroom are a lot more common than you think.
And dealing with them can be a frustrating process. Antidepressant-induced sexual dysfunction may not be as bad as some mental health issues, but it’s hard to call life “great” if you’re unable to do one of the most fun things a person can do — hook up.
Luckily, almost all sexual side effects caused by Zoloft and other selective serotonin reuptake inhibitors (SSRIs) are treatable, with a variety of options available for reducing and managing your symptoms.
Below, we’ve explained how medications such as Zoloft can cause sexual side effects like erectile dysfunction and low libido.
We’ve also shared some practical techniques that you can use to prevent ED and stay sexually healthy while using Zoloft or similar medication.
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Zoloft is a brand-name antidepressant also known generically as sertraline. Sertraline is a selective serotonin reuptake inhibitor prescribed to treat depression and anxiety disorders, like social anxiety disorder, panic disorder, obsessive-compulsive disorder (OCD) and others.
Zoloft is one of the most common SSRIs in the United States, so we have a fair amount of information about how it interacts with your sex life, specifically that:
Zoloft is often prescribed off-label to treat premature ejaculation (PE), because it can make having an orgasm take longer.
Zoloft works by increasing serotonin levels, which can cause sexual side effects such as difficulty with ejaculation and erectile dysfunction.
It may not be the SSRI with the worst sexual side effects, though. Recent research suggests that Zoloft has a lower risk of causing sexual side effects than other widely-used SSRIs.
Most of the time, you can treat performance issues by adjusting your dosage of Zoloft, taking a “drug holiday” or trying a different type of antidepressant drug. Just be sure to always make these changes with your doctor — never on your own.
So what’s a brain pill doing downstairs? It’s a damn good question, and we want answers, damn it! But let’s not get the pitchforks sharpened just yet. After all, Zoloft is effective as a treatment for depression and anxiety.
Unfortunately, Zoloft just happens to be associated with a range of sexual side effects. Commonly referred to as SSRI-induced sexual dysfunction, these side effects include:
Precisely why Zoloft and other SSRIs cause these sexual side effects is unclear to experts, though — they’re still scratching their heads at this one.
One popular theory is that the effects of SSRIs on serotonin may also impact sexual desire and performance. Increased levels of serotonin may negatively affect the production of similar neurotransmitters and hormones, including dopamine and testosterone, and you need those to get hard.
Dopamine is an essential neurotransmitter that’s involved in reward-seeking behavior, as well as processes such as achieving orgasm.
Testosterone, meanwhile, is an androgen hormone — a male sex hormone — that plays a vital role in regulating sexual response and arousal.
Zoloft, thankfully, isn’t quite as impactful for your erection as other antidepressants. Remember how up to 73 percent of people who take SSRIs experience sexual side effects? Well, data from clinical trials suggests that only two to eight percent of men using Zoloft experience sexual side effects. The most common of these are ejaculation difficulties (reported by eight percent of men) and erectile dysfunction (reported by four percent of men).
For more information about Zoloft’s side effects, check out our blog.
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If you’ve found that sertraline is helping your mental health, you may be reluctant to stop the good vibes for some better boners. That’s a totally understandable decision.
But these effects may also cause you some extra distress — which obviously isn’t what you want when you’re treating depression or anxiety.
The good news is that sexual effects from antidepressants can often be treated or reduced with some changes to the way you use your medication.
To treat ED from Zoloft, your healthcare provider may recommend using one or several of the following techniques:
Adjusting your dosage of Zoloft. Zoloft is prescribed at several dosages, from 25mg to 200mg per day. Some side effects, including sexual effects, may be more common when Zoloft is used at a high dosage.
Switching to a different SSRI. Although most SSRIs work in the same basic way, there are differences between each medication that could make one a more suitable choice for you than others.
Different types of SSRIs include Paxil (paroxetine), Lexapro (escitalopram), Celexa (citalopram) and Prozac (fluoxetine).
Taking a temporary “drug holiday.” Your healthcare provider may suggest going on a “drug holiday” — a day or two in which you stop taking your medication — to lower the severity of ED and other sexual function issues by giving the medication time to exit your body before sex. We have to repeat it though — you may be used to jetting off to the beach whenever you want, but don’t just decide to take this type of holiday by yourself.
Using medication to treat ED. In some cases, your healthcare provider might suggest using a prescription ED medication like Viagra (sildenafil), Cialis (tadalafil), Levitra (vardenafil) or Stendra (avanafil) to make getting an erection easier.
Making changes to your habits. Some habits, such as being inactive, smoking, eating an unhealthy diet, living a stressful lifestyle or watching porn excessively, may also play a role in erectile dysfunction. Our guide to naturally protecting your erection goes into more detail about lifestyle changes that you can make for better erections and sexual health.
All these changes can help, but here’s a major warning for dudes struggling with this problem right now: if you have developed signs of antidepressant-associated sexual dysfunction after taking Zoloft, don’t make any changes without first talking with your healthcare provider.
Abruptly stopping or reducing your dosage of Zoloft (or any antidepressants) can cause withdrawal symptoms.
It’s also possible for you to experience a relapse of depression or anxiety if you suddenly stop taking your antidepressant medication.
And that’s just as bad for boners as SSRI side effects, in the big picture.
Let’s look at the big picture for a moment here, starting with the real value of Zoloft. If you have depression, anxiety or another psychiatric disorder, using medication like Zoloft can help to make your symptoms less severe and significantly improve your quality of life. It’s a life-changing medication for many people.
Feeling down is not something we’d wish on anyone, but not being able to get up? That’s in the same ballpark. If you’re worried you’ll have to choose erections or joy, you can relax.
There are ways to find the right balance and ditch those sexual side effects, so you can be happy and horny at the same time. Remember the following as you chart a path to having your cake and having your boners, too:
Sexual side effects from Zoloft only affect a small percentage of users, but they can happen to anyone, even those with no previous sexual issues.
Let your healthcare provider know if you notice any changes in your sex drive, erections or ability to enjoy sexual activity while using Zoloft.
Your healthcare provider can offer you options. They may adjust your dosage of Zoloft, or switch you to a new antidepressant or another medication to improve your sexual response cycle and overall sexual performance.
Worried about sexual side effects from Zoloft? Our guide to managing sexual side effects from antidepressants goes into more detail about what you can do if you notice ED, a low sex drive or other sexual issues after starting treatment with an SSRI.
You can also learn more about Zoloft and its active ingredient in our detailed guide to sertraline, which covers everything from how this medication works to its most common uses, side effects, potential interactions and more.
Happiness and erections are something we all deserve as much of as we want. Sort out this little medication conflict and get what you deserve today.
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Dr. Martin Miner is the founder and former co-director of the Men’s Health Center at the Miriam Hospital in Providence, Rhode Island. He served as Chief of Family and Community Medicine for the Miriam Hospital, a teaching hospital of the Warren Alpert Medical School, from 2008 to 2018. The Men’s Health Center, under his leadership, was the first such center to open in the US. He is a clinical professor of family medicine and urology at the Warren Alpert Medical School of Brown University in Providence and has been charged with the development of a multidisciplinary Men’s Health Center within the Lifespan/Brown University system since 2008.
Dr. Miner graduated Phi Beta Kappa from Oberlin College with his AB in biology, and he received his MD from the University of Cincinnati College of Medicine. Upon receiving his MD, he completed his residency at Brown University. He practiced family medicine for 23 years, both at Harvard Pilgrim Health Care and in private practice.
Dr. Miner presently holds memberships in the American Academy of Family Physicians, the Rhode Island and Massachusetts Academy of Family Physicians, and the American Urological Association, and he is a fellow of the Sexual Medicine Society of North America. He is the former president of the American Society for Men’s Health and the current historian. He is the vice president of the Androgen Society, developed for the education of providers on the truths of testosterone therapy. Dr. Miner has served on the AUA Guideline Committees for erectile dysfunction, Peyronie’s disease, testosterone deficiency, and early screening for prostate cancer. He has served on the testosterone committees of the International Consultation on Sexual Medicine. He has presented both at the NIH and the White House on men’s health initiatives and has authored over 150 peer-reviewed publications and spoken nationally and internationally in multiple venues. He has co-chaired the Princeton III and is a steering committee member and one of the lead authors of Princeton IV, constructing guidelines for the evaluation of erectile dysfunction, the use of PDE5 inhibitors, and cardiac health and prevention.
Dr. Miner was chosen as the Brown Teacher of the Year in 2003 and 2007 and was recognized by the Massachusetts Medical Society’s Award as achieving the most significant contribution to Men’s Health: 2012.
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