How does depression affect sexuality?
The brain is the body’s most sensitive "sex organ." Sexual
desire starts in the brain and works its way down. Chemicals in the brain called
neurotransmitters help brain cells communicate with each other in order to
stimulate blood flow to the sex organs. In a person with depression, these
chemicals are out of balance. As a result, sexual desire is low or nonexistent.
In addition, low levels of some of these chemicals can dull pleasurable
feelings. The strain that depression places on relationships can further
interfere with sexual function and pleasure.
It is estimated that 35 percent to 47 percent of people with
depression experience some sexual problems. The severity of the problem depends
on the severity of the depression and the presence of anxiety. For those with
more severe depression, 61 percent have sexual problems.
How do antidepressant medicines cause sexual problems?
Although antidepressant medicines are highly effective in
helping you feel normal again, many of these drugs, such as SSRIs, have
undesirable side effects, including causing sexual problems. For both men and
women, this means being unable to initiate, participate fully in or enjoy
sex—and that can lead to a crippling loss of self-confidence that can, in turn,
undermine depression recovery.
It’s estimated that a third of people taking antidepressants
experience decreased desire and difficulty achieving orgasm. Some
antidepressants may make it difficult for a man to have an erection. These side
effects tend to increase with higher doses of antidepressants.
Antidepressant medicines work by restoring the normal balance of
chemicals in the brain, which—in turn—improves communication between brain
cells, reducing depression symptoms. Unfortunately, altering these chemicals can
also cause sexual problems.
What can be done to treat sexual problems?
There are ways to help manage the sexual side effects
associated with many antidepressant medicines without compromising treatment.
These include switching to drugs that have less effect on sexual function. Some
newer antidepressant medicines—such as Survector® (not available in
the United States), Wellbutrin®, Remeron®, and Serzone®—cause
fewer or no sexual side effects.
To better cope with the debilitating effects of depression, as
well as the sexual side effects of treatment, you should be open and honest with
your doctor and your sexual partner. Most people choose to continue treatment
once they realize that the sexual problems they are experiencing are associated
with the medicines and can be overcome.