Antidepressant medication can be an absolute lifesaver– I mean this literally. I say this not just professionally, but speaking for myself, as somebody who has taken antidepressants for years.
They can be the difference between coping and not coping, so that you are then in a better place to get mental health support and actually be able to implement it. Think of antidepressants like adding an extra leg to your wobbly stool or maybe adding rubber bottoms to the legs of your stool so it’s more stable.
The real bum kicker though, can be the side effects which many doctors will conveniently NOT tell you when prescribing them.
What do you do when you notice that after taking them, you notice that your desire for sex just… drops off? Or when your orgasms don’t feel as strong? Or you just feel completely disinterested in sex and this is hitting not just your confidence, but you keep pushing your partner away too until it becomes a horrible vicious cycle of doom?
Never fear, antidepressants do NOT have to be the end of your sex life. Read on for what you can do if antidepressant medication has killed your sex drive!
Do antidepressants cause low libido?
Sorry to be a party pooper but yes, they can. It is well documented that many commonly prescribed antidepressant medications– particularly SSRI medication– have negative sexual side effects. You can see some of the research, here, here, and here.
Try not to hate your doctor for it.
For many doctors and psychiatrists, their priority when prescribing you antidepressant medication is your mental health— and, you know, probably keeping you alive— so they will see the potential benefits of more stable mental health as outweighing any possible negative side effects.
It is very telling that many doctors and psychiatrists don’t believe that sexual wellness and pleasure as something important to overall mental wellbeing too — although this is slowly changing. The GPs at The Lowdown— a contraception review platform for which I’m the resident sex coach— are totally on board the pleasure train. As is my colleague, fellow sex coach and GP, Dr. Liza Thomas-Emrus.
The issue is, it really depends on each person and the dosage. Some people will experience no sexual side effects, others will, and for some the effects can be severe.
It’s also tricky because depression, anxiety, PTSD, or any other mental health concern for which you’re seeking antidepressants for can also cause low libido, so it’s sometimes a case of the chicken and the egg, which came first?
Other sexual side effects of taking antidepressants
Antidepressant medication may not just impact your libido— sorry sorry sorry sorry to poop on your party even more— they can also influence your sex drive in other ways too, for example:
- Vaginal dryness
- Harder to have an orgasm, or decreased sensation when you have an orgasm
- Generally decreased pleasurable sensations
- Erectile dysfunction in men and people with penises
- Delayed ejaculation in men and people with penises
- Weight gain (and so contribute to feeling insecure about your body.)
- Feeling sluggish and tired
From my personal experience, I noticed that when I was reducing my own dose of Venlafaxine (also known as Effexor and Viapax) in 2022, that I felt much more spontaneous bursts of, “Mrrrrr I feel horny!”, and orgasms felt easier. When I had to up the dose again because I got unwell, these decreased again. Luckily, because I’ve been doing this for so long, I didn’t panic and knew exactly what to do.
More on this later because before you give up and decide to join a nunnery, this is ABSO-BLOODY-LUTELY workable!
Why do antidepressants cause low libido?
It’s not universally agreed on WHY antidepressants cause low libido.
Remember that arousal and sexual desire are a really complex process in everybody, there is no, “one size fits all”, otherwise I would probably be out of a job! It’s an interplay between organic factors like your hormones and general physical health, your emotions, beliefs, past experiences, conditioning, trauma and so much more.
Most antidepressants are SSRI’s, which stands for selective serotonin reuptake inhibitors, and serotonin is a neurotransmitter that acts as a mood stabiliser which is known as one of the, “feel good”, chemicals. While low serotonin levels aren’t good for your mental health, it seems that SSRI’s can interfere with your body’s ability to get physically aroused, which can then impact your overall desire levels.
Remember that physical arousal (getting wet, getting hard diliated pupils, panting, flushed skin, tingles, pleasurable sensations), is NOT the same as the feeling of desire (the mental and emotional desire to get it on.)
Yes, they are linked and impact each other, but they aren’t the same.
Another theory is that SSRI’s increase serotonin in the brain, it then dampens the release of dopamine, which is another neurotransmitter that is particularly related to sexual pleasure.
Ultimately, nobody can universally agree why and how antidepressants impact your sexuality in the same way they cannot agree why and how they work in the brain in the first place.
Will my libido return when I stop taking antidepressants?
This really common question I hear or have heard is whether your libido will bounce back when you come off antidepressants– and if so, if this is a good enough incentive to come off them?
Woah, stop right there! I’ll keep saying this, do NOT try to come off any medication without talking with your doctor first, because this can go horribly wrong and you do not want to be playing with your mental health. You need to work with your doctor or healthcare provider.
The short answer is: Possibly. Maybe. It depends.
For some people, they report their libido coming back after coming off, others it didn’t.
The reason for this is that your libido in general is something very complex that is influenced by many things. For some clients I have worked with, when their libido got affected by antidepressants and other medications like hormonal contraception, it triggered an anxiety around sex that impacted their libido more.
Really consider if the benefits of potentially your libido coming back outweigh the con’s of your mental health tanking again.
There really is no one size fits all, you need to find what works uniquely for you and your overall wellbeing.
How can I get my libido back while I’m still taking antidepressants?
All is not lost! There is so much you can do to revive your sex drive and turn on your desire while still taking antidepressants. Here are some suggestions.
1. Try lowering the dose you’re on
It may be that you need to adjust the dose you are on, particularly if you have other unpleasant side effects too. Again, only do this consulting your doctor and going through your full medical history.
No messing around willy-nilly with your brain chemistry, ok? Good.
2. Talk to your doctor about switching to a different medication
While most SSRI’s can have negative sexual side effects, there are other medications you could try. For example, Bupropion, otherwise known as Wellbutrin.
“One 2014 meta-analysis of 63 studies that included more than 26,000 patients treated with antidepressants found that people who took bupropion (Wellbutrin)—a norepinephrine-dopamine reuptake inhibitor (NDRI)—had a “statistically significantly lower risk” of sexual dysfunction compared to placebo, while those who took escitalopram (Lexapro) and paroxetine (Paxil)—both SSRIs—had a “statistically significantly higher risk” of sexual dysfunction.”
Again, do NOT suddenly stop taking your medication without talking with your doctor. The side effects of suddenly stopping can be grim, like nausea, dizziness, insomnia, anxiety, flu-like symptoms, headaches, and general return of horrible mental health symptoms.
Don’t fuck around with your brain chemistry, please, my friends!
3. Look at what other medications you are taking
I recommend having a medication review with your doctor with anything else you are taking and what their possible side effects are. Particularly any heart medication, antihistamines, beta blockers, if you’re on HRT or if you need to explore it, and your contraception.
Many women and people with vulvas report their contraception impacting their libido and overall sexual satisfaction, so it may be worth reviewing this.
Sadly just like with antidepressants, it is a lottery and there is no way of telling what contraception will affect you, and to what severity.
The Lowdown have an excellent GP service you can book in if your local GP or health provider is no good.
Women’s health has been grossly underfunded, underresearched, and undervalued for years. Medical misogny is still alive and kicking today. Channel 4 from the UK did an excellent documentary by Davina McCall exploring the issues faced in women’s contraception.
4. Your overall health and wellbeing
Your mental health doesn’t exist in a vacuum, it is intricately linked with your physical health and overall wellbeing too. As one of my friends and colleagues, Tamu Thomas, said to me once when I was in a bad mental state, “There’s no such thing as physical health and mental health, it’s all HEALTH!”
This could mean checking out your vitamins D and B levels especially, along with your iron and cholesterol. I believe most GPs offer a full blood screening which could be worth looking into if there are any deficiencies that could be fixed.
You may want to consider exploring alternative medicine, such as acupuncture, shiatsu, herbal medicine, a naturopath, a nutritionist, craniosacral, or energy work.
I am a big advocate for both western medicine and alternative, and finding the balance that works for you. Just make sure that whoever you choose comes recommended and their trainings are legit, as it is a wild west out there.
Think about your overall relationship with your health and wellbeing. Yes, it’s a big ask, so let’s start with the foundations:
5. Your health foundations
Think of these things as the foundations to your health and vitality: Enough sleep, being hydrated, eating enough food and eating regularly, generally getting enough high quality nutrients, joyful movement, sunlight, and stress.
With food and nutrition, this could be a wobbly point if you have a history of eating disorders. I am also not a nutritionist, nutrition expert, or dietician, so please use your own discernment or seek a professional.
I am also NOT advocating for any particular kind of diet or way of eating, especially as orthorexia (which is an eating disorder where you become obsessed with eating healthily) is prevalent in people interested in wellness.
What I AM advocating for, is getting the balance between food that nourishes your body and food that nourishes your soul, and not going to extremes.
Eating regulary is usually a BIG one for many women and people with vulvas. If you tend to undereat, forget to eat, or keep trying new diets or wellness regimes that involve some form of restricting food or cleanses.
Trust me, this messes up not just your metabolism but your ability to trust your body’s hunger signals.
Diet culture has fucked us non-consensually in multiple ways. I highly recommend reading the book, No Need To Diet, by Pixie Turner.
But what has this got to do with your libido and anti-depressants? Um, literally EVERYTHING!
According to renowned trauma therapist and expert on Polyvagal theory, Deb Dana, your story follows your state. This means that your thoughts and feelings are directly influenced by your nervous system state.
When you have these foundations more or less in place (with lots of wiggle room and grace), you are building your overall capacity and vitality.
They are literally the solid foundations of your building. When these aren’t in place, you automatically put your body and nervous system into a more stressed state (tired, dehydrated, hungry, not getting enough nutrients, lack of sunlight, not moving etc), which will negatively impact your mental health.
6. Stress, ooooh boy
Yes, you know what I’m about to say and you’ll probably want to throw something at me. But stress really does mess with, well, everything, but in this case your libido and overall sexual wellbeing. This can be chronic stress, work stress, relationship stress, family stress, overworking, past traumatic experiences that are unresolved etc etc etc.
You probably know this already, but I am reminding you again. This is your loving bum kick to do the things that you know you need to do to help your stress levels.
For example:
- Scheduling in active rest
- Scheduling in time off
- Exercise and joyful movement
- Re-thinking your work/life balance
- Examining what relationships are big stressors and what you can do about that
- Asking for and actually accepting help
- More time in nature
- More time in water- be it swimming, baths, cold water therapy, and anything else
- Finding a creative outlet
- Deciding to work with a coach or therapist on the thing you know needs sorting out (like me!)
I talk A LOT about stress, overachieving, and overfunctioning, because these are all tied into patterns of you being in chronic stress that really hits your libido and sexual satisfacton.
7. Complete the stress cycle regularly
Why am I devoting another point to stress? Because one of the biggest misconceptions about stress in general, is that you need to calm down more. It’s interesting as soon as I wrote that phrase, I immediately heard the voice of a man being condescending in my mind, did you?
“Calm down, dear”, has probably been said to you many, many times. Did it ever work?! Aside from it being super condescending, it also doesn’t work because that’s not how stress works.
Kimberly Ann Johnson describes in her book, Call Of The Wild, that for most women and people in female bodies, we have been so conditioned to have to repress our anger, rage, power, and fullness of ourselves, that it has become automatic.
We don’t need to “calm down”, we need to allow ourselves to get angry and express power.
When we are stressed and our body is producing cortisol and generally going into flight and flight, we need to find a way to help discharge it and express it.
This usually means something physical, which can be exercising or working out, doing weights, dancing, going for a run, punching pillows, walking, or even yoga. Or maybe you need something more, like expressing rage through something like kickboxing, anger workshops, or putting on heavy metal music and thrashing to it.
There’s a reason why you feel better after going to the gym or going to a dance class, you are helping move the stress response through.
Emily and Amelia Nagoski talk about this in their book, Burnout, too.
Other ways to help the stress response is through what we call in the somatic world, “co-regulation”, which is a fancy term for being with people.
This means quality time with people you love, like catching up with friends, going to social events, spending time with your partner, with your family, going to classes, or just popping round for a cuppa and catch up.
Do you have enough connection with other humans? Humans that you love and you feel good around? Humans that build you up, love and support you? Be honest with yourself, many of us struggle with isolation.
8. Move for joy and pleasure
I put this in the previous point, but I feel that joyful movement needs it’s own point because it is so important.
Yes, it can mean going to the gym, but I challenge you to think about whether this is JOYFUL for you. Does going to the gym and working out bring you JOY? Does it feel pleasurable? Does it give you the tingles? A rush of bliss?
If so, keep doing it!
But if you are like so many people who unconsciously use exercise as a subtle form of self-punishment, I am side-eyeing you and generally diet culture big time.
Do you work out because you, “should”, but you really hate it? Do you work out to, “earn” your food? Do be skinny? To look a certain way? Because you “should” be healthy?
There is a subtle difference, and most people seem to fall into the latter.
When exercise becomes a form of, “should”, you are more likely to have a weird arse relationship with it. You either overexercise to exhaustion, or have a love/hate/on/off relationship where you never feel good enough.
It also means it’s harder to trust your body, I see it as a very, “top down” way to relate to our incredibly wise body.
In my client work, a big component of our work is learning to not just learn how to feel pleasure, but move your body in a way that brings pleasure.
What if you ONLY decided to move your body in a way that brings you joy and pleasure? What if by doing this, you start to follow the breadcrumbs of what actually feels good to you and what you actually enjoy, instead of what you think you, “should” do?
Joyful movement could be literally anything and it can be as simple as a gentle walk in the park (I have my local park up the road that I call my, “therapy park” for this reason.), going to a dance class, dancing at home, hiking, rollerblading, or even hula hooping.
You can absolutely still go to the gym if it brings you joy and tingles, and you can gain a lot of pleasure from lifting weights and feeling your strength.
But the key is asking yourself if it actually feels good.
9. Be proactive about turning yourself on
Emily Nagoski explains the difference between responsive and spontaneous desire in her book that I recommend to EVERYONE, Come As You Are.
Basically, if you are somebody who really struggles to get turned on– and this could be caused by your antidepressants and/or it could just be who you are generally– it could mean you have more responsive desire.
So the way that you work with it instead of always waiting for your partner to initiate, is you need to learn how to proactively turn yourself on.
What lights your erotic fire? What turns you on?
One of my favourite pieces of wisdom from renowned couples’ therapist, Esther Perel, is that you actively turn YOURSELF on, rather than waiting to be turned on.
This could look like:
- NERD ALERT! Getting educated and exploring your own sexuality! Yes, I am a nerd advocate and encourage you to be a sex nerd too. My favourite books to start with are Mind The Gap, Come As You Are, Shake Your Soul Song, and Becoming Cliterate.
- Reading smut or erotica (download it to your kindle or e-reader and nobody will know!)
- Watching or listening to porn or erotica
- Regular self-pleasuring/masturbation. The goal isn’t to orgasm, just to feel pleasure.
- Creating a pleasure practice using exercises from tantra, taoism, and qi gong. I teach these to my clients both 1:1, in groups, in workshops, and we do them in Soul Sex Circle.
- Sensual movement like pelvic movements, burlesque, belly dance, twerking, pole dance, learning strip tease, or putting on a sexy playlist and grinding. Here’s a Spotify Playlist for you of my favourites.
- Sensual self touch
- Buying or making erotic art
- Flirting more with your partner
- Sending flirty or filthy texts aka sexting
- Clearing out your lingerie drawer of all the old crusty knick knocks and buying new ones
- Going to sex positive workshops, festivals, or retreats
- Want more inspiration? Buy the book Ecstasy is Necessary, by Barbara Carellas.
10. Find natural oxytocin boosts
Another way to help kickstart your desire is to help it along with good old oxytocin boosts.
Things that build oxytocin:
- Kissing. Have a full on make out session
- More touching- massage, holding hands, cuddling, sensate focus
- Extended foreplay sessions
- Exploring all the ways you can be intimate without having PIV sex
The key is to explore these WITHOUT the pressure or goal for it to end up in sex.
11. Learning the art of self pleasuring
This deserves a whole paragraph of it’s own, because self-pleasuring and masturbation really are an art to be learned. Self-pleasuring isn’t just something that feels amazing, but it’s one of the most effective ways to actively turn yourself on, light your erotic fires, get to know your body, and love yourself.
There’s a reason why the late Dr. Betty Dodson called masturbation one of the most empowering things you can do for yourself.
Studies suggest that regular masturbation helps with increasing sexual desire and sexual confidence. Like here and here.
When I say that self-pleasuring is an art and a skill set, I mean it. It isn’t just about learning how to cum– even though this is super important– but how to circulate pleasure around your body, experience your full pleasure potential, reach full arousal, and experience yourself as a sexual being just for you, without thinking about pleasing your partner.
I am not exagerating when I say that I believe that women and femmes learning the art of self-pleasuring is one of THE most empowering and liberating things you can do for yourself.
My digital course, Orgasmic Liberation, contains many of the ingredients to turn yourself on and feel more sexual pleasure, even while taking antidepressants.
It includes sensual movement, self touch, getting educated about your sexual response cycle, and practical exercises to enhance your pleasure like breath and movement.
Summary
I hope this post has made you see that taking antidepressants does NOT have to mean the end of your sex life and orgasms. You just need to get more creative and learn new skills.
Having great sex really is a skill to be learned, waiting for it to just magically happen all by itself is kind of like making a solid financial plan based on waiting for your inheritance or winning the lottery.
I want all women and people with vulvas to not just have the most satisfying sex life, but to liberate your sexuality.
How I can help you
I help women and people with vulvas get their libido and desire back, including if you’ve been affected by your meds.
Learn more about how I can help you reclaim your pleasure and sexuality in my coaching programs here.
Lucy Rowett, CSC – Pronouns: She/Her/Her