So, Your Antidepressant Is Killing Your Libido. Here's How To Handle It

When it comes to easing symptoms of depression and minimizing the resurgence of depressive episodes, antidepressants are often prescribed in combination with psychotherapy as the first form of treatment. Antidepressants can potentially help you sleep better, calm you down, improve concentration, and stave off suicidal thoughts to a great extent. Although antidepressants are only accessible with a prescription, you can still try various over-the-counter herbs and vitamins with modest antidepressant properties, which may aid in the relief of mild depression symptoms.

While antidepressants can relieve symptoms of depression to a certain degree, they are not without side effects. One risk associated with antidepressants is that they can lower libido in adults, making it harder to become aroused, reach orgasm, or become interested in having physical intimacy altogether. Dealing with depression is draining enough, let alone coping with the added pressure of a physical intimacy-deprived relationship. If that's what you're going through right now, here's what you can do to turn the tide and bring the sexual spark back into your bedroom.

What is an antidepressant?

Antidepressants are a class of medications prescribed to treat moderate to severe depression, parasomnia, non-neuropathic pain, panic disorders, anorexia, bulimia, social phobia, and more. They work by boosting neurotransmitters, such as serotonin and norepinephrine, to inhibit pain signals sent by nerves, enhancing feelings of well-being and reducing emotional imbalances. "Antidepressants help by balancing chemicals in the brain. This can give the person the boost they need to reduce their symptoms, which makes it possible for them to work toward feeling better overall," psychopharmacology specialist Dr. Kevin P. Caputo told Crozer Health.

There are many types of antidepressant medications. Serotonin-noradrenaline reuptake inhibitors (SNRIs), noradrenaline and specific serotonergic antidepressants (NASSAs), monoamine oxidase inhibitors (MAOIs), and selective serotonin reuptake inhibitors (SSRIs) are some of the commonly used types of antidepressants. Each has its own pros and cons and yields different results for different people. The way the brain works varies from person to person, which is why one antidepressant doesn't work for everyone. That's why you need to follow up with your healthcare provider regularly while you're on medication and refrain from making changes without speaking to a specialist first.

Side effects of antidepressants

Every antidepressant has side effects. It's not uncommon for antidepressants to make you feel dry mouth, anxiety, fatigued, unbalanced, and unable to sleep when you're new to the medicine. For instance, SSRIs and SNRIs are known to cause reduced concentration ability, headaches, gastrointestinal problems, diabetes, oral problems, nausea, and loss of sexual desire. Antidepressants, such as MAOIs and tetracyclic antidepressant mirtazapine, are often linked with increased appetite and weight gain. Meanwhile, tricyclic and tricyclic-related antidepressants can reportedly cause constipation, excessive sweating, hypomania or mania, suicidal urges, serotonin syndrome, and neuroleptic malignant syndrome. Antidepressants such as Paxil (paroxetine HCl, GlaxoSmithKline), Celexa (citalopram HBr, Forest Laboratories), and Zoloft (sertraline HCl, Pfizer) are notorious for visual changes as their side effects.

Your mental health professional will typically warn you of these side effects before prescribing any medicine. If you're experiencing changes in your body or your mind, it's important to keep your healthcare provider in the loop so they can monitor your condition and help you reduce side effects. This may be done by adjusting the dosage, adding medication, or switching to another antidepressant. No matter how you feel, don't stop taking your antidepressants or switch them unless your healthcare provider says so. Discontinuing antidepressant medications comes with its own risks and side effects.

Can your antidepressant affect your libido?

There's a link between the use of antidepressants and experiencing a reduced libido, even though this side effect might vary from person to person. In fact, most people with depression don't have to wait until they take antidepressants to experience a reduced sex drive. Reduced sexual arousal and function are pretty common in people with depression. A 2018 study published in the Indian Journal of Psychiatry polled a group of 56 depressed male patients. About 62.5% of the patient group reported experiencing sexual dysfunctions, including decreased sexual desire, erectile problems, and feelings of unfulfillment. "Myths about masturbation and penile size and shape were higher in the depressed population. After treatment with escitalopram, there was an improvement in depression and satisfaction with intercourse and overall sexual life," the study authors concluded.

Since depression is largely associated with lower libido, taking antidepressants may worsen things if your sex drive is already at rock bottom. Antidepressants, such as SSRIs, SNRIs, tricyclic and tetracyclic antidepressants, and MAOIs, are most likely to cause sexual dysfunction. In women, some common sexual side effects of antidepressants include lack of interest in sex, absent or delayed lubrication, delayed orgasm, and pain during intercourse. If your sexual life is tanking because of antidepressants, it may eclipse the favorable results you're getting from the medicine. Low sex drive or your overall inability to enjoy the things you used to can also lead to depression-like feelings.

What can you do about low sex drive caused by antidepressants

If you think your antidepressants are spelling trouble for your sex life and the problem is getting in your way of enjoying life, consider bringing the matter up with your prescribing healthcare provider. Depending on your condition, your physician might advise you to give the medicine time to work and ride out the unpleasant side effects. Alternatively, they may adjust the dosage of your medication to help improve your situation without compromising the effectiveness of your treatment.

In certain cases, your healthcare provider might prescribe you another type of antidepressant that helps with alleviating the sexual side effects. "Just because someone has a reduced libido on one SSRI doesn't mean they will have a reduced libido on all SSRIs or other antidepressants," OB-GYN Dr. Lauren Streicher told SELF. For example, SSRIs include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), and vortioxetine (Trintellix).

Some antidepressants, such as mirtazapine (Remeron), vilazodone (Viibryd), bupropion (Wellbutrin XL, Wellbutrin SR), and vortioxetine (Trintellix) are less likely to cause sexual side effects than others. Sometimes, your prescribing physician might recommend you take a short break from antidepressants to reset your brain receptors and reduce the unwanted side effects of the medication.

Other ways to boost sex drive

If you're a woman struggling with a reduced sex drive due to antidepressants, hormone therapy might help. By replenishing some of the sex hormones your body no longer produces and rectifying hormonal imbalances, hormone therapy is helpful in regaining your libido and increasing your sex drive. Hot flashes and vaginal soreness are two prevalent menopausal symptoms that are typically addressed with this kind of treatment. Many women who receive hormone therapy see a significant increase in their sexual interest and drive. Since hormone therapy has a ramp-up phase, the treatment may require up to six months to reach its peak effectiveness. The good news is, you can get hormone therapy while you're on antidepressants, as they don't contain elements that impact each other adversely.

If you don't like the idea of adding more pills to your medication list, you can try a more simple hack like using estrogen cream. A libido booster, estrogen cream is a drugstore cream that improves sensitivity in the genital area, increases vaginal lubrication, and enhances sexual functioning to a certain degree. Any physical activity that gets your heart pumping faster coupled with long foreplay before sex can lead to greater arousal for women. Several supplements, such as maca root, red ginseng, ginkgo biloba, and saffron, are also useful in amplifying blood flow throughout the body and boosting libido. Having said that, before attempting any hack to enhance your libido, consult your healthcare provider first. 

Foods that boost your libido

Dietary adjustments can go a long way in helping you get back in the mood for sex while on antidepressants. As far as aphrodisiac foods go, zinc-loaded foods like pork, beef, and lamb are famed for their effectiveness in regulating testosterone and increasing sex drive. "Beef is a lesser-known but potent addition to the libido-boosting diet. As a saturated fat, it contains the building blocks for our sex hormones, such as testosterone, which boost libido in both men and women," nutritionist Amy Prior tells Women's Health. Oysters, an aphrodisiac in their own right, are also rich in zinc and other stimulating properties.

Another food that turns up the heat in the bedroom is pomegranate juice, a folic acid-rich drink that's known to stimulate a healthy sex drive. According to a 2012 study published in Endocrine Abstracts, out of 22 male participants and 38 female participants, those who consumed one glass of pomegranate juice a day for two weeks reported an average 24% increase in salivary testosterone levels. This hormone is responsible for increasing blood flow, uplifting moods, and enhancing libido. 

At the same time, it's best to refrain from excessively consuming foods that might decrease your testosterone levels or reduce your sex drive. These include soy, polyunsaturated fats, high-sodium foods, and fried foods. Alcohol can also lead to a reduced desire for sexual intercourse over time.