You’re on a journey to heal and perhaps medications are a part of this process. Great! You start on an antidepressant and begin feeling a bit better but then…something is missing…your libido. Unfortunately many people experience a loss of their sex drive, difficulties reaching orgasm or changes in their sexual satisfaction with psychotropics and SSRI’s in particular. The CDC estimates that around 16.5% of the US population uses SSRI’s to treat conditions such as anxiety and depression. Of those, 58-70% experience sexual side effects. This creates quite the conundrum. Nobody wants to play a game of symptom whack-a-mole where you treat one issue just to have another emerge.

How to effectively treat your mental health without sacrificing your sexual health?

One thing to consider is that conditions such as Depression and Anxiety when left untreated can actually lead to loss of sex drive, decreased arousal and difficulties with orgasm. If you’ve lost your motivation, find yourself in a pit of despair or can’t seem to turn off the noise in your brain, chances are your mojo will be a no-show. Seeking treatment for your mental health is a powerful decision and strong first step to reclaiming your vitality. It’s equally important to know what your options are, potential side effects of medications and choices for alternative treatments.

Antidepressants (Selective Serotonin Reuptake Inhibitors, commonly known as SSRI’s) are first line treatment and considered the ‘gold standard’ in psychiatry when it comes to treating Depression and Anxiety. SSRI’s can increase serotonin levels (great for mood, sleep and appetite regulation) and decrease testosterone (not great for our sexual appetite). Common SSRI’s (listed by the most likely to cause sexual dysfunction to the least likely) include:

• Sertraline (Zoloft)

• Citalopram (Celexa)

• Paroxetine (Paxil)

• Fluoxetine (Prozac)

• Escitalopram (Lexapro)

• Fluvoxamine (Luvox)

• Vortioxetine (Trintellix)

So how do we stay HAPPY and HORNY?

Talk to your medical provider about potential medication adjustments and/or alternative. Discuss taking a lower dose. It might help to experiment with the time you take the medication. Spacing out the time ensures you have the lowest levels of the medication in your system and may help ease potential sexual side effects. On the other hand, switching or adding a different medication that is known to have few sexual side effects or a different class of medications such as:

• Tricyclic Antidepressants (TCA): Nortriptyline, Amitriptyline, Imipramine

• Noradrenergic and Specific Serotonergic Antidepressants (NaSSA): Mirtazapine

• Norepinephrine and Dopamine Reuptake Inhibitor (RDRI): Wellbutrin

You may be able to take a “holiday” from your medication over the weekend- but PLEASE discuss with your provider before doing so, as it is easier to do with some medications than others.

Holistic Approaches

1. Acupuncture has been shown to improve all aspects of sexual functioning (including lubrication and libido) for those on SSRI’s. Research indicates weekly treatments over 3-12 weeks to be effective.

2. Exercise and weight training can naturally increase testosterone and improve sexual health and arousal.

3. Communication is key! Having open and honest conversation with your partner about what you are experiencing can help reduce feelings of guilt, shame or helplessness. Healthy conversations can also build trust and understanding within your relationship.

4. Supplements/Herbal Support

• Ginkgo Biloba: (Dose 120-240mg/day for 6 months). Known to have positive effects on arousal, lubrication, erection, orgasm and even afterglow.

• Ginseng: (Dose 1.5-3g/day for 12 weeks). Helps improve blood circulation to sex organs.

• Maca: (Dose 1.5-3g/day for 6-16 weeks). Increase sexual desire. Also known to be very helpful for sexual dysfunction in menopause.

• L-Arginine: (2-3g/day for 4-12 weeks). Improves blood circulation, helps with desire and achieving orgasm in women.

It can be challenging to have this conversation with your provider especially when you are not ASKED about your sexual side effects. Sex is a normal and vital aspect of our overall health! By advocating for yourself and your sexual needs you can work with your provider to find a safe and effective solution and bring some passion and pleasure back into your life!

*Medical Disclosure: This information is for educational and information purposes only and not meant to be taken as medical advise. Please discuss with your health provider before making any changes to your treatment.

If you’d like to get in contact with Kate to discuss medication and/or supplement options for you, click here.

If you’d like to discuss the psychological aspects of sexuality, relationships, and somatic approaches to address issues and explore yourself, click here.