Has your libido dropped due to antidepressants? Causes and tips for consultation

Consultation points when your libido drops due to antidepressants

Since I started taking antidepressants, my libido has disappeared.
My body doesn't react easily even when touched.
I have started avoiding time with my partner.

These changes are not something you should endure just because you are in treatment.

However, the cause is not always the medication. Symptoms of depression, physical illness, other medications, and stress can also be involved.

First, let's organize these changes and think about how to consult safely.

▼ What you will learn in this article

・The impact of depression itself on libido
・Changes in sexual function that can occur with antidepressants
・4 confirmation items to organize the cause
・Specific details you want to convey during the consultation

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⏱ This article takes about 4 minutes to read

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Libido also decreases with depression itself

With depression, you may lose not only your energy but also the interest and joy in things you previously enjoyed.

This change is called anhedonia, and it appears not only in eating and hobbies but also in sexual interest.

Fatigue, insomnia, low self-esteem, relationships with partners, and anxiety about pregnancy also have an impact. Therefore, you cannot judge it as a side effect of the medication based solely on a decrease in libido.

What is important is to perceive it as a change that should be checked during treatment, rather than thinking your feelings have weakened.

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Antidepressants also affect physical reactions

With antidepressants related to serotonin, such as SSRIs and SNRIs, a decrease in libido, difficulty becoming aroused, problems with erection or lubrication, and delayed orgasm may occur.

The package insert for duloxetine also lists decreased libido, orgasm abnormalities, ejaculation disorders, and erectile dysfunction as side effects.

It becomes easier to convey sexual function if you divide it into the following four categories:

・Sexual interest and desire have decreased
・The body is less reactive even when aroused
・Erection or lubrication is difficult to maintain
・It takes time to reach orgasm, or it is difficult to reach

The possible causes and responses change depending on which stage you are having trouble with.

Check for causes other than medication as well

Diabetes, cardiovascular disease, hormonal changes, and neurological diseases are also related to sexual function.

Medications other than antidepressants, such as antihypertensives, may also have an impact. Furthermore, it is not uncommon for psychological and social factors such as stress, relationships, and anxiety about failure to overlap.

It is useful to organize and convey the following four points during the consultation:

Timing
Did it happen after starting the medication or after increasing the dose? Was it present before that?

Symptoms
What has changed regarding libido, physical reaction, erection or lubrication, or orgasm?

Impact
To what extent is it affecting your self-esteem or your relationship with your partner?

Other changes
Are there any changes in menstruation, sleep, mood, weight, alcohol consumption, underlying diseases, or concomitant medications?

You may write it down as a memo and bring it with you. You do not need to talk about everything in detail all at once.

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Do not stop on your own judgment; consult about adjustments

Even if an impact on sexual function is suspected, the response is not a binary choice between enduring the medication or stopping it immediately.

There are multiple options, such as observing the progress while watching the symptoms and the degree of recovery, considering the dosage, or changing to a medication with a different mechanism of action. Which method is appropriate depends on the state of the depression and the history of recurrence.

Overseas, bupropion may be an option, but it is not approved as a depression treatment drug in Japan. You should avoid using it through personal import and need to consider methods possible within the country with your attending physician.

In rare cases, examples of sexual function changes continuing after stopping SSRIs and SNRIs have been reported, which may be called PSSD. However, there are many unknown points regarding the frequency and cause, and there is no need to think that it will happen to everyone.

If you suddenly reduce or stop the medication due to anxiety, it may lead to withdrawal symptoms or a relapse of depression.

Continue the medication safely while protecting the important parts of your life.
It is important to explore the adjustments for that together in the consultation room.

It is okay to talk about sexual concerns as part of treatment

Libido and sexual function are important health issues related to quality of life and relationships with partners.

It is natural to feel embarrassed. Even so, for medical professionals, it is important information for considering treatment, just like changes in appetite or sleep.

Even if you cannot explain it well, you can start the consultation just by saying,

I have been having trouble with sexual aspects since I started the medication

Do not blame yourself, do not stop the medication suddenly, and try to talk about both your current treatment and the life you want to cherish.