Antidepressant Side Effects: Do SSRIs Block Sexual Pleasure And Orgasm?

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This question originally appeared on Quora. Answer by Marie Streifel.

SSRIs can block orgasms — or cause anorgasmia — because they increase the levels of serotonin in your brain. Serotonin levels affect our physical ability to sense pain and pleasure.

I like to compare taking SSRIs to being drunk. When we get drunk, we temporarily have more serotonin in our brains (which will be followed by a crash the next morning). How do we feel when drunk? Well, usually all physical sensations are reduced. It’s hard to have an orgasm because our sex organs feel kind of numb. We don’t notice physical pain as much because our sense of touch is numbed. The physical sensations of both pain and pleasure are reduced because that’s one effect of having extra serotonin floating around.

female orgasm Trimel Pharmaceuticals Corp.'s new testosterone nasal gel, Tefina, led to an increase in the average number of orgasms among women suffering from female orgasmic disorder. Photo courtesy of Shutterstock.

Low serotonin has the opposite effect. For example, when hung over, your serotonin is low and everything will hurt a lot more. Women also have lower serotonin levels right before our periods. That makes us more likely to feel anxious, but it also lowers our pain tolerance. (Never schedule a painful procedure, such as getting a tattoo, right before your period!)

These same things happen no matter how your serotonin levels are increased. If you take an SSRI, you have more serotonin, so the physical sensations of both pain and pleasure can feel numbed.

(Unfortunately I have no idea how or why serotonin levels affect the sensations of pain and pleasure.)

It’s worth noting that there are anti-depressants that don’t work on serotonin and are much, much less likely to cause sexual dysfunction.

I take Wellbutrin, which isn’t an SSRI. It’s called an “atypical anti-depressant” because it works on dopamine and adrenaline instead of serotonin. Instead of making me fat and sexless like SSRIs do, it helped me lose weight and it keeps me motivated. For a while it even increased my sex drive.

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