Anxiety and depression have always been difficulties I’ve struggled with ever since my early teen years. After years of panic attacks and days spent lying in bed, I decided to inquire about medication with my therapist. Specifically, an SSRI. Though I was given information about side effects, I was completely unaware of the sexual aspect that was threatened.
After confiding in my therapist about all the struggles I had been facing, she offered the idea of starting Lexapro. Lexapro, also known as Escitalopram, is a selective serotonin reuptake inhibitor. This was supposed to help improve my mood and miserable sleep schedule.
Sexual side effects
Many people complain about experiencing sexual dysfunction after starting SSRIs. This includes facing low libido, delayed orgasm, or a lack of orgasm. The National Library of Medicine reported in 2025 that 27–65% of female patients experienced either a deterioration of pre-existing sexual difficulties or new sexual problems during the first weeks of starting an SSRI. For men, 26–57% reported the same struggles. This information was gathered from a questionnaire of 452 people.
For many people, these sexual dysfunctions can have long-lasting effects. They can also cause lots of discomfort and frustration.
“SSRIs are serotonin reuptake inhibitors, which means that they will increase the amount of serotonin in the brain,” Dr. Lori Davis, a certified sex counselor, said. “The interesting thing is, when serotonin goes up, dopamine goes down, it’s an unintended side effect for decreased dopamine levels, which then impacts sexual functioning.”
As some people begin to experience these sexual side effects, the fear of going to their doctor and expressing discomfort becomes a new barrier. Specifically, some women avoid voicing their problems because of the fear of being judged or not believed.
Disbelieving women
Women are continuously overlooked in the medical field. There also continues to be a lack of proper research when it comes to women’s health. Because men are typically used as research subjects, women face many barriers. This includes inadequate treatment and the shame drilled into their heads.
The topic of sexual functioning, such as orgasms and libido remain “taboo” for some. With this, the need to find proper treatment can be difficult, especially for women.
A 2019 survey conducted by TODAY found that 52% of the 2,105 participating women considered discrimination against patients to be a serious issue. In the same report, 17% of women said that they felt they had been treated differently because of their gender.
Women with chronic health conditions reported feeling that healthcare providers often ignored their symptoms. Women were also more likely to report that they felt like they had to prove their symptoms to doctors. They also reported that their pain was taken less seriously compared to their male counterparts.
There is an ongoing history of bias against women in healthcare settings. This includes diagnosing problems as a psychosomatic issue. This could contribute to women feeling as though they don’t get proper education and treatment about their sexual struggles.
Women’s struggles in healthcare
Sarah FitzGerald, a sex therapist and licensed clinical social worker, said that there are ways in which women’s sexual side effects are taken less seriously than men’s.
“I think focusing on pleasure, especially for women, is a radical act,” FitzGerald said. “This is a cultural statement, not necessarily statements about individuals. I think in the United States, based on our Puritanical history, that pleasure has been viewed as a sin, or that if it feels good, you should feel bad.”
When conversations around sex are considered taboo, many women feel as though it’s inappropriate to discuss sexual struggles. With the lack of research, some women don’t know that their symptoms are normal when starting an SSRI. When feeling uncomfortable with a doctor, voicing issues can be difficult.
For women who face these struggles, advocating for wellness is imperative for health and happiness. Not only are doctors a good resource, but there are also other options for people to consult when facing sexual dysfunction, said Anabel Perez-Gonzalez, a licensed clinical social worker and certified sex therapist.
“If you are having any kind of sexual side effect or any sexual phenomenon, please seek out a practitioner that is specially trained in sex therapy or sexuality counseling,” Perez-Gonzalez said. “Sexuality educators count as therapists.”
She suggested using the American Association of Sexuality Educators to find resources such as sexuality educators, counselors, and therapists. Perez-Gonzalez said that counselors and therapists are medical providers with extra training. They could be general practitioners, psychiatrists, or psychologists.
Perez-Gonzalez recommended that patients not stop SSRIs without consulting a medical professional first.
Lasting problems
In another report from The National Library of Medicine, a study by Lüning in 2019 found that genital anaesthesia and/or nipple insensitivity are struggles that 26.3% of the participants reported. These are common for people facing Post-SSRI Sexual Dysfunction. These long-lasting symptoms can be frustrating for some and discourage those from starting, or continuing, an SSRI.
Between consulting doctors and considering a medication change, it’s also advocated for people suffering from sexual dysfunction to advocate for themselves in sexual settings as well. It may be difficult for some people in long relationships to suddenly face sexual struggles, as this means changes to a routine or foreplay. Communication with a long-term partner is extremely important when pleasure changes.
For people facing sexual dysfunction while they have a partner, there are difficulties because there’s another person involved who has different definitions of happiness and pleasure.
Communication in the bedroom
Davis said that people should come with a “contract” with their partner, this being communication outside of the bedroom and not during sex. This “contracting” would include setting up a time to talk in an appropriate setting with a time limit.
“Leading with positivity towards your partner in terms of what you enjoy about what’s happening or have enjoyed, and then letting them know what’s been going on with you,” Davis said. “One way that we engage in sex is about intimacy. So, that intimacy requires sharing how it actually is for you.”
FitzGerald offered a unique perspective for people who are seeking pleasure while dealing with SSRI-caused sexual dysfunction. She suggested stepping away from focusing on orgasming as the point of sex.
“We participate in sexual pleasure with one another for many other reasons, other than orgasm,” FitzGerald said. “In order to have that bonding and connection, sometimes it’s worth focusing on what you can do, which is maybe have fun without an orgasm.”
FitzGerald emphasized that she isn’t suggesting that women shouldn’t advocate for their own pleasure. Women’s sexuality isn’t treated the same as men’s sexuality and is often considered an “accessory” to men’s arousal.
She said that people should advocate for the pleasure that they can find and not focus on what is lacking. She said to find “small victories” in new sexual arousal responses.
Maintaining pleasure
Perez-Gonzalez advocated for speaking with medical providers and trying different medications as well. After covering that ground, people should then try to retrain their brains to find what’s pleasurable for them.
“Stretching the understanding of sexuality, intimacy, pleasure, and eroticism can be really helpful,” she said.
However, even though a person struggling with sexual dysfunction may communicate with a partner and advocate for themself, they could still find that desires no longer align. If a partner feels as though they can’t support someone through sexual dysfunctions, there might be a grief process that is important to accept.
Grief is understandable for a person who faces sexual difficulties after starting an SSRI. It’s ok to feel different and feel a sense of loss when pleasures and desires change drastically.
After consulting with a doctor and working on different strategies to maintain a healthy relationship with boundaries, sex while on SSRIs can be fun.
In the end, it’s important for people to advocate for their own needs, their own pleasure, and their own happiness.
