Sex & Relationships

The Joy of Sex After Prozac

Sometimes, the sexual side effects are enough to force people off the medication.

Blond lady laying on the bed
Photo Credit: Arman Zhenikeyev

The other day, I found myself in bed with my Hitachi counting off orgasms. One. Two. Three. Four. Five. Six. All in under 30 minutes. Not too long ago, it would have taken me at least that long to have just one. I kept going just because I could. I felt like the Cookie Monster of climax — my googly eyes rolling around in my head while I barked, ”Me want orgasm!” It may or may not have occurred to me at one point to get out a stopwatch. I sort of wanted to call a friend about my newfound orgasmability. I kind of wanted to tweet about it.

The secret to this surprise sexual awakening? A couple of months ago, I stopped taking Prozac.

I went on antidepressants not too long after my mom was diagnosed with terminal cancer. It was my second experience with antidepressants, but also by far my longest. There was just so much to endure for so long —  the diagnosis, the illness, the years of uncertainty waiting for something we didn’t want to happen and then the grieving when it did. All in all, more than four years. So when I decided to go off Prozac, I couldn’t even meaningfully remember what anything was like before it. Least of all sex.

Of course, when I first went on I was well aware that sexual side effects were a possibility. I’d seen the antidepressant commercials, where a voice-over going a mile a minute summarizes all the potential hazards. Being depressed, though, I was more concerned with fixing my damn brain than the chance that it might take me a little longer to orgasm. Getting out of bed in the morning was my pressing issue, not my ability to achieve toe-curling ecstasy. You know, joie de vivre, not la petite mort.

But also, I just didn’t think it was all that likely that Prozac could get in the way of sex. How easily could a man-made pharmaceutical overpower the primal act of boning?

It turns out I’m not alone in my underestimation of the risk. Sexual side effects are far more common than popular wisdom, or even actual drug inserts, suggest. Studies show that between 30 and 73 percent of adults on SSRIs experience sexual dysfunction, according to a paper published in the Journal of Contemporary Psychotherapy. That’s a lot of sexual dysfunction — especially when you consider that one in 10 Americans is on antidepressants. Throw in our insane cultural dysfunction around sex and it starts to seem a wonder that anyone ever does it.

Among men, the reported sexual side effects include things like the disappearance of morning wood, finicky boners and trouble ejaculating. Ladies experience arousal and lubrication issues, low libido and delayed orgasms or the inability to orgasm. Add to the list “loss of genital tactile sensitivity and diminished intensity of orgasm, or pleasureless orgasm” for both sexes. Pleasureless orgasm? Try to wrap your head around that.

When Jarett, 46, went on Celexa,  he soon found it difficult to orgasm. “Everything else worked and it felt good,” he says, “but alas, crossing the cusp was nary impossible.” Of course, there was also a benefit to that: “When I was with a lover, it was nice, because it all felt as good and I could just keep going and not have to worry about losing control,” he said. “But that was a double-edged knife — so to speak — in that eventually all good things should come to a conclusion.” Shortly after he went off Celexa, his orgasms came back strong. It was a huge relief — at least for his solo sessions. As for partnered sex, he occasionally misses the “go-forever” thing.”

Never-ending boners aside, the impact on relationships can be devastating. In a matter-of-fact email bearing the subject line, “Wellbutrin and me,” one woman wrote to me, “I haven’t had sex in 2.5 years with the love of my life.” Another message from Sam, a 33-year-old from Florida, described how Cymbalta ever so slowly began delaying his orgasms; he wasn’t at first sure that it was the medication, and that introduced problems in his marriage. “She was very understanding, but there were some feelings of inadequacy, I think, on both sides at times. It got into both our heads, those ‘what am I doing wrong?’ thoughts,” he said.

Sometimes, the sexual side effects are enough to force people off the medication. “When I’m at my worst vis-a-vis depressive episodes, masturbating is one of a few things that I can trust to give me a few moments of reprieve,” says Dana, who tried Zoloft. “Not being able to have that” — because she couldn’t reach orgasm — “was counterproductive to my treatment, and I was fortunate enough to have a doctor who gave due credit to my concern.” Four days after she stopped taking it, she says her “body returned to factory settings.”

“Richard,” a 38-year-old living in Brooklyn, tells me that he went onto Lexapro knowing that there could be some sexual downsides but, as he puts it, “[I] was pretty crazy depressed and thought I could live with them.” Then came the diminished sex drive and difficulty getting an erection or having an orgasm. “The stress from it all kept me up at night,” he says. “So I’d sit at my computer and google everything I could find about this drug and the side effects.” It was during one of these middle-of-the night information binges that he found a message board with similar stories to his. “The last message I read was from a guy who wrote, ‘…I feel great now and not being able to get a erection or achieve an orgasm is a small price to pay,’” he says. “Like hell it is! I stopped taking them the very next day.”

The sexual side effects are by no means inevitable. Forty-two-year-old Kathleen went on Wellbutrin for postpartum depression. She says it helped her lose her baby weight faster than with her first pregnancy, which actually had a positive effect on her sex life. “Since I felt good about my body, I felt more sexual,” she says. Since then, she tried Abilify, which caused her to gain weight and consequently lose sexual desire, she says. Now she’s on a combination of Wellbutrin and Zoloft and her love life is rockin’. “I love sex, and it was important to me that any medication I took wouldn’t dull my desire. I expressed that to my therapist and psychiatrist, so they worked with me on what course of treatment would be best,” she says. “I can’t emphasize enough that women should be very vocal about what they need from their therapist and doctor — it’s okay to say ‘sex is important to me.’”

Unfortunately, not all doctors are savvy about sexual health issues (understatement of the year.) David Ley, a clinical psychologist specializing in sexuality, says that after his wife went on an SSRI, she began having orgasm-induced migraines. Her doctor responded to this news by asking, ”Is that a problem for your husband?” Ley says, “My wife was amazed, and responded appropriately, that it was her head, her headache and her orgasm that were the important issues here. I’m still shaking my head over this experience, embarrassed for the mental health and medical profession.”

In his own practice, Ley sees many patients who struggle with sexual side effects of SSRIs. Given his area of expertise, he tends to attract patients for whom “sexuality is often a critically important piece of their emotional functioning,” he says. ”It becomes a real dilemma, and trade-off between enjoying sexual health and satisfaction, versus enjoying life and experiencing decreased depression,” he said. “For people used to a high libido, who place a lot of personal value on sexuality in their life, this can be a very challenging negotiation.”

The bottom line is that antidepressants can kill your sex life, but so can depression. In fact, depression can literallykill you. It’s no wonder people are willing to potentially sacrifice their sex lives. In my case, Prozac made me a total believer in the power of antidepressants. Looking back, knowing what I know now about the sexual side effects, I would have gone on it all the same. But I tell you this: I would have gone off it much, much sooner. I just didn’t realize how many orgasms were waiting on the other side.

 

Tracy Clark-Flory is a staff writer at Salon. Follow @tracyclarkflory on Twitter and Facebook.

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