Depression can impact your sexual health in more ways than one — but there are ways to cope.
If you live with depression, everything may feel like it takes too much effort, including sex.
You may not even realize your libido (aka sex drive) has lessened until your partner mentions it. For you, sex might be the last thing on your mind, so you may not prioritize it like you used to. Or it just might not feel the same.
If you’re experiencing depression-related loss of libido, the road back to the sex life you want starts with understanding a bit more about how depression affects sexual health.
Both depression and some depression medications can affect your sex life and sexual desire.
Psychological symptoms, like low mood and a loss of interest in activities you used to enjoy, as well as physical symptoms like fatigue and chronic pain, can all result in much less interest in sex.
Imbalances in brain chemicals (neurotransmitters) that are associated with depression — like serotonin and dopamine — may also play a role.
On top of that, some antidepressants used to treat depression may have side effects that affect sexual desire and functioning.
Depression can affect anyone and will look different from person to person — no matter their gender identity. Still, some differences have been noted in those who identify as male or female.
Depression symptoms in men may manifest as anger instead of sadness. Men may be more likely to lose interest in once-enjoyable activities and less likely to communicate their feelings.
Women, on the other hand, may experience depression related to hormonal changes. This includes:
- postpartum or perinatal depression
- premenstrual dysphoric disorder (PMDD)
- menopause-related depression
Women also tend to have more feelings of guilt or worthlessness.
All of these challenges — anger, substance use, hormonal changes, and more — may lead to less desire for sex or problems with sexual functioning like erectile problems, vaginal dryness, and trouble reaching orgasm.
Together, these symptoms can result in a low desire for sex.
Additionally, your sexual response may be linked to the amount of brain chemicals like dopamine and serotonin in your body. For example,
However, low dopamine levels may not cause depression directly. Instead, it could promote specific symptoms of depression like loss of interest in pleasurable activities — which can manifest as a low libido.
Sex-related symptoms you might experience if you have depression include:
If you’re taking an antidepressant, one possible side effect is low libido. This is thought to occur because of how these medications interact with brain chemicals like serotonin and dopamine — which are required for sexual response.
Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) typically have the highest chance of causing sexual side effects.
A 2010 study found that nearly 25–75% of people taking an SSRI, and 58–70% of people taking an SNRI reported having some type of sexual side effect.
Still, research suggests that your sex drive can wane even if you’re not taking an antidepressant.
In an older study, 70% of people living with depression had a loss of interest in sex while not taking medication.
If you have depression and experience low libido or other sexual health challenges, you’re not alone. There are ways to help enhance your desire and enjoyment of sex again.
Consider a change in your current medication
Although any antidepressant might produce sexual side effects, some types are more likely to cause issues than others.
- duloxetine (Cymbalta)
- escitalopram (Lexapro)
- citalopram (Celexa)
- paroxetine (Paxil and Paxil CR)
- fluoxetine (Prozac)
- sertraline (Zoloft)
So, if you’re taking any of the above antidepressants and experience low libido, some research suggests that these medications might be a better option:
- agomelatine (Valdoxan or Thymanax)
- bupropion (Wellbutrin)
- desvenlafaxine (Pristiq or Khedezla)
- moclobemide (Amira, Aurorix, Clobemix, Depnil and Manerix)
- trazodone (Desyrel, Desyrel Dividose, Oleptro, and Trazodone D)
- vilazodone (Viibryd)
- vortioxetine (Trintellix)
Sometimes, your doctor may want to start by adjusting your dose to try improving your libido.
If you do want to make changes to your medications or dosage, it’s important to reach out to your prescriber or mental health professional. They can best help you come up with a plan to manage any sexual side effects you’re having.
Try exercise if it’s safe for you to do so
So, if it’s safe for you to exercise, lacing up a pair of workout shoes and heading to the gym might not only help your physical fitness, but also have a positive effect on your sex-related depression symptoms.
Consider doing it, even if it’s not on the top of your to-do list
Sometimes, a low libido can create a pattern of not having sex that’s difficult to break. To help promote desire, consider engaging in intimacy, even if it’s not a priority for you right now.
This doesn’t have to include intercourse — even cuddling can help increase feel-good chemicals in the brain, which may eventually lead to an increase in desire for sex.
If you’ve been recently diagnosed with depression, you may be worried about how it will affect your sex life.
To be proactive, the first thing to consider is finding an appropriate treatment for depression that works for you. This could include medication, psychotherapy, or a combination of both.
But try not to be discouraged if the plan you’re following doesn’t work right away. It may take time for you and your treatment team to determine which combo of treatments manages your depression without causing sex-related side effects.
Low sexual desire can feel discouraging and even increase feels of low self-esteem.
So, if you’re concerned about your sexual desire or functioning, consider talking with a healthcare professional to determine why this is happening and what you can do to manage it.
Depression affects everyone differently and can cause many symptoms — some of which might lead to less interest in sex.
Antidepressants may also impair your sexual functioning or desire.
But a low libido is actually fairly common for people living with depression. So if you’re having sexual health challenges, you’re not alone and help is available.
There are actionable steps you can take to manage your depression and related libido challenges. This might include lifestyle changes, talking with your partner, or working with a healthcare professional to adjust your antidepressant medication.