This story was originally published on January 14, 2022, and updated on August 14, 2026.
It sounds like a cruel joke: Depression can cause problems in your sex life, from decreased libido to issues with arousal and orgasm. Antidepressants can cause some of the same exact problems.
Does this vicious circle mean that you have to choose between your mental health and your sexual satisfaction?
Absolutely not, says UNC Health psychiatrist Katie Pollard, MD.
“Both mental health and sexual relationships are a huge part of being human, and most people find their sexual health gets better when they treat their depression,” Dr. Pollard says. “Sex is more than your genitals—it gets to how we feel, which is why mental health is part of the issue.”
The Effects of Depression on Sexual Health
Both men and women can experience difficulties initiating and enjoying sex because of depression.
“More than half of people with depression have bothersome sexual dysfunction, whether it’s changes in libido, erectile dysfunction or delayed orgasm,” Dr. Pollard says.
Depression symptoms include feelings of sadness and worthlessness, loss of interest in activities, fatigue and sleep changes, all of which will affect your relationship with your partner, your desire for intimacy and your ability to enjoy it.
“When you have decreased motivation and interest in things, that easily starts to affect sexual function,” Dr. Pollard says. “Sex is a vulnerable thing, and it’s hard to do when we don’t feel good about ourselves.”
It’s especially tricky if you don’t recognize that you or your partner is experiencing a depressive episode. If you’re experiencing problems in your relationship or sexual dysfunction and haven’t yet tied those issues to your mental state, you might start to blame yourself or your partner without considering that depression might be a factor.
“If a man is experiencing erectile dysfunction, he might go to his primary care provider, ask for Viagra, and not look more deeply into other issues that could be causing this,” Dr. Pollard says. “People do well to take a moment and dig into what’s going on.”
When you talk to your provider about depressive symptoms, they’ll likely recommend options including healthy lifestyle habits, psychotherapy and medication. It’s worth noting that healthy lifestyle habits and therapy can improve both mood symptoms and sexual functioning.
“Psychotherapy can be an especially important part of treating depression, and it can be really good to have a place to talk about these issues in a relationship more deeply,” Dr. Pollard says. “Exercise, adequate sleep, good nutrition and hydration are also important for both mental health and comfort with sex. Those are things most of us know, but you can downplay just how important they are when you’re depressed.”
The Effects of Antidepressants on Sexual Health
While antidepressants are extremely effective at relieving symptoms of depression, they do have side effects that can affect sexual function.
“Sexual dysfunction with many antidepressants, including SSRIs, is a common side effect,” Dr. Pollard says, with symptoms including decreased libido, erectile dysfunction or vaginal dryness, and difficulty having an orgasm.
While your doctor can’t predict exactly which side effects you’ll have or their severity, they can work with you to address them so that you can take medication and have a fulfilling sex life.
“Have an open dialogue with your doctor about what you’re experiencing, because we might be able to switch you to a different medication,” Dr. Pollard says.
You may find that your sexual functioning actually improves when you’re on an antidepressant, because you feel so much better. But if the medication that works best for your depressive symptoms has noticeable sexual side effects, you have options.
“We might be able to lower the dose a little bit, which can help,” Dr. Pollard says. “Or, if you’re at the particular dose that really helps you and there are side effects, we can sometimes try adding a low dose of Wellbutrin.”
Wellbutrin, or bupropion, is a different class of antidepressant than an SSRI and works by increasing levels of norepinephrine and dopamine, which affect pleasure and arousal.
Sexual side effects of antidepressants will stop once you stop taking the medication, but stopping an antidepressant abruptly puts you at risk for symptoms of depression and anxiety returning. It also puts you at risk for antidepressant discontinuation syndrome, flu-like symptoms of fatigue, headache, achiness and nausea. While these symptoms aren’t permanent or harmful, they likely will be milder if you work with your doctor to create a plan to taper off the antidepressant over the course of a few weeks.
Talking to Your Partner and Your Doctor
Changes in your sexual functioning can happen for many reasons besides depression.
Hormonal shifts, new medications and conditions like diabetes can cause changes to your sex life, and there will be ebbs and flows over the course of a long-term relationship. Children, jobs and other stressors play a role.
Try to stay connected and open with your partner if things are changing and you’re trying to figure out why. If you need help navigating these types of issues, a couples therapist can help guide the conversation. Often, through talking, you may be able to lessen the pressure you may be feeling, work through relationship stressors and identify ways to strengthen your bond.
Stay in contact with your doctor, too. In addition to ruling out other causes for sexual dysfunction, they will want to help you manage both your depression and any side effects from your medication.
“For the most vulnerable health issues—and mental health and sex are very vulnerable—people think, ‘No one else is dealing with this; my doctor will be weirded out if I talk about it,’” Dr. Pollard says. “Just know, doctors talk about these things all the time, and you’re never the only one dealing with it.”
If you’re experiencing symptoms of depression, talk to your doctor or find one near you.