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How to Have a Sex Life on Antidepressants

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When quitting isn’t an option, is it possible to overcome the sexual side effects that come with an SSRI?

By Shannon Holcroft

So, you’ve finally filled the antidepressant prescription that’s been acting as a bookmark for the most recent novel you’re feigning interest in. Somewhere between missing your own birthday party and watching everyone else have fun without you, you gave in. After a few medicated weeks, things are starting to look up. Except for your sex life, that is.

Just last week, you were tied to a kitchen chair enjoying an amazing (albeit rather mournful) few minutes of escape through sex. Today, getting naked seems less appealing than all the other pressing tasks you have new-found energy to complete.

“Is it the meds, or is it just me?” you wonder as you deep-clean the fridge with new vigour. After some soul-searching, it becomes clear that you’re still the same person—just with fewer festering foodstuffs and a lot less crying.

“It must be a side effect,” you decide. But months after filling your prescription, your genitals are still giving you the physiological equivalent of 8d2cc2c1a43108301b149f7f33e1664d.png

Why Antidepressants May Be a Downer for Your Sex Life

“[Sexual dysfunction] is a difficult, frustrating, and very common issue with this class of medications,” says Jean Kim, M.D., clinical assistant professor of psychiatry at George Washington University.

Twelve percent of American adults reported filling an antidepressant prescription in the most recent Medical Expenditure Panel Survey. Not just for clinical depression, but for all kinds of off-label conditions like chronic pain and insomnia.

Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressant class. And between 30 percent and 50 percent of individuals taking SSRIs experience sexual dysfunction. Desire, arousal and orgasm may be affected by changes in function of neurotransmitters like serotonin and dopamine; the very mechanisms through which SSRIs treat depression.

How to Work Around the Side Effects

When fighting to survive a potentially fatal mental illness, there are often more important concerns than getting it on. It’s frequently not an option to stop taking life-saving medication to avoid side effects. So what’s a sexual being to do?

Despite SSRIs being pretty pedestrian, there’s no concrete answer to addressing sexual side effects. “Unfortunately, not much is reliably effective to deal with this [sexual dysfunction],” Dr. Kim notes.

This may sound pretty gloomy, but there are plenty of things you can try to bring sexy times back around. “Don’t hesitate to bring up the issue with your prescribing clinician, as there might be some helpful interventions available,” says Dr. Kim.

Here are other ways to work around the sexual side effects of antidepressants:

1. Time It Right

“Some literature advises trying to have sexual activity when the serum level of a daily antidepressant might be lowest in the bloodstream,” says Dr. Kim. In other words, the ideal time to get it on is right before you take your next daily dose.

If your dosing schedule makes it tough to pencil in sexual activities, chat with your clinician about changing the time of day you take your meds. In many cases, there’s room for flexibility.

“This would not work much with some SSRIs that have a longer half-life like fluoxetine (Prozac),” Dr. Kim adds. Those taking antidepressants that exit the body quickly, like Paxil and Zoloft, could be in luck.

2. Switch It Up

Switching to a different medication, with the support of your prescribing clinician, may make all the difference. Certain antidepressants have a greater incidence of sexual side effects than others. Commonly prescribed SSRIs associated with a high frequency of sexual dysfunction include paroxetine (Paxil), sertraline (Zoloft) and fluoxetine (Prozac).

Besides exploring the SSRI class, venturing into atypical antidepressant territory is another option. Buproprion (Wellbutrin) is an atypical antidepressant observed to present the lowest sexual side-effect profile of all antidepressants.

It may take some trial and error, mixing and matching to identify what works best for you, but it will all be worth it when you can [insert favorite sex act here] to your heart’s content again.

3. Augment

Some treatment add-ons may act as antidotes to SSRI-induced sexual dysfunction. “Supplementing with other medications that have serotonin blocking effects (like cyproheptadine [Peritol] or buspirone [Buspar]) or enhance other neurotransmitters like dopamine (like Wellbutrin) might help,” says Dr. Kim. She is quick to note that these findings are yet be confirmed by “larger-scale randomized controlled clinical trials.”

“Another common strategy is to prescribe erectile dysfunction drugs like sildenafil (Viagra) and the like for as-needed use before activity,” says Dr. Kim. Viagra has been found to reduce sexual side effects, even if you’re not in possession of a penis. In Dr. Kim’s clinical experience, “[Viagra] seems to help in more than a few cases.” Discuss with your doctor before adding any more medications to the mix.

4. Exercise

Now’s the time to take up aquacycling, indoor surfing sans water or whatever fitness fad tickles your fancy. Keeping active could be the key to preventing sexual dysfunction caused by SSRIs.

“Sometimes sexual dysfunction is not just a primary SSRI drug side effect but part of underlying depression/anxiety as well,” Dr. Kim explains. “Anything that helps enhance overall blood circulation, mood and libido might be helpful, such as exercise.”

Complete Article HERE!

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Who’s avoiding sex, and why

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By Shervin Assari

Sex has a strong influence on many aspects of well-being: it is one of our most basic physiological needs. Sex feeds our identity and is a core element of our social life.

But millions of people spend at least some of their adulthood not having sex. This sexual avoidance can result in emotional distress, shame and low self-esteem – both for the individual who avoids sex and for the partner who is rejected.

Yet while our society focuses a lot on having sex, we do not know as much about not having it.

As a researcher of human behavior who is fascinated by how sex and gender interact, I have found that sexual avoidance influences multiple aspects of our well-being. I also have found that people avoid sex for many different reasons, some of which can be easily addressed.

People who have more sex report higher self-esteem, life satisfaction and quality of life. In contrast, lower frequency of sex and avoiding sex are linked to psychological distress, anxiety, depression and relationship problems.

In his landmark work, Alfred Kinsey found that up to 19 percent of adults do not engage in sex. This varies by gender and marriage status, with nearly no married males going without sex for a long duration.

Other research also confirms that women more commonly avoid sex than men. In fact, up to 40 percent of women avoid sex some time in their lives. Pain during sex and low libido are big issues.

The gender differences start early. More teenage females than teenage males abstain from sex.

Women also are more likely to avoid sex because of childhood sexual abuse. Pregnant women fear miscarriage or harming the fetus – and can also refuse sex because of lack of interest and fatigue.

The most common reasons for men avoiding sex are erectile dysfunction, chronic medical conditions and lack of opportunity.

For both men and women, however, our research and the work of others have shown that medical problems are the main reasons for sex avoidance.

For example, heart disease patients often avoid sex because they are afraid of a heart attack. Other research has shown the same for individuals with cerebrovascular conditions, such as a stroke.

Chronic pain diminishes the pleasure of the sexual act and directly interferes by limiting positions. The depression and stress it causes can get in the way, as can certain medications for chronic pain.

Metabolic conditions such as diabetes and obesity reduce sexual activity. In fact, diabetes hastens sexual decline in men by as much as 15 years. Large body mass and poor body image ruin intimacy, which is core to the opportunity for having sex.

Personality disorders, addiction and substance abuse and poor sleep quality all play major roles in sexual interest and abilities.

Many medications, such as antidepressants and anti-anxiety drugs, reduce libido and sexual activity, and, as a result, increase the risk of sexual avoidance.

Finally, low levels of testosterone for men and low levels of dopamine and serotonin in men and women can play a role.

For both genders, loneliness reduces the amount of time spent with other people and the opportunity for interactions with others and intimacy. Individuals who are lonely sometimes replace actual sexual relations with the use of pornography. This becomes important as pornography may negatively affect sexual performance over time.

Many older adults do not engage in sex because of shame and feelings of guilt or simply because they think they are “too old for sex.” However, it would be wrong to assume that older adults are not interested in engaging in sex.

Few people talk with their doctors about their sexual problems. Indeed, at least half of all medical visits do not address sexual issues.

Embarrassment, cultural and religious factors, and lack of time may hold some doctors back from asking about the sex lives of their patients. Some doctors feel that addressing sexual issues creates too much closeness to the patient. Others think talking about sexuality will take too much time.

Yet while some doctors may be afraid to ask about sex with patients, research has shown that patients appear to be willing to provide a response if asked. This means that their sexual problems are not being addressed unless the doctor brings it up.

Patients could benefit from a little help. To take just one example, patients with arthritis and low back pain need information and advice from their health care provider about recommended intercourse positions so as to avoid pain.

The “Don’t ask, don’t tell” culture should become “Do ask, do tell.”

Complete Article HERE!

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Heightened Awareness: Anxiety Can Lead to Pain During Sex

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Clearly anxiety can be an obstacle to a healthy sex life and needs to be talked about.

By Carrie Weisman

clenched-fists

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Men, Depression and Sex

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As anyone who has been depressed will tell you, depression isn’t just about feeling blue.

Man and woman with pensive expression --- Image by © Ocean/Corbis

It is an incredibly complex condition which brings with it a whole slew of emotional, mental and physical symptoms with it. For men and women both, part of the problem can revolve around their sexuality – and this in turn can cause problems in a relationship at the time when the depressed person most needs the support.  Fortunately, there are ways to help treat this particular problem and restore intimacy and pleasure to a relationship.

Depression and Male Sexuality

It is common for both men and women to experience sexual problems as part of their depression – but the ways in which this presents itself can be different.  Healthline notes that in men, depression will often express itself as feelings of low-esteem, anxiety and guilt and this, in turn, can cause problems with erectile dysfunction, delayed orgasm, premature ejaculation or just a loss of interest in sex itself.

There is still a lot we just don’t know about exactly how depression affects the brain. But according to Net Doctor, researchers have learned that the chemical changes which take place when someone has this condition can lead to an increase in emotional withdrawal and low energy levels so that activities like sex, which require a connection to your partner as well as physical energy to perform, can become a challenge.  This can be hurtful for the person’s partner and make them feel unwanted or unloved, putting a strain on the relationship that can, in itself, be difficult to deal with.

To make matters worse, many antidepressants are notorious for their side effect of causing sexual dysfunction or loss of interest.  Included in this group are MAOI inhibitors, SSRI’s and SSNRI’s and both tetracyclic and tricyclic antidepressants. 

What to Do

So the long and short of it is, both depression itself and some of the treatments for depression can both put a damper on a guy’s sex life. So what are some solutions to the problem?

Get the Treatment You Need

Depression is not a choice that people make – and it is usually not a problem that goes away by itself. If you have not yet been diagnosed, talk to your doctor about the symptoms you are having and get started on a plan of care that involves the combination of medications, therapy and lifestyle changes that are right for you.

If you are already being treated for depression and suspect that your anti-depressants might be putting the kybosh on your sex life, find out if you can switch medications. While it might take a little time to take effect, there are some drugs which do not seem to effect one’s libido, including Wellbutrin and Remeron.

Exercise

Both Healthline and Everyday Health recommend regular exercise – preferably with your partner – as part of a program to help reconnect sexually. First, it gives you and your partner time together doing something enjoyable and this alone can be good for a relationship. It also helps to release feel-good chemicals like endorphins that help fight depression naturally and keeps you in good shape so that you feel good about yourself and the way you look. All this can go a long way to enhancing your sex life.

Take Your Time

According to Everyday Health, sex therapist Dr. Sandra Caron also has a few tips for couples who are struggling to overcome the barrier that depression has placed on their sives.  She recommends, first of all, that couples engage in more foreplay and other physical expressions of intimacy – hand holding, caressing, massage – before engaging in intercourse itself.  Depression tends to slow down all responses, so taking this extra time to achieve arousal can help enhance the pleasure for both partners.  She also recommends the use, if needed, of estrogen creams or lubricants and even erotica (like lingerie or sexy movies) to help sparthe mood.

Open Up

Probably the most important advice for men who are trying to reconnect with their partner sexually is to open up and communicate with your partner. This can be more difficult for men to do in general, but is even more of a challenge when it comes to talking about intimate issues like sexuality, desire and arousal. But being honest about how you are feeling and letting your partner know that it is the depression that is a problem and not a loss of interest or a loss of love can be an incredibly powerful way to overcome this challenges and get support from your loved one at a time when you need it the most.  Also, partners can be more understanding and supportive if they understand more about what is going on – otherwise, it is easy to interpret a low mood or lack of responsiveness as being hostile or unloving.

In short, depression is a difficult condition with a whole slew of symptoms that go far beyond just feelings of sadness or being blue.  And when depression begins to affect a person’s sexuality, this in turn can lead to a strain on intimate partner relationships.  However, while there are no quick solutions to this problem, getting on a treatment program that is tailored to someone’s individual needs as well as exercising regularly, spending time with a partner to engage in more foreplay and simply opening up and talking about the problem can all help to reignite the sexual spark in a relationship – and hopefully make the battle against depression that much easier.

Complete Article HERE!

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10 Reasons Why Women Lose Their Libido

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Ladies, libido means sexual desire. Women having decreased libido is one of the most common complaints I hear in the office, especially for those stressed out supermoms. Trust me – you’re not alone, ladies. It is estimated that more than 40% of women experience some sort of sexual dysfunction in their lifetime. Here’s why, and what you can do about it.

Dried Rose On Old Vintage Wood Plates

Female sexual dysfunction can include problems with desire, arousal, achieving orgasm and sexual pain that causes significant distress in your life. More specifically, decreased libido is when you don’t want to engage in any type of sexual activity, including masturbation, and you don’t want to have any sexual thoughts or fantasies. Sound like someone you know? Let’s review some reasons why you may not want to have sex with your significant other:

1. Bad Relationship.

Fighting with your partner is an easy way to kill your sex drive. When you are angry or hurt, sex is the last thing on your mind. Fix your relationship — go to couples’ therapy.

2. Stress.

It doesn’t matter where the stress comes from, all of it can cause your libido to drop. It doesn’t matter if you’re stressed out from financial problems, from trying to get pregnant, or from worrying about your job – it all negatively impacts your libido. Stress can also lead to you being fatigued, which worsens the problem. Find ways to chill out ladies – I mediate daily to deal with stress, and that might work for you, too.

3. Alcohol and Smoking.

Both of these drugs have been shown to decrease sexual desire and satisfaction. While alcohol in moderation is okay, when you binge drink, sexual dysfunction starts to occur. On the other hand, any kind of smoking is bad – just quit!

Easier said than done, right? You have to know why you are smoking. Substitute that why with something else. For example, if you smoke because you are bored, instead of lighting up go to the gym.

4. Mental Illness.

Mental conditions such as depression and anxiety can also cause your libido to drop. Talk to your doctor and get treated. Sometimes medications used to treat these conditions can also cause a drop in libido – but not every medication does, so talk to your doctor.

crying girl

5. Birth Control.

Hormonal birth has been shown to decrease testosterone in your body, which could lead to a lowered libido. This is because testosterone is one of the hormones that makes you horny.

Other medications such as antidepressants, anti-seizure meds, opioids, medical marijuana, antihistamines, and hypertensive medications can also decrease your sexual desire. Talk to your doctor about switching your medications if you think any are giving you a problem. Your healthcare provider can also potentially switch you to a non-hormonal birth control option, like the Paragard IUD.

6. Trauma in your Past.

Negative sexual experiences in the past can cause issues with decreased libido. Women who were raped or have been victims of domestic violence may, understandably, have issues here. Going to therapy to work through your pain can help.

7. Poor Body Image.

In a world full of fake butts and boobs, it isn’t hard to image women struggling with their body image. Not thinking you are sexy enough can cause your sex drive to plummet. If you don’t like something about yourself, change it – in a healthy way, of course. Eat clean, drink water and exercise – though, keep in mind that a lot of times this is something that you have to work out in therapy.

8. Medical Conditions.

Medical illnesses such as diabetes, hypertension, thyroid disease, congestive heart failure, or cancer can all affect libido. They can alter hormones that have an impact on your sex drive. Proper treatment of the underlying disease can often improve libido.

9. Pregnancy and Breastfeeding.

Hormones fluctuate during pregnancy and breastfeeding, which can decrease your sex drive. Being pregnant can cause you to be tired and not feel sexy, which certainly doesn’t help your libido! Do your best to focus on intimacy with your partner — also, when you have the baby, get help. Let those grandparents help out with babysitting!

10. Aging.

In menopause, estrogen levels drop drastically because the ovaries aren’t working anymore. Low estrogen causes, among other things, a dry vagina, which makes sex painful. This can lead to decreased sexual desire. Arthritis in the aging population can make having sex less fun. When vaginal dryness makes sex uncomfortable, use lubricants (try a free sample of Astroglide Liquid or Astroglide Gel, which temporarily relieve dryness during intercourse). Some women find using vaginal estrogen also helps.

Complete Article HERE!

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