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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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Recharge your sexual energy

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If lack of energy has drained your sex life, there are ways to reignite the passion.

close-up of a mature couple relaxing in bed at home

Your sexual drive can stay high late in life, but often your energy for sex can diminish. Low energy not only affects your sex life, but can carry over to other parts of your life, too. You can become apathetic, no longer find pleasure in favorite activities, and become more sedentary.

However, many of these issues related to lost sexual energy can be addressed. “Never think lack of energy means an end to your sex life, and there is nothing you can do about it,” says Dr. Sharon Bober, director of the Harvard-affiliated Dana-Farber Sexual Health Program. “There are many strategies you can adopt to get back in the game.”

Find your energy drainers

Your lost sexual vim and vigor is often related to some kind of physical, emotional, or relationship issue. Here’s a look at the most common causes.

Low hormones. Lack of sexual energy could be due to male hypogonadism, which occurs when the testicles do not produce enough testosterone, the male sex hormone. In fact, fatigue is one of the most common side effects.

Testosterone levels drop about 1% each year beginning in a man’s late 30s, and could fall by as much as 50% by age 70. (A blood test from your doctor can determine if you have low testosterone.) Testosterone replacement therapy, which is given via absorbable pellet implants, topical gels, patches, and injections, can often help spark sexual energy in men with low levels.

Findings from a study published online Aug. 1, 2016, by The Journal of Clinical Endocrinology & Metabolism showed that a year of testosterone therapy improved libido in 275 men (average age 72) with confirmed low testosterone. Compared with men in a placebo group, frequency of sexual arousal increased by about 50%, and they were able to have almost twice as many erections.

Speak with your doctor about whether testosterone therapy is an option for you. Long- term risks are not well known, but there is concern for an increased risk of heart disease and prostate problems.

Erectile dysfunction. Men with erectile dysfunction can experience low energy because the condition can be a blow to their self-esteem. “Men may feel embarrassed about it or worry they will be judged in some way if they cannot perform as well as they once did, so motivation and energy for sex gets depleted,” says Dr. Bober.

In this case, speak with your doctor about taking an ED drug or exploring other options for getting or keeping an erection, like using a penile pump.

Even though talking about ED may be difficult, it’s important to open up lines of communication with your partner. “For many men, it can help relieve stress to know they are not alone and someone is there for support.”

Poor sleep. Lack of sleep can be one of the main energy zappers. Poor sleep can increase stress levels and interfere with how your body and brain store and use energy, which is why you feel so sluggish after not sleeping well. And if you are tired, you have less energy for sex. Talk with your doctor if you have trouble sleeping. Steps like changing medication or dose, cognitive behavioral therapy, and adjusting your diet and sleeping environment can often improve sleep quality.

Lack of movement. When you have no sexual energy, you need to get moving. Regular exercise is one of the best natural energy boosters. Numerous studies have linked exercise with improving fatigue, especially among sedentary people. You don’t need much to get a jolt — 2.5 hours per week of moderate-intensity exercise can do the trick. Focus on a combination of cardio and weight-bearing exercises like brisk walking and strength training.

Get checked out

Many medical conditions can affect sexual drive, such as obesity, diabetes, heart disease, high blood pressure, and high cholesterol. So be diligent about regular medical check-ups. Also, many drugs, including blood pressure drugs, antidepressants, and tranquilizers can produce erectile difficulties. Consult with your doctor if you take any of these.

Back in sync

Lack of energy also could be relationship-oriented, if you and your partner are not in sexual sync. For instance, you may have energy for sex, but your partner doesn’t, or at least not at the same level.

“Sex may not always be comfortable for women because of menopausal symptoms like vaginal dryness. If sexual activity is physically uncomfortable, not surprisingly, a woman’s sex drive also diminishes,” says Dr. Bober. “This can affect both partners, and if a man is worried that he might hurt his partner, that will certainly affect his interest in sex, too.”

In this situation, you need to communicate with your partner about how important sex is to you. It’s not about making demands, but about finding ways to explore mutual goals, such as pleasure and closeness.

“Perhaps it means negotiating a compromise just like you do in other aspects of a relationship,” says Dr. Bober. “Partners find ways to share everything from household chores to bill planning, and sex shouldn’t be any different.”

There’s a lot of room to find common ground, she adds. “There are many ways to be sexually active with your partner besides traditional intercourse. For example, you can ask your partner to be with you when you pleasure yourself, which feels intimate and can allow both partners to feel connected.”

Talk about it

Sometimes the sexual barrier is not about sex at all. An open dialogue also can reveal issues beneath the surface that may interfere with your partner’s sexual energy.

“Your partner may desire sex as much as you, but there may be underlying problems in the relationship that could affect sexual desire and need to be addressed,” says Dr. Bober.

Finally, another way to ignite lost sexual energy is to do new things together. “Couples can get into routines that can make for boring sex lives,” says Dr. Bober. “It can be fun to speak with your partner about ways to keep the relationship interesting and erotic.”

Many times, this can be done outside the bedroom, like having more date nights, going for long weekend romantic getaways, or even doing simple activities together like joining a club or taking a class.

“Investing in change can energize both you and your partner, and most important, pave the way for a renewed sense of closeness and novelty that is great for all couples,” says Dr. Bober.

Complete Article HERE!

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How to enjoy sex even when your mental ill-health is working against you

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Anxiety and low self-esteem can seriously impact your sex life

By

Ever had one of those days when your brain seems to be dead set on working against you?

You’re planning a nice bit of sexy time – whether with a partner or simply some solo fun – but your head’s just not in it.

However much you might want to get jiggy with it, your brain is skipping around elsewhere and you just can’t concentrate, let alone roll around in orgasmic delight.

So what causes your head to seemingly separate from your body at just the moment you want to be able to focus on fun times?

All too often it boils down to lack of confidence in yourself and what you’re doing.

If you have problems with self esteem, it can trickle into all areas of your life – and that includes the bedroom.

The saying ‘first you have to love yourself’ is bit of a cliche – but like most cliches, it’s actually true. Many things can sap your confidence, both mental and physical.

For my friend Amy, the problem is a lack of confidence caused by physical issues.

The problem has grown over the years, to the stage where it’s such a big issue that she’s unsure how to even start working through it.

‘I was born with cerebral palsy and I also have ME and fibromyalgia,’ Amy says.

‘I’ve gone from being moderately active and social to spending most of my time at home and sleeping a lot.

‘I was never particularly confident with guys because I have always been overweight.

‘I’ve had four sexual partners so far, three men and a woman. All were basically one night stands that were pretty unsatisfactory for me (and probably them too).

‘I’ve not had sex in years now and have never really dated anyone.

‘I’m pretty fed up of that to be honest but I feel quite isolated socially and wary of anyone who might take an interest because I feel so unattractive.’

You need to learn to love yourself

My personal suggestion in any situation like this always boils down to that same cliche – you have to learn to love yourself first.

Mirrors, masturbation and practice is the key.

Look at yourself so that you’re used to what your own body looks like and learn what really turns you on.

If you practice this alone then you’ll have all the more confidence when it comes to getting down to it with someone else in the room.

Amy’s story is just one of many I hear all the time from people whose sex lives have become unsatisfactory through no fault of their own.

I spoke to relationship and sexuality counsellor Jennifer Deacon and asked for her general advice on separating sex from anxiety.

‘When you’re anxious it’s often hard to feel turned on – or even have any desire at all.

‘That in turn can feed the anxiety more, particularly if you’re in a relationship where you might feel you’re letting your partner down, bringing up a whole heap more anxiety.

‘As with any anxiety the first thing is to try and find that tricky balance between reflecting on what’s going on with your thoughts and over-analysing.

‘What’s stopping you – is it the thought of being naked with someone else? The physical acrobatics that you might feel you ought to be performing?

‘Or is your sexual desire being suppressed because of meds that you’re taking?

‘Try to reflect on what’s going on, and then work through the ‘what ifs’ and ‘shoulds’ that often make up a huge part of anxious thoughts.

‘If you have a partner, try to communicate with them what you need – for example if you’re missing intimacy but are scared of initiating hugs or cuddles because you’re not sure you want full sex, then try to find a way to talk about this with them.

‘If your anxiety has roots in a trauma that you’ve experienced then communication becomes even more important – both communicating with yourself as to what you need and want, and communicating with your partner so that they can support you.

‘Lack of libido can be a common side effect from medication so if you notice that your sexual desire has waned since you started a new medication or changed your dose, consider discussing this with your GP or specialist.’

Many prescription drugs do indeed have side effects that affect the libido – and doctors aren’t always up front about explaining the risks.

Okay, so ‘losing interest in sex’ might be a long way down the list of worrying potential side effects, but given that antidepressants often cause this issue, I’m always amazed that it isn’t discussed more.

Sex is a healthy part of life and if you still want it but struggle to get any joy out of it, that’s going to affect your happiness levels.

After literally decades of living with chronic anxiety, I’ve been through endless different drugs in the hope of finding one that will help without ruining the rest of my life.

The problem is that drugs affect everyone differently – what works brilliantly for one person can potentially have drastically negative effects on another.

The first antidepressant I was given was Prozac.

Back then it was the big name in drug therapy and widely considered to be suitable for everyone.

And yes, it helped my depression – but it also completely removed my ability to orgasm.

I still wanted to – my sex drive itself wasn’t affected in any way – but I simply couldn’t ‘get there’.

I still regale people about ‘that time I gave myself RSI through too much w*nking’ – it’s a funny story now, but at the time it was utterly true and completely miserable.

I went back to the doctor and had my meds changed.

At the last count, I think I’ve tried about thirteen different anxiety meds and I still haven’t found one that I can cope with.

Ironically, if I was happy to lose my libido then several of them would have been perfect – but why should we be expected to go without one of the most enjoyable life experiences?

Personally, that makes me just as miserable as being anxious or depressed, so it invalidates the positives anyway.

Currently I’m med-free – and not very happy about it – but at least I still have my sex life.

For some people, finding the right medication without it affecting their libido will be easy.

But everyone has to find their own balance – some might prefer to take the meds and sacrifice their physical enjoyment.

But it’s okay to want both.

Complete Article HERE!

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Some drugs can cause unwanted sexual side effects in men

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You might assume that erectile dysfunction, or ED, is a normal problem that men face as they age. But because men (and women) take more medications as they age, the experts at Consumer Reports’ Best Buy Drugs report that side effects from those drugs are a little-known yet common cause of ED.

“Many medications can affect things like erectile dysfunction, desire and ejaculation in different ways and through different mechanisms of action,” says J. Dennis Fortenberry, former chair of the board of the American Sexual Health Association and the Donald Orr Professor of Adolescent Medicine at Indiana University School of Medicine.

Medications that can have these effects include high blood pressure drugs such as beta blockers, including atenolol (Tenormin), clonidine (Catapres), metoprolol (Lopressor) and methyldopa (Aldomet), and diuretics such as hydrochlorothiazide (Hydrodiuril).

Popular antidepressants and anti-anxiety drugs such as alprazolam (Xanax), diazepam (Valium), duloxetine (Cymbalta), fluoxetine (Prozac) and paroxetine (Paxil) can cause sexual problems such as delayed ejaculation, reduced sexual desire in men and erectile dysfunction. Lesser-known drug types that can also cause such sexual problems include antihistamines such as diphenhydramine (Benadryl) and antifungal drugs such as ketoconazole (Nizoral).

Surprisingly, heartburn drugs, including famotidine (Pepcid) and ranitidine (Zantac) are known to reduce sexual desire in men. In addition, reduced desire and erectile dysfunction have been reported in men taking the powerful painkillers oxycodone (OxyContin) and hydrocodone (Vicodin), muscle relaxers such as baclofen (Lioresal), and even over-the-counter ibuprofen (Advil, Motrin).

And perhaps not surprisingly, the more drugs a man takes, the greater his odds are of experiencing an issue. For example, in a 2012 study of men ages 45 to 69, those who took three to five drugs were 15 percent more likely to have erectile dysfunction than men taking two or fewer. Men who took six to nine drugs were 51 percent more likely to have erection problems.

What you can do

Before making any change to your medications, talk with your doctor, says David Shih, a board-certified emergency medicine physician and executive vice president of strategy on health and innovation at CityMD, a network of urgent care centers in the New York metro area and Seattle.

If appropriate, your physician can make changes such as “lowering the medication dose, switching to a new medication or a combination therapy of lower doses each,” notes Shih.

Your doctor may also suggest temporarily stopping a medication — often referred to as taking a “drug holiday” — before having sex, if that is possible.

If you’ve just started taking a new drug, sexual side effects may disappear as your body adjusts. But if after a few months they don’t, discuss it with your physician. He or she will want to rule out other conditions that could cause your sex drive to take a nose-dive.

“The prescribing physician will need to explore if these symptoms are from cardiovascular disease, depressive disorder, diabetes, neurological disease and other illnesses,” says Shih.

Even suffering from sleep apnea is known to affect sexual interest or response.

That’s why, if you experience ED, it’s important to get to your doctor’s office for a detailed discussion about what could be causing it.

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9 Reasons You Might Not Be Orgasming

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By Sophie Saint Thomas

While orgasms don’t define good sex, they are pretty damn nice. However, our bodies, minds, and relationships are complicated, meaning orgasms aren’t always easy to come by (pun intended). From dating anxiety to medication to too little masturbation, here are nine possible culprits if you’re having a hard time orgasming — plus advice on how to deal.

1. You expect vaginal sex alone to do it for you.

One more time, for the cheap seats in the back: Only about 25 percent of people with vaginas come from penetration alone. If you’re not one of them, that doesn’t mean anything is wrong with you or your body. As licensed psychotherapist Amanda Luterman has told Allure, ability to come from vaginal sex has to do with the distance between the vaginal opening and the clitoris: The closer your clit is to this opening, the more vaginal sex will stimulate your clit.

The sensation of a penis or a dildo sliding into your vagina can be undeniably delightful. But most need people need that sensation paired with more direct clitoral stimulation in order to come. Try holding a vibrator against your clit as your partner penetrates you, or put your or your partner’s hands to good use.

2. Your partner is pressuring you.

Interest in your partner’s pleasure should be non-optional. But when you’re having sex with someone and they keep asking if you’ve come yet or if you’re close, it can throw your orgasm off track. As somatic psychologist and certified sex therapist Holly Richmond points out, “Being asked to perform is not sexy.” If your partner is a little too invested in your orgasm, it’s time to talk. Tell them you appreciate how much they care, but that you’re feeling pressure and it’s killing the mood for you.

It’s possible that they’re judging themselves as a partner based on whether or not you climax, and they may be seeking a little reassurance that they’re making you feel good. If they are, say so; if you’re looking to switch it up, this is your opportunity to tell them it would be so hot if they tried this or that thing next time you hop in bed.

3. Your antidepressants are messing with your sex drive.

As someone who continues to struggle with depression, I can’t emphasize enough how important it is to seek treatment and take medication if you and your care provider decide that’s what’s right for you. Antidepressants can be lifesavers, and I mean that literally.

However, certain medications do indeed affect your ability to come. SSRIs such as Zoloft, Lexapro, and Prozac can raise the threshold of how much stimulation you need to orgasm. According to New York City sex therapist Stephen Snyder, author of Love Worth Making: How to Have Ridiculously Great Sex in a Long Lasting Relationship. “For some women, that just means you’re going to need a good vibrator,” says New York City sex therapist Stephen Snyder, author of Love Worth Making: How to Have Ridiculously Great Sex in a Long Lasting Relationship. “For others, it might mean your threshold is so high that no matter what you do, you’re just not going to be able to get there.”

If your current medication is putting a dramatic damper on your sex life, you have options, so talk to your doctor. Non-SSRI antidepressants such as Wellbutrin are available, while newer medications like Viibryd or Trintellix may come with fewer sexual side effects than other drugs, Snyder says. I’m currently having excellent luck with Fetzima. I don’t feel complete and utter hopelessness yet can also come my face off (a wonderful way to live).

4. Your birth control is curbing your libido.

Hormonal birth control can also do a number on your ability to climax, according to Los Angeles-based OB/GYN Yvonne Bohn. That’s because it can decrease testosterone levels, which in turn can mean a lower libido and fewer orgasms. If you’re on the pill and the sexual side effect are giving you grief, ask your OB/GYN about switching to a pill with a lower dose of estrogen or changing methods altogether.

5. You’re living with anxiety or depression.

“Depression and anxiety are based on imbalances between neurotransmitters,” OB/GYN Jessica Shepherd tells Allure. “When your dopamine is too high or too low, that can interfere with the sexual response, and also your levels of libido and ability to have sexual intimacy.” If you feel you may have depression or an anxiety disorder, please go see a doctor. Your life is allowed to be fun.

6. You’re not having sex for long enough.

A good quickie can be exciting (and sometimes necessary: If you’re getting it on in public, for example, it’s not exactly the time for prolonged foreplay.) That said, a few thrusts of a penis inside of a vagina is not a reliable recipe for mutual orgasm. Shepherd stresses the importance of foreplay, which can include oral, deep kissing, genital stimulation, sex toys, and more. Foreplay provides both stimulation and anticipation, making the main event, however you define that, even more explosive.

7. You’re recovering from sexual trauma.

Someone non-consensually went down on me as part of a sexual assault four years ago, and I’ve only been able to come from oral sex one time since then. Post-traumatic stress disorder is common among survivors of sexual trauma; so are anxiety and orgasm-killing flashbacks, whether or not the survivor in question develops clinical PTSD. Shepherd says sexual trauma can also cause hypertonicity, or increased and uncomfortable muscle tension that can interfere with orgasm. If you’re recovering from sexual trauma, I encourage you to find a therapist to work with, because life — including your sex life — can get better.

8. You’re experiencing body insecurity.

Here’s the thing about humans: They want to have sex with people they’re attracted to. Richmond says it’s important to remember your partner chooses to have sex with you because they’re turned on by your body. (I feel confident your partner loves your personality, as well.) One way to tackle insecurity is to focus on what your body can do — for example, the enormous pleasure it can give and receive — rather than what it looks like.

9. You’re shying away from masturbation.

Our partners don’t always know what sort of stimulation gets us off, and it’s especially hard for them to know when we don’t know ourselves. If you’re not sure what type of touch you enjoy most, set aside some time and use your hands, a sex toy, or even your bathtub faucet to explore your body at a leisurely pace. Once you start to discover how to make yourself feel good, you can demonstrate your techniques to your partner.

Complete Article HERE!

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