Sex and antidepressants: what to do if you struggle to orgasm

Medically reviewed by Dr Juliet McGrattan (MBChB), words by Sophie Peacock
Photo credit: Digital Vision. - Getty Images

From Netdoctor

Mental health comes with its fair share of stigma before you add sexuality into the mix. But the fact is people who take antidepressants can experience difficulty reaching orgasm, struggles with sexual arousal and decreased vaginal lubrication, not to mention low self-esteem in (and out of) the bedroom.

But antidepressants are also invaluable for many people suffering from mental illnesses such as depression, anxiety and stress – all of which can also impact your libido irrespective of what medication you might be taking anyway. So is it possible to take antidepressants and still enjoy sex, or does medicine signal the death knell for your libido?

We speak to former nurse, sexual health expert and co-founder of Jo Divine Samantha Evans about effective ways to navigate your mental health and your sexual desire:

Communication is key

Talking is the first step to increased sexual intimacy, so if you're struggling to reach orgasm and it's making you feel self-conscious, talk things through with your significant other before you hit the bedroom.

'Being honest about your condition and the medication you take to treat it and control it is important to help you enjoy sexual intimacy and pleasure,' explains Evans. 'If your partner knows there is a reason why you struggle to orgasm, don't become aroused or don't feel like sex, it will help them to understand why this is happening. It can open up the conversation about ways in which you can enjoy intimacy together and discover what works for you.'

Sharing is caring

You may not feel comfortable disclosing your mental health issues to every single sexual partner, and that's okay. But if you are in a relationship where you care about each other and want to enjoy sex as much as possible, its worth being open about any problems or concerns you might have. Unless you're dating a mind reader, they won't know what you're going through. But once you open up a dialogue, you'll be able to work through this together.

'Having a diagnosis of depression can be life-changing for a person, but can be even more confusing for their partner as they may not understand what is happening or why their partner is feeling this way,' says Evans. 'Many couples tell their doctor that depression has ruined their sex lives, but often it is due to a lack of communication that has caused their sexual activity to falter or stop.'

It's about the journey, not the destination

If orgasms don't come easily to you, that doesn't mean it's game over for your sex life. Traditionally the grand finale is seen as the main aim for both parties involved, but if you switch the focus you might find you enjoy the ride just as much as the destination.

'We tend to focus on having an orgasm as the end of the sexual journey, yet sex isn't just about orgasm, it is about feeling pleasure, exploring new sexual sensations and having fun,' points out Evans.

'The majority of women, not just women who have depression, need clitoral stimulation to orgasm often lacking during penetrative sex because of positioning, depth of penetration and poor technique,' she adds. So stop worrying about the end goal and enjoy the ride.

Ask your GP for advice

If the antidepressants you take are impacting your sex life drastically, it might be worth talking to your GP about whether the medication you take is the right one for you as different medicine can affect people in different ways.

However, for many people, changing or stopping medication is not an option. Some people may even experience anorgasmia as a result of taking antidepressants, but it's vital to keep taking what the doctor recommends and reassess your sexual agenda, rather than risk your mental wellbeing without medication.

'Many people fixate on having an orgasm rather than concentrating on just how good sex feels,' says Evans. 'You don't need an orgasm for sex to feel pleasurable. It is important to have good mental health controlled by medication rather than be unhappy just to achieve an orgasm.'

The take away here is to enjoy being and feeling sexy with your partner, not relying on arbitrary sexual goals such as penetration or orgasm.

Experiment with sex and have fun

Provided you and your partner can talk to one another openly about how to sexually interact in a way that is comfortable and pleasurable for you both, there are some fairly simple suggestions which can help you feel physically more excited.

Lubricants can be a lifesaver for vaginal dryness, and sex toys such as a bullet vibrator can help you to feel more stimulated. To get you in the mood, Evans recommends the following ways to experience sexual pleasure and increase your level of arousal:

  • Foreplay
  • Mutual masturbation
  • Oral sex
  • Intimate massage
  • Using sex toys for solo and couples' play
  • Bondage and lubricants during sex play
  • Watching erotic films
  • Reading erotic fiction
  • Sharing sexual fantasies can help you create sensual imagery

Go with the flow

Mental health is not a one-size fits-all condition and different solutions will help different people to cope. However it's worth mentioning that sexual activity can temporarily help boost a low mood and produce feel-good endorphins, so experiment and work out what feels good.

'Having sex can be an effort for many people, not just those who have depression,' explains Evans. 'But making time to indulge in sex play can have a positive effect upon your mood. You don't even have to go the whole hog, just indulge in some foreplay fun or sexual teasing and see where it takes you.'

Sex and relationship resources

For further advice about sex and antidepressants or any other relationship or sexual concerns you might have, try one of the following resources:

Last updated: 03-12-19

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