Sexual side effects of Zoloft

[Lucy4]

I just got home with a prescription for Zoloft and the only thing that’s making me hesitant about taking the first pill is in doing my research I saw some accounts of the sexual side effects not going away even after the drug was stopped. I am aware that this seems to be rare. I have left a message for the psychiatrist who prescribed it saying I have a question about the side effects. For the record my sexual life only involves myself, no partners. I would very much like to take the pill so I can start feeling better but if I believed I would be doing something that could affect the rest of my life, I would want to give it a second thought. Has anyone experienced permanent side effects from Zoloft or know of a situation where someone has?

[KierC]

Hey there Lucy,

Persistent sexual dysfunction can occur after stopping Zoloft, though you’re right that it is rare. When deciding whether or not to take it, it’s important to consider side effects, but it can help to look at it as weighing the pros and the cons. So, while a con is the potential for sexual side effects, a big pro is feeling better and less depressed. Sexual side effects, especially lowered sex drive, can also occur when you’re depressed, so there is reason to believe that the opposite effect could occur.

I want to say, too, while there are anecdotes coming out that these sexual side effects can be permanent, there is also evidence that those side effects can respond to treatment. Persistent sexual dysfunction after Zoloft use can show up as lack of sexual desire, anorgasmia, vaginal dryness, and more. But, there are interventions and steps you can take to alleviate those symptoms. Some folks find that lowering their dose, taking a medication “holiday,” or taking it at a certain time so your side effects come when you’re not having sex, can really help with those side effects. Using lubrication to alleviate vaginal dryness, talking in therapy about any issues, and regularly practicing sexual self-care can be helpful ways to manage any side effects.

In any case, you’ll want to discuss any side effects with your doctor, and they can help you manage your dose with any potential side effects. They may also be able to talk with you about other antidepressants with less sexual side effects if you didn’t talk about them yet. But all that’s to say: you won’t immediately and negatively impact the rest of your life by taking this, and there are ways to manage the effects if they do happen. What’s more likely, though, is that the medicine may help you feel less depressed.

I can tell you from personal experience taking Zoloft for several years that when I experienced sexual side effects, they weren’t permanent and responded well to therapy and adjusting the dose, but that’s another anecdote that should also be taken with a grain of salt. I’m wondering, though, how *you* feel about this, and what sort of worries creep in when thinking about this. Would it help you to list out here some of the pros-and-cons you’re considering, or some of the thoughts you’re having about this?

[Heather]

I also always want to add, with a question like this, that untreated depression and anxiety are much, much more likely to cause issues with sex and desire than medications to treat them are.

By all means, if you want to talk to your prescribing psychiatrist about this, I think it's a good idea. There are some SSRIs, SNRIs and other medications like these that have greater or lesser associations with sexual side effects, so it can help for someone prescribing for you to know that that is something you care about so they can choose accordingly for you.