No orgasm on SSRI and low sex drive in general

[potatosoup]

just found this site and it's so good. especially if you don't have anybody to talk about this stuff irl
so. this is more of a vent than anything else
- I'm 22, a woman, 6 months into my first relationship.
- Have masturbated since teen years, not because I felt horny, but to de-stress a little bit.
- Was always able to orgasm with no difficulty up to the point I started taking SSRIs (paxil, lexapro).
- Am not able to orgasm with my partner (happened only once) and we've tried A Lot of things.
I've been depressed for a long time and lost the ability to enjoy things, but since I've started taking lexapro I also feel nothing sexually. I get aroused pretty easily, but don't feel any pleasure let alone orgasm, no matter if it's with a partner or solo.
On paxil I was able to orgasm solo and did enjoy alone time. Didn't have a partner at the time.
I never had thoughts about sex, masturbation just helped with anxiety. So I always thought I'm asexual.
Now I feel pretty helpless because I would like to enjoy sexual things with my partner, but this situation brings a lot of anxiety and makes me fear that I'm never gonna get better. Just sucks.
I feel weird because everyone else (on the internet at least, I don't talk about sex with my friends) seem to enjoy sex and it comes naturally to them, and I just don't. My partner is supportive but I can't help but feel broken.
Hopefully I can switch medication and see how this turns out.

[Heather]

Hi there, potatosoup. Welcome.

From what you have said here, it does sound like your medication is probably playing at least some part here. It may also be that your depression itself is playing a part, and that could be more than it might be if the current medication isn't a good fit for that either!

I do think that talking with your prescribing doctor about this is the best place to start. If it's helpful, here's a pretty good piece that addresses the SSRIs least associated with sexual side effects: https://www.mayoclinic.org/diseases-con ... q-20058104

I do want to check in to see how you feel emotionally with this partner overall, and if you do experience sexual desire with them. I hear you saying you would like to feel that, but I want to find out if you ever have with this person. Have you enjoyed being sexual with them in the ways you have been, or when you have been sexual together have you, as you have said, not been experiencing pleasure in any respect, even emotionally? If not, it might be helpful for me to know a little more about how this developed as a sexual relationship, and how much of that was about what you wanted and initiated.

[potatosoup]

thanks for a quick reply! I do experience desire with them, even if my overall libido is low when they're around I feel relaxed and will initiate intimacy myself. About the emotional part, I'm pretty unstable emotionally and often can't tell what I feel. One day I feel warmth towards them and the other it's like I don't care about anything or anyone. What makes it more difficult is that I've only known this person for half a year, but so far I've never felt bad around them and they never spoke or done anything I think is bad for me. The only thing that makes me feel bad are my own thoughts and personal issues I'm yet to figure out. The person is nice and I like them, but! it's my first relationship and I'm too anxious about everything
I'm just hoping I can turn everything around.

[Heather]

You say you never feel bad around them: does this mean you feel good around them or more neutral?

Right now what I am hearing is that if you mostly feel bad much of the time, are having trouble finding joy and pleasure in life, that you often feel anxious in this relationship and that the feelings for or about them are like...maybe good, but nothing that really thrills you at best? All of that also is likely to keep a person from not just orgasm, but from pleasure in sex and other parts of life, period.

Do you have a therapist you see?

[potatosoup]

Hi again! Sometimes it's neutral when I'm more depressed, but lately I've been feeling better and noticed I feel very warm around them again. And it's really sudden, too. Like we're just chilling in bed together and talking and suddenly I'd look at their face and feel really fuzzy inside. I guess I'm learning communication all over again, because in the past due to family trauma I could never feel good around others
It's.. weird. But it's a process I guess
I see a psychiatrist and want to get into therapy soon.

[Latha]

Hi there, Potatosoup! I'm responding because I'm on shift, I hope you don't mind.

Ahh, I see- so when your mental health is better, you do feel good around your partner. You're right, learning to communicate and feel good around people can be a process. Progress isn't always linear, so be patient and remember to appreciate yourself.

As Heather suggested, I do think it would be a good idea to check in with your doctor about adjusting your medications- since you were able to feel pleasure with Paxil but not Lexapro, the latter may be the place to start.