A loss of libido is one of the lesser spoken about side effects of antidepressants, as Thea De Gallier knows first-hand...
Lying next to my boyfriend in bed and feeling his arms encircle me should have been one of the simplest and most pleasurable things in my relationship. I should have wanted to embrace him and relish the feeling of his hands on me.
Instead, I felt nothing. No physical responses to his touches, no wide-eyed desire to make love. The problem wasn’t that I didn’t fancy him; I wanted nothing more than to be fully in the moment, but something was stopping me – the tablet of fluoxetine, which I took daily to combat my clinical depression.
A quick Google search for accounts of how antidepressants affect sex drives yields almost no results. Generic advice on the likes of NHS Choices and WebMD acknowledges that it happens. Some sites suggest that taking a medication for erectile dysfunction alongside the SSRI could help. That may improve the situation for male sufferers, but what about the thousands of women, like me, also suffering from this?
I didn’t stop finding my (now ex, it should be said) boyfriend attractive or wanting to show him affection in some way, but the thought of him touching me elicited no response, either mentally or physically. Even when we started having sex, it was nigh on impossible for me to reach orgasm. Some may find it surprising that this didn’t actually bother me; having been on various different antidepressants since the age of 16, I was used to it. I knew there was little chance of me experiencing any physical sensations from sex, so I told him to stop trying to please me. As long as he was enjoying himself, I was happy.
It was nigh on impossible for me to reach orgasm
This might sound like a wildly unhealthy attitude to sex, but Dr Petra Boynton, a psychologist and relationship expert, disagrees. ‘It’s actually common – and fairly sensible – for people with a low sex drive from antidepressants not to be bothered by it,’ she says. ‘Our culture has built up the notion that sex is a big thing, and if you can’t do it there’s something medically wrong with you. It’s a negative message, and you should only do what you’re comfortable with.’
I’m certain that, as one of a huge number of British antidepressant-takers, I’m not the only one suffering from this issue. But, as Dr Tom Stevens, Consultant Psychiatrist at London Bridge Hospital, points out, it’s not something many people want to talk about. ‘Problems with sex are common in both men and women with depression, but many can be reticent to discuss them,’ he says.
This reticence comes not only from patients, but from doctors too. Dr Boynton agrees. ‘The prescribing doctor may not think to mention this side effect,’ she says. ‘Depression itself can cause a loss of libido, so when patients start their medication and find it gets worse, they can feel very disappointed because they weren’t prepared.’
Sexual dysfunction wasn’t something that was ever mentioned to me as a side effect, despite me being in a sexually active relationship with my first boyfriend when I began taking the medication. At 21, boozy gossiping sessions with girlfriends were a regular occurrence, and I began to wonder why I could never relate to my friends’ tales of fantastic sex and mind-blowing orgasms. I’ll admit that I felt inadquate next to these blossoming sex goddesses I hung out with. It was then that I decided to ask questions.
I felt inadquate next to these blossoming sex goddesses
It wasn’t easy or fun telling my therapist about my sex life, but no trained professional is going to snigger or judge. Having the possible causes and solutions explained to me was the first step towards regaining faith in my own body.
Although I had a bona fide reason for my indifference to sex, it was immensely difficult for my then-partner not to take it personally. As much as it was frustrating, I understood why; going to bed with someone that you know the earth won’t move for, despite your best efforts, is a blow to the ego for even the most empathetic. As Dr Boynton puts it, the unaffected partner can feel that they’re not ‘fulfilling their duty’.
I refuse to believe, though, that sufferers of sexual dysfunction are doomed to a life of bad sex and singledom. I’m fine with the fact that I’ve never had, and probably never will have, multiple orgasms. I’ve found that one of the best things I’ve ever done is to be honest about it. If any relationship is going to survive both parties having wildly mismatched libidos, you’ve got to talk. Yes, you might cringe a bit, but it’s worth it. Shying away from an honest discussion – something I was guilty of in that relationship – only serves to create a ‘you versus them’ dynamic, and makes the problem harder to overcome.
The first step, according to Dr Boynton, is to work out what, if any, sexual activities you are comfortable with, and tell your partner. ‘It’s important to be clear about your boundaries,’ she says. ‘You might be comfortable pleasing your partner, but not want anything done to you in return. Long-term partners may benefit from taking a short break from sex, and slowly building it up again through cuddles and affection.’
I refuse to believe, though, that sufferers of sexual dysfunction are doomed to a life of bad sex and singledom
If you’re single, there’s no reason to think you can’t date – unless you don’t want to. Antidepressants may have dulled certain sensations, but those fleeting stomach-flips when sending flirty, late-night texts have, for me, remained very much intact. ‘If you’re comfortable explaining what you’re going through to a new partner, you may find they’re very understanding,’ Dr Boynton says. ‘This notion that new relationships shouldn’t come with any baggage is silly; everyone has their own issues. But if you’d rather not date while you’re not into sex, that’s fine. We’re conditioned to believe we should be having great sex all the time, but that simply isn’t true!’
For me, having a low libido was fairly easy to manage because I’ve never really known any different. Starting on antidepressants at 16 laid the groundwork for my entire sex life, and I’ve learned, through trial, error and a few experimental one-night stands, how to deal with it. My sex drive might be lower than that of my friends, and orgasms about as regular as the solar eclipse, but my sexual experiences have been far from miserable. Yes, there have been arguments and misunderstandings along the way, and one relationship that couldn’t survive the (lack of) heat, but I’ve learned to work with what I’ve got.
Antidepressants: the facts
1. In 2013, the BBC reported that 50 million antidepressant prescriptions had been issued in the last year in England – this was the highest levels ever and up 7.5 per cent on the year before.
2. Reduced sexual desire is recognised as a side effect of most SSRI (selective serotonin reuptake inhibitor) antidepressants, the most commonly prescribed type of depression medication. SSRIs include fluoxetine, citalopram and sertraline, most commonly used to treat depressive and anxiety disorders.
3. Desire often returns if antidepressants are changed or stopped completely, but this can also mean the return of depressive symptoms. Dr Stevens says: ‘Some medications are less likely to cause problems, so it’s a good idea to discuss this with your doctor. Joint counselling may also benefit the patient and partner.’