But while medication might be absolutely necessary for me, it’s not without some low-key side effects. Most symptoms of SSRIs aren’t all that challenging or noticeable, but one important one definitely is: Orgasms are harder to, ahem, come by.
Sexual side effects can vary, but the most common ones are lower libido and trouble climaxing. Nina Vasan, MD, MBA, chief medical officer at Real and founder and executive director of Brainstorm at Stanford University, says most of those side effects are because SSRIs increase serotonin. “Serotonin decreases orgasms and vaginal lubrication for women and erection and ejaculation for men,” Vasan says. “It also inhibits the production of nitric oxide, which is responsible for blood flow to sex organs during sexual response.”
As a 37-year-old single mom who is dating and, yes, sometimes having sex, I find not being able to orgasm while taking SSRIs the most inconvenient thing about them. I mean, if I don’t keep my brain healthy, I won’t be that much fun to share appetizers and witty banter with. But dating without orgasms feels like a really unfair trade-off.
A lot of people, given their SSRI has rendered them less interested in sex anyway, don’t worry about a lack of orgasms. More power to them. But I’m not willing to let this slip away from my life, especially as a divorced woman who only started having more consistent sex a few years ago! I still view it as a deeply important part of my overall health.
Ashleigh Renard, author, sex expert, and creator of the viral video series Keeping It Hot, agrees. She says that while it’s important for sex to never feel like “an obligatory act,” feeling fulfilled matters. “No one needs sex, but really wanting it and enjoying it can lead to a higher quality of life for many of us,” she says.
Renard also says that while transitioning onto medication, taking a break from sex can be beneficial, for the purpose of not adding any additional stress to the situation. While, at times, over the last five years, I had to focus purely on my mental health and not worry too much about my sex life, these days I have the bandwidth to prioritize both, so I am. Luckily, I’ve found there can be ways to still get down, even on brain medication.
5 ways to still have an orgasm while taking SSRIs
1. Practice on your own first
For a lot of people, having orgasms is easier when getting it on solo. While ideally, you’d like to be able to share that experience with a partner, knowing what you need to make it happen on your own after the introduction of medication, is really important. There’s no pressure to orgasm, so it may be easier to figure out what it takes. If you do, you’ll know that it’s not impossible, so you’ll be in a better headspace once you're with a partner. Plus, you’ll be better equipped to tell them exactly what to do.
2. Emphasize the “warm up”
Renard suggests starting a relaxation routine about 30 to 60 minutes before sex to prepare for intimacy. “Take a bath. Light a candle. Listen to relaxing or feel-good music,” she says. “Many of my audience members love listening to erotic audio stories to help get them in the mood.” She recommends using the Dipsea app.
3. Ask about switching medications
If making changes to your medication is an option, lowering the dose or getting on a new drug that still does what it needs to for your mental health could alleviate the unwanted sexual side effects, Dr. Vasan says. Some SSRIs are less likely to interfere with the ability to climax, so talk to your doctor about what your options may be.
4. Use a vibrator
Sometimes, adding a little battery power can seriously get things moving in the right direction. Incorporating a vibrator, either for foreplay, or clitoral stimulation during sex, could have big gains.
Liz Tracy, a 43-year-old mom who has been on a handful of different SSRIs since she was a teenager, says that a vibrator has been key to her ability to climax. She recommends women “buy a high-quality vibrator” or even a few, “and experiment with them,” both on your own and with a partner.
5. Talk to your doctor about adding a new drug
If you’ve exhausted your options in the bedroom, and changing your medication altogether is not an option, adding a drug can have positive impacts. Dr. Vasan says that a low dose of Bupropion (aka Wellbutrin) is an option that she has personally seen “work well in some patients” who are not ready to kiss orgasms goodbye.
Remember, taking care of your brain is hard work, but it doesn’t have to mean giving up one of the best parts of your sex life.
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