Dealing with Sexual Side Effects

Dealing with Sexual Side Effects

Worried about the sexual side effects of your medications or the ones you’re considering? Let’s talk about it. It’s not uncommon for medications that help us manage anxiety, depression, blood pressure, even stuffy noses to correlate with sexual difficulties. [several side effects listed on screen] Then add all the physical side effects that may have sexual repercussions like… [on screen] Frustrating! You’re taking the med to improve one aspect of your well-being, and it messes up another. Strategy 1 One thing that can help is knowing what actually happens when you swallow the pill. For me it’s reassurance the medication is designed to deal with the problem I have and not to torture me. Plus I learned how various chemicals also affect my sexuality, and I can keep learning from there how to resolve this. Strategy 2 …or prescriber or pharmacist. Let them know that you really care about your sexual health and that the side effects matter to you. You might say, “Doc, I want an antidepressant that helps me get out of bed but not one that’s going to disrupt my sex life.” Medical professionals are trained to make modifications — maybe lower or higher the dose, suggest a different time of day to take them: like after you have sex rather than before. Perhaps there’s a similar drug with fewer side effects or one that will counteract them. Ask. If your provider doesn’t care or won’t help, please go elsewhere. Strategy 3 One thing some offices are now capable of is
{on screen} With just a cheek swab, it’s possible to determine which meds will work best in your body and which ones won’t work at all. Which is so great, because you don’t have to trial and error meds and all of their sexual side effects. You can target treatment and focus on dealing with the sexual side effects of the correct med. Strategy 4 Have sex a few times before starting a med, or if you’ve already started one, have sex right now so that you have a realistic picture of your situation. Were you turned on mentally and physically? How long did it take to climax, if at all? Did you feel satisfied? Did your partner or partners observe anything? Was it really that bad, or were you phyching yourself out? Write it all down. Strategy 5 Having a journal is a good way to track what’s really happening, and it’s also something that you can share with your prescriber. [example journal entries on screen] Strategy 6 Give the med time, or rather give your body time to adjust to the med. It’s possible that sexual side effects will dissipate on their own, so what seemed unmanageable at the beginning might be no big deal after a few days or weeks. Strategy 7 When I’m working with clients who struggle with the sexual side effects of their medications, one of the most important things is to stress re-evaluation of healthy sexuality. They may think that the 15-minute routine they’re used to is it, and that the meds will or have ruined their sex lives. In reality changes to sexuality for whatever reason are opportunities for sexual enhancement. Changes in sexual desire could lead to experimentation with fantasies. Trouble becoming aroused could improve your foreplay. Difficulty getting or maintaining an erection could mean attention for other body parts. And difficulty reaching orgasm could put emphasis on sensuality like kissing and erotic massage. This strategy and all the ones I mentioned are what sex therapists and clinical sexologists promote. Medications can be incredibly beneficial. I’d hate for you to miss out on the health improvements they offer because you’re scared or disappointed about the sexual effects. Please do your research, and ask for help. It’s possible to have a better life and better sex if you’re willing to stay curious. This episode was brought to you by Sexpla(i)nauts. Those of you who believe in and support our efforts to create honest, accessible sex education via Patreon. We couldn’t do it without you. [Outtakes] In reality {muddled gibberish} sexual enhancement!! {No clue. She’s gone loony.}

Comments (93)

  1. Love the enthusiasm! Makes it way less weird to talk about sex

  2. Such a good topic! People often don't talk about this!

  3. After reading the topic.. my first thought was.. What?! there are sideeffects to sex? and then Lindsey went all " The Sims" in the end.. awesome

  4. How about a video on those over the counter erectile dysfunction pills?

  5. Have you ever heard of this going the other way? I was on a medication for anxiety which I had to go off of because of other negative side effects, however it was the only time I've had multiple orgasms during sex. I was kind of disappointed to go off of it! Do you think this is just coincidence or could the multiple orgasms really have been from the medication?

  6. "partner or partners" <- THIS. I love you for not making any assumptions. I know you do this kind of thing with your language all the time, but I really appreciate it.

  7. Great topic! While I'm thinking about it, what do you want for Christmas? Like your hair!

  8. damn i read the title the wrong way. i thought it was about the side effects of sex. oh well

  9. I thought she was going to talk about post wank remorse

  10. If you have to take antidepressants, but are worried about sexual side effects, ask your doctor to prescribe you Remeron, Wellbutrin or Aurorix. Those three have 0 sexual side effects and are as effective (yes, I did look up the studies to say that) as all the other antidepressants. The active ingredient in those medications are Mirtazapine ,Bupropion, Moclobemide.

  11. I've been on SSRIs for anxiety since middle school, right around the same time I discovered masturbation. That was 10 years ago. So I have no baseline for my sex drive while unmedicated (and I have no desire to learn at the cost of my mental health). I started taking an NDRI earlier this year because I've developed depression as well and will soon go off the SSRI completely. Will I notice any significant difference? I don't know.
    Do I just accept this? Or do I wait to tackle this only if it causes problems once I become sexually active (I don't think it currently affects my masturbation)? Are there any alternatives?

  12. Lindsey, do you think you could do a video on tips to help guys who can't reach orgasm during intercourse?

  13. Trans people who take hormones have a LOT to say about this stuff

  14. I've been on anti-depressants since high school (so about 6 years), and since I wasn't sexually active during school and never really had a high libido I never thought I had any side effects until a year or so ago when I became (or tried to be) sexually active. As a result of being on these meds for so long I've never developed a relationship with sex and don't even know how to begin how to start one since everything I've ever tried, on my own or with someone else, has never done anything for me. I started taking Wellbutrin alongside my current anti-depressant about a month ago to counteract the side effects but haven't noticed any change. Feeling kind of at a loss tbh 🙁

  15. Are there any that might increase at all?? :-/

  16. Lindsey you are such a beautiful person. You pour contagious enthusiasm and wit from such a naturally pretty face, your demeanor when talking about sex is the kind of personality I think we all strive for in our lives.
    Thank you for being such an excellent role model and keeping people curious.

  17. Oh my goodness! Thank you so much for talking about this!

  18. Great topic that I have experience with. I have hi BP and chronic nerve pain. Between the BP meds, the pain control meds, and my divorce, I went seven years without a sex partner. And when I did finally try to "get back on the bike" my desire was really strong but my erection wasn't and it killed that relationship right there. I tried to explain (she was a director of nursing at a hospital and you would think would understand) but she took it as I didn't find her attractive. But far from it, I really liked her. So, I went to my Dr. And he put me on cialis and testosterone (after blood work) and wow I feel almost 21 again (I'm 48 btw and was injured on duty as a firefighter). Modern meds work great, and your ideas are wonderful.

    Please don't be offended, but I really wonder what adult braces feel like during a BJ?? Sorry, you're very cute, talking about sex and wearing braces. My mind was roaming.

  19. I have some awful sexual side effects as a result of contraception but hesitate to talk to my doctor. Maybe I'll just watch this video over and over until I pluck up the courage!

  20. 1:38 yeah so that's the part I'm having trouble with haha. Also I like the color coordinated organization of the books in the background

  21. You did this for meeeeeeeeeeeeeeeeeee!

    Thanks Dr Doe. 🙂

  22. How great is this channel??!!

  23. Wow! I just asked you a question about this on your tumblr, and I don't know if this was a direct response to that but either way this video helped a lot! It made mea realize I can actually take steps. Thank you, Lindsey!

  24. TIL people spell it "come."

  25. When I was first diagnosed with anxiety/depression, I was prescribed fluoxetine (Prozac). After a week or two on the meds, I noticed it was taking me a lot longer to reach orgasm, sometimes being completely incapable of it. I know it wasn't a placebo effect because I hadn't heard there were sexual side effects of this drug until after I felt them and did some research. When I spoke to my prescribing psychiatrist about it…he told me I was wrong, that those effects only occur in women, and that if I think I have the effects I should just focus on my partner more until I can clear my mind enough to perform better.

    Yeah, I didn't like him very much after that. I did some research and found out it's actually a quite common side effect in both men and women, and an effective solution would have been to lower the fluoxetine dosage and supplement it with Wellbutrin (which works on dopamine levels in addition to serotonin, while fluoxetine only adjusts serotonin levels, meaning it has less sexual side effects). Of course, before I had been diagnosed, I didn't know much about the whole therapy/psychiatry/mental illness world beyond academic study, so I wasn't comfortable changing doctors. By the time I was comfortable enough to change doctors, I also didn't have the funds to continue any medication at all.

    So, yeah, if you tell your doctor there's a side effect of your meds and they dismiss you, find a new doctor. Especially if you do your research and find out that the side effects are real and happen in other people, too.

  26. Are there any side-effects to sex itself?

  27. This great! Thank you

  28. Tip: Have sex.

    Yeah, ok, I'll get right on that… 🙁

  29. When I sprained my neck, I took this muscle relaxant medication that would increase my orgasm's volume, but also made my penis burn afterwards. I'm off them now, but it's good to know for the future that I can get tested for meds that could prevent the burn…and keep the volume ^.^'

  30. anti anxiety drugs made my sex life miserable, so I decided to understand what caused my (heavy) anxiety in the first place and how to avoid, manage, and understand it better. It took a lot of work but I managed to get off the drugs, manage my anxiety and keep a healty sex life.

  31. Pharmicogenetics, what?!
    I've had tons of issues trying to find an ADHD med that works. This could help immensely. 😀

  32. Thanks for making this video! While it doesn't super apply to me as of right now, it's something good to know if I have a partner in the future. knowledge is power! 😁

  33. I rmember sex being very different before I started taking my depo shot. Has anyone else experienced this or is it just perception?

  34. I would encourage review of the science behind the "cheek swab" recommended in this video. Pharmacogenetics is an important emerging technology, however the majority of the available tests have not been validated in clinical trials. The tests can identify genes correlated with enzyme activity, but there are only a few examples where these tests accurately predict which medications with have a clinically significant impact. Keep up the good work, but please ensure your recommendations are based on solid evidence.

  35. Perfect timing. Thank you 🙂

  36. would you do a video on incompatibility of opinions on sex (how it should be, how much time, foreplay and tenderness is neccessary/reasonable, etc) in a relationship and how to navigate it?

  37. Thank you for this video!

    I would like to suggest a bit of a follow up video, because it's an area that I have so many questions about right now: sexuality and mental health. I am one of those that take meds for anxiety and depression and for the majority of my adult life, my mental health has been the one to dictate my sexuality. I was so worried about all the consequences of sex I was fed in sex ed* that I actually didn't lose my virginity until I was almost 30. Of course, now that it's happened, and I"m in what's considered to be the peak time for women, being single and sexless is just as painful as being an older virgin and sexless. Almost all that I've ever had is masturbation and that's become completely stale. What's worse, is that sex is something that just doesn't get brought up in my therapy. Not that I couldn't bring it up, it's just something that gets pushed by the wayside by more pressing issues (like maintaining the relationship I hope would turn sexual).

    Am I the only one with mental health issues that has difficulty expressing their sexuality? Are there any resources for someone like me? Is this a thing?

    (*I would just like to mention that my high school sex education actually was actually quite good and covered everything properly. I just listened too intently and combined with high anxiety made things difficult later on.)

  38. Can you do a video or blog post with essential sexology books/textbooks?

  39. I was so pumped about this episode since it's something I deal with heavily, but I must say I am disappointed. I've done all of these. I've had sex, written down every encounter, every masturbation attempt. I feel like my sexuality as a whole has been traded for a slightly less shitty life, and both my therapist and my pharmacologist tried a lot of variations and meds without success, even going for those specifically marketed as sexual-friendly. I've tried to get me off in such numerous ways, trying new positions, timings, kinks and toys, and while really, really fun, and pleasurable for the mind, nothing works in the body. (while before my meds I could achieve pleasure, and more rarely orgasms)
    I was hoping there would be some insights into how permanent some side effects can be, or you know, anything, really. Because all I ever get is "masturbate", "relax", "try new stuff" or "talk to your doctor". Which I've done. A lot. And now while I still try to have sex, it just feel so detached and boring, no sensations, no libido, no fun. I feel like it would be less worse if I'd never had any pleasure before.
    Anyone else in this boat? Not that I would wish it on anyone.

  40. I tried one medication for my depression that made it so I could get aroused but couldn't finish. After two weeks of waiting it out it wasn't any better at all so I switched to another med. This one is less effective though so I'm going to look into other options.

  41. Question: I used to have a very low sex drive, to the point where I actually thought I might have been asexual. I have recently been diagnosed with a hormone condition (mainly to do with my sex hormones) and was put on the pill to manage it. Ever since then, my sex drive has gone through the roof and I have no idea how to deal with it. 😮 Any advice?

  42. Thank you for this! When I've been on anti-depressants, I've lost most of my ability to orgasm. Even with my immense knowledge of sex and sexuality it still caught me by surprise the first time. These tips could have really helped me back then. Thank you for putting them out there in the world. I love the work you do. 💗💗💗

  43. Are you spying on me????

    This topic is great for me at the moment…..

  44. Your videos are perfect while eating breakfast (for me), it's educational in a way it helps your nerves to wake up and gets you ready for the other educational stuff that are waiting for you during the day.

  45. Hello! Could you please talk about high testosterone in women?
    Thank you!!!

  46. You missed the side effect of birth defects, for those who are trying to make babies. And it's not just women who need to worry about that: I take methotrexate and it can be a problem if the male partner is taking it.

    Talk to your doctor about side effects, yes, but ALSO read that package insert that comes with your medication! You should always be reading it anyways. It will let you know about possible sexual side effects, yes, and also whether to avoid alcohol, or avoid direct sunlight, or avoid grapefruit, etc. Lots of things you might not otherwise think about that could disrupt the effectiveness of the drug, and your doctor might not think to tell you of all those things, if he or she is even aware of them all in the first place.

  47. this video helped my friend who's been self conscious about her sexual side effects for a year now. Thank you, Dr. Doe!

    could you maybe discuss quoiromantic people and elaborate on the difference between romantic and platonic love? I think I am that, and my own feelings feel foreign to me

  48. Does she cut out the breathing? XD

  49. I cannot figure out why intercourse continues to be painful! I've checked with doctors and we can't figure it out! I'm frustrated and disappointed that I can't enjoy it like my friends.

  50. This video was so helpful to me and at a perfect time in my life. I stopped taking an anti anxiety and anti depressant pill because it changed my overal sexuality which was a big problem for me. This video has inspired me to go back to my psychiatrist and talk with them about my other treatment options.

  51. dude wait… they can cheek swap to see what meds would work for you????? where was this year's ago. ughhhhh

  52. I'm on an array of medication, I'm 27 and my sex drive has disappeared. So upsetting as I used to be highly sexual. Sadly I need the drugs 😣

  53. I'm learning so much I love you.

  54. You look great in the thumbnail Dr.Doe. Thank you for your videos!

  55. just started sertraline a couple weeks ago (after being on desvenlafaxine for over a year) and my sex drive is completely fucked up…

    but what is worse.. having constant thoughts of suicide or not being able to orgasm.

  56. Hey Lindsey! Big fan of your videos! It would be so awesome if they were captioned though to make them more accessible!

  57. do you have a video on sexuality after extreme alterations to one's genitalia (be it gender conformation surgery, or reparative / reconstructive surgery) and effects on sexual interaction and intimacy, or something like it? if not, would you possibly consider making one? i just had a fairly major surgery last week and I'm honestly somewhere on a scale from quite nervous to rather scared…

  58. There are side effects of sex… Pregnancy, Sleepiness, Satisfaction why not address those as well..

  59. can you make more vids on relationships specifically in younger people

  60. Thank you! I really appreciate this video. There aren't enough resources on this.

  61. Love that you talked about pharmacogenetic testing! This has helped so many of my clients find the right medication 🙂 Great video as always! xo

  62. Please make a video on dealing with & preventing injuries during sexual activity. While sex can be very fun, sometimes accidents can occur that cause physical damage. This can be anywhere from minor scratches/bruises/bite marks to a twisted ankle or concussion (for instance if you were trying to get busy somewhere with less space to move around). I think it'd be an interesting & informative topic

  63. Thank you so much for this video!
    ps. Please do a video on endometriosis!!

  64. I don't know why but you remind me of Lizzie Bennet of LBD (go Hank & co.!) in this video. 🙂

  65. another big one – dryness, affects the mouth, skin, and vagina 🙁

  66. Oh.  I thought this was going to be about the side effects of having sex.

  67. One side effect not mentioned in the video, and a common side effect for anxiety medications, is increased sweating. True, this can happen as a result of weight gain on these meds, but some people have increased sweating without changes in weight.

    Anyone have success in dealing with this? Because being a soaking mess from the exertion of walking across a parking lot makes me feel disgusting. (Will talk with my prescriber, but suggestions are appreciated.)

  68. It's so terrible that sexual education isn't required in so many places. In my high school in PA, we had one day set aside for sex ed in my health class in 9th grade and that was the end of it.

  69. Why did she start it off like an episode of good mythical morning

  70. What if we can't have sex to test it because we're a fifteen year old nerd who can't get girls let alone ones that are dtf and plus I'm a minor and all that bullshit

  71. My pills that help me cope with things like my (ASD) actually make make me cum more

  72. Yeah, I was prescribed phentermine, and it made me not be able to have an erection. Worst thing ever. I would be very "mentally" sexually aroused, but my body just would not, WOULD NOT get an erection for anything. It really worried me, and I thought that I would be "broken" forever. But, then, one week when I forgot to get my prescription filled, my erections IMMEDIATELY came back 24 or 48 hours after the drug wore off. I've never had those types of issues, but I sure feel for men that do have those problems. So, if anyone else had had that issue, do let me know and, if so, I feel for you now. Know how it felt, so it's not as humorous or comical as it once was, after it happens to yourself.

  73. Stop masking your feelings with pills. Take the time to find the root cause, and start dealing with that

  74. Hi,

    Can you please do a video on PSSD? It's a problem with catastrophic proportions.

  75. Isn't that 'cheek swab' thing being oversold? Mostly the genetic tests are for incompatibility – drugs that can cause problems for you (regardless of whether they also would work). Its not (yet) to the point of a shopping list of ideal drugs.

  76. I wonder will this effect my boyfriend doing sexual needs since he has a permanent shoulder injury that will never heal he got back in high school days playing football he has to take to keep down neck all the way down to his shoulder under control. Meds for summer and winter

  77. Hello, I have some further questions if you don't mind and have the time. Do you have any advice for or perspective on people who have taken SSRIs, stopped, and still aren't back to what they were? How long does it take most people to get back, how many never get back to what they were? What if the libido is generally just gone so there is little motivation to try things, or it feels very half-hearted and unsexy? What if there is a strong base-level drive to have sex, but sex also simultaneously seems uninteresting.

    Thank you 🙂

  78. interesting… I think this info can help very many folks, thanks for the great video. for me this would have been great info years ago, the sex part of life is now over, old age is not always fun, just saying. but memories are still very good.

  79. What sucks is having schizophrenia and being on several medications that make your sex drive severely damaged. It's hard (haha) to stay within the scale of being aroused to where it hurts to being repulsed by sex.

  80. I think that psych meds are designed to have sexual side effects. It's actually a direct effect not a side effect.

  81. Dr. Doe. You’re cute and funny, especially in the bloopers!!

  82. All the methods are good and work for me sometimes. Sex with my partner is sporadic and I need a some medication to perform. It takes time to take effect. She is not into waiting. I have tried oral and message but sometimes it is not enough. When I do get and erection, I it take a long time to orgasm because of a antidepressant I am taking. Most of the time we just quit because she is getting sore. Discussed with my urologist and he said this is the problem with all antidepressants. I will try your suggestions (especially fantasizing) to help with my orgasm.

  83. Hey Dr. Doe.. I'm Clyde.. I feel you have a perfect mouth n a nice set of teeth. Then y the braces..? Honestly nuthin looks outta shape as far as ur jaw line, teeth and ur entire mouth area.. I luv ur smile.. Ur big eyes too.. Ur adorable.. I'm sorry if I've missed any video in which you may've explained y u have those braces but I couldn't help noticin it from quite a few videos I've been watchin randomly now.. No offence..

    PS: I love ur videos.. The way u explain stuff makes it so easy to understand.. Its like magic.. I never understood shit about these things in school.. So THANK YOU!

  84. My doctor put me on an anti depressant that made me completely miserable when it came to my body and sexual desire, I told her about it and she told me I should choose between being hot and horny and depressed. Then continued to charge me $100 for a 15 min session. It's really cool to see doctors like you talking about it and from a more holistic perspective. Thank you.

  85. Please help us for beating PSSD .

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