Depression and Sexual Health

Patients with depressive disorders are at increased risk for presenting sexual dysfunction, not only because of the depressive symptoms, which include reduced motivation for or reward from engaging in pleasurable activities, but also due to sexual side effects of antidepressants. These medications have shown negative effects on different domains, such as sexual desire, arousal, and orgasm. Drug-induced sexual dysfunction reduces treatment adherence and increases the risk of recurrence of depressive episodes. Antidepressant drugs with the greatest serotonin effect are those associated with the highest rates of sexual dysfunction in both men and women. Some antidepressants have also been associated with impaired male and female fertility, but these effects seem to be reversible. In clinical practice, determining the cause of sexual dysfunction may be challenging. The assessment of sexual functioning is important before the prescription of an antidepressant, and at subsequent visits, it might impact treatment compliance and patients’ quality of life. Treatment options for antidepressant-induced sexual dysfunction include non-pharmacological and pharmacological strategies, which consider different options, such as switching to a different antidepressant or adding complementary treatments.