Selective serotonin reuptake inhibitors (SSRIs) learning module - main section

4.4. Sexual dysfunction

Serious couple with a doctor

Very common and common adverse effects

SSRIs can reduce libido and cause difficulty achieving orgasm in men and women. Men may not be able to sustain erection and ejaculation may be delayed or abnormal. In women, there may also be alteration to menstrual bleeding, changes in breast size, and breast tenderness. It is likely that problems with sexual dysfunction are underreported. Further, the picture might be complicated by the effect of depression itself.

Factors which increase risk

Factors that affect sexual function, such as physical illness (eg diabetes and hypertension), concomitant medicines (eg for cardiovascular disease), and substance abuse can increase the risk of sexual dysfunction in those treated with SSRIs.

Risk-reduction measures

Sexual dysfunction is a common reason for the patient to discontinue SSRI treatment. Sensitive and frank questioning and discussion of sexual side effects during medication review can help promote adherence to treatment.

Lifestyle changes (exercise, weight reduction, smoking cessation, abstinence from substance abuse) can be conducive to improved sexual function.


Sexual counseling may be called for and specific treatment for erectile dysfunction can be considered. If symptoms persist, consider reduction in dose or alternative treatment.

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Page last modified: 17 February 2015