People with depression typically lose interest in many activities they once enjoyed, including sex. This can significantly reduce their quality of life. Because many patients are reluctant to discuss sexual problems with their physician, the problem often goes unidentified and untreated.
Sexual dysfunction includes a loss of interest (libido) as well as problems with sexual functioning and performance. In one study of depressed patients who reported sexual dysfunction, two-thirds complained about lack of interest, making it the most severe symptom. Other patients said they have difficulty achieving orgasm. Depression is not the only risk factor for sexual dysfunction. Smoking, alcohol consumption, co-existing diseases, stress, and other medications can also reduce sexual interest and performance.
Unfortunately, depression and sexual dysfunction can be a double-edged sword. On the one hand, untreated depression can give rise to sexual problems. In fact, one study found that 70 percent of depressed patients lost interest in sex when they were not taking their medications. They also reported that the severity of this loss was worse than their other depression symptoms. People with more severe or long-lasting depression were more likely to report sexual dysfunction.
For some patients, treating depression with antidepressants treats the sexual dysfunction as well. However, while antidepressants are effective in relieving symptoms of depression, one of the common side effects is a decrease in libido or sexual functioning. For example, three quarters of patients who take SSRI antidepressants (selective serotonin uptake inhibitors), and some who take tricyclic antidepressants, report suffering from sexual problems.
If you are depressed and it's affecting your love life, don't despair. You can take steps to restore your interest and sexual performance.
The first step is to talk to your physician. In one of the studies cited above, only 35 percent of participants voluntarily complained to their physician about sexual problems, even though 69 percent were actually suffering; the rest reported difficulties only when directly questioned by their physician. Your physician should evaluate whether other factors are causing sexual dysfunction, such as hormones, co-existing diseases, or side effects from medications.
The most common remedies for addressing this problem are to decrease the dose of antidepressants to a level that manages the depression without causing side effects, and changing-or adding-medications. The American Psychiatric Association guidelines recommend changing medications when antidepressants cause sexual dysfunction. Although SSRIs and tricylic antidepressants often cause sexual side effects, there are other antidepressants, such as Wellbutrin, Desyrel, and Serzone, which generally do not cause sexual problems.
Sources
Phillips, Robert L. Jr. MD, and Slaughter, James R. MD. "Depression and Sexual Desire." American Family Physician. Web. 15 August 2000. http://www.aafp.org/afp/20000815/782.html
Bonierbale, Mireille, Lançon, Christophe, and Tignol, Jean. "The ELIXIR Study: Evaluation of Sexual Dysfunction in 4557 Depressed Patients in France." Current Medical Research and Opinion 19(2) (2003). Medscape Medical News. Web. 22 May 2003. http://www.medscape.com/viewarticle/452987
