a couple with sex problems

So many couples struggle with their sex lives. The partners may have inherent differences in their sex drives that create tension or guilt and interfere with enjoyment. In other instances, medication is to blame for changes in libido or ability to achieve orgasm. Certain antidepressants can have devastating effects on the pair’s love life.

Could Paroxetine Be a Problem for Sex?

Q. I have a question concerning my husband. He has been on clonazepam (Klonopin) for about a year now for anxiety. He never had any problems while taking this drug.

His physician recently added paroxetine (Paxil) and naproxen due to increasing anxiety and pain. My husband is 40. He has no problem getting an erection; however, after a few minutes of intercourse he begins to get numb. An hour later, still no orgasm and he has to stop from exhaustion.

This has been going on close to a month now! He gets frustrated but tries to hide that fact. I, however, am going nuts. I keep telling myself that it is the medication the doctor put him on but I think he is a little embarrassed to discuss this with his female physician. I would be too!

After twenty years of a happy marriage with a great sex life I am starting to worry that it’s my fault and that I just can’t please my man anymore. Could it be the medications the doctor has him on?

Talking with the Doctor:

A. We can understand your husband’s reluctance to discuss this delicate matter with his female physician. Nevertheless, it is an issue that should be brought to the prescriber’s attention.

Antidepressant drugs such as fluoxetine (Prozac), paroxetine, and sertraline (Zoloft) are notorious for causing a range of sexual side effects. For many, it may be reduced sex drive. Others say that they have difficulty becoming sexually aroused.

More commonly, both men and women have a hard time achieving orgasm. Studies have suggested that such complications may occur in up to 60 to 70 percent of those treated with standard antidepressant medications. Doctors have taken advantage of this side effect and sometimes prescribe paroxetine for men with premature ejaculation (Journal of Sexual Medicine, Aug., 2010).

A study of the antidepressant citalopram (Celexa) published in the journal Neuropsychopharmacology (online, March 18, 2009) revealed that 54% of patients reported decreased libido and 36% complained of difficulty achieving orgasm.

Anti-anxiety agents such as alprazolam (Xanax)
, chlorazepate (Tranxene)
, clonazepam (Klonopin) and diazepam (Valium)
 can also put a damper on sexual desire.

Other Readers Have Also Had Trouble:

Here are some stories from others who have experienced sexual side effects from their medicine. CHS said:

“My husband was prescribed clonazepam for his panic disorder. It definitely affected sexual function, which, I think, compounded his depression. When he tried to gradually give up the medication, he experienced many withdrawal symptoms.

“Medications for his panic attacks, while stopping the panic, essentially ruined the last 12 years of his life.”

Mark reported:

“I was on Lexapro in my early 20s. It worked well but killed my sex drive. Now I’m on generic Zoloft (sertraline) because my new insurance doesn’t cover Lexapro. At first, it was great, but now the usual side effects have begun.”

Kim wrote:

“My husband has always had a very good sex drive until about a year ago. He broke his foot and started taking pain meds. He takes tramadol and hydrocodone. We have not had sex in 10 months and he will not talk to the doctor about it. The only thing he will say to me is he is just not in the mood. Is there any thing that I can buy, maybe a vitamin, that can help? This is really starting to hurt our relationship.”

As you can see from Kim’s message above, antidepressants aren’t the only drugs that can zap libido. Pain relievers can also affect sex drive.

Tramadol and Sexual Interest:

There isn’t much in the medical literature about tramadol, but we suspect it can dampen desire and affect performance because it affects neurochemicals such as serotonin and norepinephrine. The result is that it may act a little like antidepressants such as sertraline, fluoxetine and venlafaxine (Effexor) in the brain. Since such drugs have a profound impact on human sexuality, it is hardly any wonder that tramadol might also. Hydrocodone (a narcotic) can also have a negative impact on sexuality.

Don’t Stop These Drugs Abruptly:

None of these medications can be stopped suddenly. Withdrawal symptoms from antidepressants (or tramadol) can be disastrous. Brain zaps (shock-like sensations) are common along with dizziness, anxiety, irritability, insomnia, nausea and digestive difficulties.

Should someone ever need to stop an antidepressant medication or a pain reliever like tramadol, very gradual tapering (over weeks or months) is called for. It must be supervised by a physician.

Our free Guide to Psychological Side Effects will reveal more about withdrawal and other complications of these medications.

Share your own story below about the sexual side effects of your medication and how you have coped.

Revised 10/20/16

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  1. JP
    new mexico usa

    I knew that paxil reduced sexual interest; however, until reading this page, I never knew that both xanax and zoloft interfere just as much! No wonder i can’t get to orgasm now! Crap! Why didn’t the doctor tell me this would happen!? I changed from paxil to zoloft and now i find this out!

    And here I’ve been scared that the romance i now have with this wonderful man, who loves me the way I always craved, was fading away and had just ‘run its course’. . . I kept apologizing to my lover, fearing that the blaze was running out of fuel, saying ‘I guess no fire can burn that hot forever, huh?’ And now i learn that it’s these damm meds! It’s not me! My provider is gonna get an earfull about this.

  2. Tony,o

    My primary Dr. Told me it was because i was taking valium and hydrocodone, that i would be able to get an erection and i told him i can get an erection but sometimes I can’t ejaculate

  3. Tony,o

    Well i can have an erection but sometimes can not ejaculate and sometimes my erection doesn’t last too long.

  4. Martin
    Great Neck, N.Y.

    If you are taking an anti-depressant, your Dr. believes that you are depressed.
    After stopping all of the meds, I was still unable to achieve an orgasm. I spoke with my urologist who told me to see a psychologist. The psychologist’s opinion is that my body produces adrenaline which blocks the blood from going into my penis. It is his opinion that this is the major cause of ED.

  5. Ginger
    VA - Virginia

    My husband has only been on paxil a couple of months and we have a very healthy sex life (5-6 times a week) the past month on paxil, though he hasn’t been able to ejaculate even on his own, he just gives up from exhaustion, or I do…And even though I know it is just the medication it doesn’t help with my own insecurities or his b/c it feels like I am failing him in some way when I can’t get him off. It has seemed to help with his aniexty and depression so I hate to have him switch medications, but this side effect I wish it was one that the drs had warned us about.

    • Chrystal

      My husband is taking and it has started making it to where he can’t ejaculate. And with him having the depression issues that he has, has made it to where it’s my fault. We had sex for an hour and a half last night, and he got nothing. I hate this BC I was pleased several times to his none! And today it was like I didn’t care to keep trying . It’s very heart breaking to know that may I could have done something different, and didn’t. Have you had any luck???

  6. Yonu

    I just started reading this thread…..I was searching for information on how to help him overcome this side effect…..I have suffered the same thing and thought it was just psychological as a response to him not being able to achieve climax with me ….even though I knew that it was possibly the drug…it’s something you want to think you can overcome if you try hard enough but this is a real issue.

    In reading I discovered that more than one of my medications could be causing this in me too…..I have coincidentally tapered off my meds recently for other reasons and I have already noticed a difference in my overall libido ….just the feeling and interest, that’s what prompted me to do this search…..so it’s definitely from the meds and I’m not sure it’s a fair trade off…..but I am very grateful for this post and everyone who took the time to share because I feel so much better about the situation having heard so many similar feelings of frustration I know now it isn’t about ‘he and I’ but the medications and we can deal with that together with our doctors now if we want to….so at least I have a clear choice and a little more control then I felt I had before..l.THANK YOU ~ Y.U.

  7. mujahid

    Hey I’m 22 male..
    I have long time depression but Im aware of side effects of antidepressants listed above…
    I am afraid about taking that…
    So can any one suggest me what to do ….please help me am anxious from a month

  8. Michael

    I have been prescribed an anti-depression medication and I can assure you that it does affect a man’s ability to have an orgasm. …

  9. SGH

    Anyone who wants to stop taking PAXIL had better do it under a doctor’s supervision. Paxil is well-known for causing distressing symptom when not done very gradually. While I’m happy for the person who had no problems with it, you can probably find 10 more who’ll give your their disaster story, including me.
    I don’t think any of the SSRI antidepressants should be abruptly stopped without medical supervision. This is important enough to cal it a warning. While we’re on the subject, a couple of other things about Paxil. It caused me weight gain more than the other SSRI’s and made me sleepier during the day.

  10. JLH

    The condition is called anorgasmia and is a KNOWN side effect of many anti-depressants. It’s usually not an answer to premature ejaculation, as it doesn’t just prolong an erection as much as it nullifies a person’s ability to derive pleasure from the act of copulation, or EVER achieve orgasm. It has the same effect on many women (it did on me), and it can be hellishly frustrating. (If you weren’t depressed BEFORE you went on the drug, you sure would be afterwards.)
    Check out table 2, near the end: http://www.drugs.com/pro/lexapro.html
    St. John’s Wort does work pretty well on depression; the one side effect I experienced was a marked photo-sensitivity. I felt like my skin was burning even in weak, winter sunlight. Kava Kava also works well, and despite FDA warnings the natives of Fiji have been eating this stuff for hundreds of years with no discernible problem. Well, other than they’re generally a happy bunch. (I would read the original FDA data before making a decision about using the herb; the part of the plant that caused liver enzyme issues in one person isn’t the part of the plant usually used; the root–moreover, most of the prescription drugs listed here can cause the same liver enzyme fluctuations when used long-term.)
    What finally worked for me was seeing a bioidentical hormone specialist who, after extensive testing, managed to stabilize my crippling depression in ONE DAY–with a testosterone implant the size of a grain of rice. Seriously–I woke up the day after the in-office procedure filled with energy and a zest for life I hadn’t felt since I’d entered into menopause. While I know that this won’t be the answer for everyone–it may well be the answer for some folks, and one worth exploring.

  11. GJ

    I, too, had all of the sexual performance problems named above on anti-depressants. I had been taking them for many years and have been on most of the popular ones, most recently, Paxil. The side effects were getting worse so I started taking only half-tablets daily. This went on for a couple years with mixed results – not much change in depression level and little difference in libido. A life change event happened recently and left me feeling very good for a change. I had not felt that good in years!
    So, I chose to take advantage of the very positive feelings to see if I could “kick the habit”. I have been Paxil free now for over six weeks and still feel fine. Part of the good news is that my libido has returned to “normal”. I may not be typical and I did this on my own without discussing it with my doctor which may not have been the best plan but it worked and I’m never going back on these drugs!

  12. R M

    My husband has suffered all of our married life from early ejaculation. Very early ejaculation, sometimes before penetration. There are options for men to achieve erections but very few to slow them down. We tried both kinds. We have not tried Paxil. Perhaps one man’s problem side effect will be another man’s very satisfying side effect.

  13. Bfm

    IMHO wife and I have had these side effects! What would be some possible alternatives to Zoloft and Lexapro, ones which might be less likely to cause problems?

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