Mood Up, Libido Down: Antidepressants & Sexual Dysfunction in Women

One in six women in the United States rely on antidepressants to live a “normal” life (Tierney et al., 2016). Selective serotonin reuptake inhibitors (SSRIs) constitute some of the most commonly prescribed drugs, and they work to increase serotonin levels in the brain by blocking the reuptake of serotonin, keeping more of it available to improve overall mood (Lee et al., 2010; Quaile, 2025). While more serotonin can stabilize emotions, it can have inhibitory effects on sexual function (Lorenz et al., 2016; Quaile, 2025). Specifically in women, increased serotonin can cause diminished or absent libido, difficulties with arousal (reduced genital sensitivity and lubrication), and delay/trouble reaching orgasm or anorgasmia (Lee et al., 2010). These side effects can impact a woman's quality of life and create severe distress (Lee et al., 2010). This blog explores the ways in which antidepressant prescriptions can negatively impact libido, arousal, and orgasm in women, leading to sexual dissatisfaction.

Libido is the term for someone’s sexual desire, and loss or decline of this is a commonly reported adverse sexual side effect in women taking antidepressants (72% of women in one study; Tierney et al., 2016). Higher serotonin can suppress dopamine, a necessary neurotransmitter for sexual motivation and reward (Michelson et al., 2000; Quaile, 2025). When there are fewer dopamine signals in the brain, there is less desire, contributing to lower libido (Michelson et al., 2000; Quaile, 2025). The effect of diminished interest in sexual activity is something that affects more women than men globally and is highly reported by Americans. An analysis of low sexual desire from antidepressants across various European countries revealed that up to 34% of women compared to 15% of men reported post-SSRI low sexual desire (Kennedy & Rizvi, 2009). However, changes in sexual interest may be more subjectively experienced and context dependent, making it more difficult to specifically attribute to medicine (Michelson et al., 2000).

Another commonly reported adverse sexual effect in women taking antidepressants is problems with sexual arousal, operationally defined as vaginal lubrication for individuals with vulvas (83%; Tierney et al., 2016). Elevated serotonin can inhibit nitric oxide synthase – a family of enzymes - which decreases blood flow to the genitals, making genital arousal feel blunted (Lee et al., 2010; Quaile, 2025). Vaginal arousal is also facilitated by activity in the sympathetic nervous system and harmony between it and the parasympathetic nervous system is necessary for vaginal lubrication (Tierney et al., 2016). SSRIs interfere with the natural balance between the two systems which may explain why women taking SSRIs report more dysfunction in sexual arousal than men (Tierney et al., 2016). Psychological arousal could also potentially be dissociated from physiologic arousal, meaning that even if women experience sexual desire/interest or are mentally aroused, they may not have sufficient vaginal lubrication to have enjoyable sexual intercourse (Michelson et al., 2000).

Lastly, many women on antidepressant medications experience extreme difficulty achieving orgasms or anorgasmia (the inability to achieve an orgasm; Jani & Wise, 1988). SSRIs can halt the brain’s reward response and delay or completely block orgasmic ability (Kennedy & Rizvi, 2009; Lee et al., 2010; Quaile, 2025). Studies show that a high frequency of women (anywhere from 30% to 70%) prescribed serotonergic antidepressants report orgasm difficulties since starting the medication (Quaile, 2025). Since pressure is often placed on making orgasms the final goal of sexual activity (Janssen et al., 2025), many women with this side effect are left feeling sexually unsatisfied (Janssen et al., 2025).

In conclusion, with the decrease of mental health stigma and the increase of pharmacological treatments being prescribed (Angermeyer et al., 2013), the issue of antidepressants potentially causing sexual problems needs more awareness and a deeper understanding. It is crucial that women around the world can receive treatment for anxiety and depression without sacrificing their pleasure or sexual wellbeing. People should be able to have both medicinal assistance and sexual satisfaction, without being forced to choose one.

Katrina Caeiro (she/her), Psychology and Sociology Joint Honors, 4th year, Queens University.

References

Angermeyer, M. C., Matschinger, H., & Schomerus, G. (2013). Attitudes towards psychiatric treatment and people with mental illness: changes over two decades. British Journal of Psychiatry, 203(2), 146–151. doi:10.1192/bjp.bp.112.122978

Jani, N. N., & Wise, T. N. (1988). Antidepressants and inhibited female orgasm: A literature review. Journal of Sex & Marital Therapy, 14(4), 279–284. https://doi.org/10.1080/00926238808403810

Janssen, A. K., Csako, R. I., Rowland, D. L., & Hevesi, K. (2025). The Satisfaction of Women's Orgasms: The Relationship Between Women's Orgasmic Pleasure and Sexual Relationship Satisfaction in Aotearoa/New Zealand. International journal of sexual health: official journal of the World Association for Sexual Health, 37(2), 251–262. https://doi.org/10.1080/19317611.2025.2464535

Kennedy, S. H., & Rizvi, S. (2009, April). Sexual Dysfunction, Depression, and the Impact of Antidepressants. Journal of Clinical Psychopharmacology, 29(2): p57-164. https://doi.org/10.1097/JCP.0b013e31819c76e9  

Lee, K. U., Lee, Y. M., Nam, J. M., Lee, H. K., Kweon, Y. S., Lee, C. T., & Jun, T. Y. (2010). Antidepressant-Induced Sexual Dysfunction among Newer Antidepressants in a Naturalistic Setting. Psychiatry investigation, 7(1), 55–59. https://doi.org/10.4306/pi.2010.7.1.55

Lorenz, T., Rullo, J., & Faubion, S. (2016, September). Antidepressant-induced female sexual dysfunction - mayo clinic proceedings. Mayo Clinic. https://www.mayoclinicproceedings.org/article/S0025-6196(16)30302-0/fulltext

Michelson, D., Bancroft, J., Targum, S., Yongman, K., & Tepner, R. (2000). Female Sexual Dysfunction Associated With Antidepressant Administration: A Randomized, Placebo-Controlled Study of Pharmacological Intervention. Am J Psychiatry. 157: p239-243. https://psychiatryonline.org/doi/pdf/10.1176/appi.ajp.157.2.239

Quaile, H. (Ed.). (2025, August 19). A guide to the sexual side effects of ssris: Vella. Vella Bioscience. https://vellabio.com/blogs/vella-voice/sexual-side-effects-of-ssris