Sertraline (Zoloft) is a drug from the SSRIs group. It is commonly used to treat depression, anxiety, and OCD (obsessive compulsive disorder). Like most other SSRIs, sertraline causes some degree of erectile dysfunction.
Erectile dysfunction and being unable to reach a climax may be associated with psychological problems. Patients may develop depression or have a worsening of the symptoms of depression when they develop erectile dysfunction.
In certain cases, sertraline is used to treat premature ejaculation in men. Since, it prolongs the time to reach a climax, it is used to treat men who complain of premature ejaculation.
How sertraline causes erectile dysfunction?
The chances of sexual side effects with the use of SSRIs including Zoloft (Sertraline) vary between 25 and 73 percent. Men frequently complain of erectile dysfunction while females mostly complain of being unable to achieve climax.
It can be frustrating to deal with side effects of Zoloft such as erectile dysfunction or other sexual side effects. Fortunately, most sexual side effects from Zoloft or other SSRIs can be treated. There are many options for managing and reducing your symptoms.
Sexual side effects with sertraline (Zoloft) can occur but is not universal. Most patients do not complain of sexual side effects even with prolonged use. In addition, compared to other SSRIs, Sertraline (Zoloft) has fewer sexual side effects.
Zoloft has a lower risk of causing sexual side effects compared to citalopram and paroxetine. Among the SSRIs, paroxetine causes the most side effects related to sexual health. However, if erectile dysfunction develops while using Zoloft (Sertraline), reducing the dose or switching to another SSRI may be useful.
Apart from erectile dysfunction, patients may also report:
- decreased sexual drive or reduced libido
- difficult to reach climax
- difficult to ejaculate
- difficulty becoming sexually aroused.
It is also estimated that 30 to 50% of patients who have depression have pre-existing symptoms related to sexual dysfunction and erection.
The exact mechanism of Sertraline and other SSRIs causing erectile dysfunction is not clearly known. However, serotonin may play a role in sexual desire. Serotonin can directly depress the desire centers in the brain. It is also believed to affect other hormones like testosterone and dopamine which play important roles in sexual desire, performance and pleasure, orgasm, ejaculation and sexual arousal.
Simply put, SSRIs can cause erectile dysfunction and other side effects. They affect the hormones and neurotransmitters which make you feel sexually active and stimulate your sexual function.
How to treat erectile dysfunction with Sertraline?
Before treating the sexual side effects and erectile dysfunction associated with Sertraline, it is important to note that patients must be asked not to reduce the dose or discontinue the treatment abruptly. This could result in very serious withdrawal symptoms.
Furthermore, patients may have a relapse of depression and anxiety that can also result in further frustration and worsening of erectile dysfunction.
Strategies that can reduce the chances of erectile dysfunction and sexual side effects include:
- Reducing a dose can help some people. This can be done in patients who have well-controlled depression and completed or almost completed the course of treatment.
- A different SSRI may be used. Sometimes drugs from different class of medications like serotonin modulators (Vortioxetine) may be preferred. It is not uncommon to test several antidepressants before you find the one that works best for you. Bupropion, available by the brand name, Wellbutrin, is less likely to cause sexual side effects. Another drug that is least likely to be associated with erectile dysfunction include mirtazapine.
- Sometimes to relieve the side effects, patients may be asked to take a “drug holiday”. This is a drug-free period in which the patients are off the medicines to relieve the patient of all the drug-related side effects including sexual side effects. This can be advised especially on weekends or other days when the patient’s symptoms of depression are least likely to worsen.
- Patients may need medications that are used to treat erectile dysfunction. These include Sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra) and avanafil (Stendra). It is important to note that not all patients respond to these medications since these drugs cause erection only when the patient is aroused. Depression is associated with decreased libido and arousal that can limit the utility of these drugs when treating ED.
- It is also important to explore the cause of erectile dysfunction as some patients might be deficient in sex hormones or have other concomitant illnesses that can cause ED. Treating the underlying cause of erectile dysfunction can improve sexual health and ED in most patients.
- Some patients might benefit from over the counter supplements such as zinc and selenium. Studies have found that Saffron, a plant-derived compound, has beneficial effects in SSRIs-induced sexual dysfunction. It is an aphrodisiac that enhances sexual function and causes arousal and erection.
In conclusion
Like other SSRIs, Zoloft (sertraline), can cause sexual side effects including erectile dysfunction. Adding supplements that boost sexual health, medicines that improve erection, and sometimes switching to another antidepressant can help patients overcome the problem of erectile dysfunction.
No matter what you do, you should not suddenly stop taking Zoloft. This could make your depression worse and increase your chances of suffering withdrawal symptoms.