Depression and Sexual Health
Despite social stigma, depression is a very common illness. According to the Centers for Disease Control and Prevention (CDC), about one in 20 Americans over the age of 12 has some form of depression. While the National Institute of Mental Health (NIMH) reports a higher prevalence in women, the fact is that depression can develop in anyone, and at any age. The types of depression include:
- persistent depressive disorder (symptoms last for two years)
- psychotic depression
- major depression
- bipolar disorder
- postpartum depression (occurs in women after having a baby)
- seasonal affective disorder (occurs during the winter months)
- depression coupled with anxiety disorders
For those affected, having depression means more than just feeling blue — it can cause a range of symptoms, including sexual health problems. Learn more about the link between depression and sexual dysfunction, and what you can do about it.
Symptoms and Gender Differences
Both men and women can experience difficulties with initiating and enjoying sex because of depression. Still, there are some differences in the ways depression affects women and men.
According to the NIMH, a higher rate of depression in women is connected to hormonal changes. This is why a woman’s risk of depression may increase:
- before and during menstruation
- after childbirth
- when juggling work, home, and family life
- during perimenopause and menopause
Women are the most likely to experience persistent “bluesy” feelings that can make them feel less confident and less worthy. These feelings can drastically change your overall sex life.
As women age, physical factors can make sex less enjoyable (and sometimes even painful). Changes in the vaginal wall can make sexual activity unpleasant. Also, lower levels of estrogen can disrupt natural lubrication. Such factors can be depressing for women if they do not seek help to find relief.
Anxiety, low self-esteem, and guilt are common causes of erectile dysfunction. These are all symptoms of depression, but such issues can also occur naturally with stress and age. The NIMH explains that men are also more likely to lose interest in activities during depression. This could also mean that men might not find sex as appealing.
In men, antidepressants are directly related to impotence. Delayed orgasm or premature ejaculation may occur, too.
In both men and women, having troubles with sexual health can worsen feelings of worthlessness and other depression symptoms. This in turn can cause a vicious cycle of both worsening depression and sexual dysfunction.
Causes and Risk Factors
Chemical imbalances in the brain cause depression These can occur on their own as a result of genetics and hormonal issues. Depression can also coexist with other illnesses. No matter the exact cause of depression, it can result in numerous physical and emotional symptoms. Some of the most common symptoms of depression include:
- persistent sadness
- lack of interest in activities you once loved
- guilt and hopelessness
- insomnia and fatigue
- irritability and anxiety
- weakness, aches, and pains
- sexual dysfunction
- concentration difficulties
- weight loss or gain (usually from changes in eating habits)
- suicidal disposition
The symptoms of depression vary in frequency and severity for each person. Generally, the more severe of depression you have, the more problems you’re likely to have with sexual health.
Sexual desire is cultivated in the brain, and sex organs rely on chemicals in the brain to promote libido as well as the changes in blood flow needed for the sexual act. When depression disrupts these brain chemicals, it can make sexual activity more difficult. This may be worse in older adults who already have occasional problems with sexual dysfunction.
It is also not just the depression itself that may interfere with sexual health. In fact, antidepressants — the most common forms of medical treatment for depression — can often have unwanted sexual side effects. The most common culprits are:
- monoamine oxidase inhibitors (MAOIs)
- serotonin and norepinephrine reuptake inhibitors (SNRIs)
- selective serotonin reuptake inhibitors (SSRIs)
- tetracyclic and tricyclic medications
Treating depression is just one way you can overcome sexual dysfunction. In fact, according to a study published in American Family Physician, 70 percent of adults facing depression without treatment had problems with libido. Feeling good again may help you get back to a normal sex life.
Still, the problem may not always resolve in adults who do seek depression treatment. If your primary care provider determines that sexual dysfunction is a side effect of an antidepressant you take, they might switch you to a different medication. Mirtazapine (Remeron), nefazodone (Serzone), and bupropion (Wellbutrin) do not typically cause sexual side effects.
Aside from additions and adjustments within conventional depression treatment, there are other steps you can take which may improve overall sexual health:
- Take antidepressant dose after engaging in sex.
- Ask your provider about adding a medication for sexual function (such as Viagra for men).
- Exercise regularly to improve mood and physical well-being.
- Talk to your partner about how your depression is affecting your sexual health. Open communication may not automatically resolve the issue, but it can help alleviate feelings of guilt and worthlessness.
Depression and its related treatment can sometimes cause issues with sexual health, but there is hope in resolving both issues. Treating one can often help the other. However, finding the right balance can take time and patience. In the meantime, you should not alter any medications on your own without checking with your healthcare professional. Tell your provider if sexual dysfunction worsens despite any alterations in treatment.
It’s also important to remember that, while depression and sexual dysfunction can go hand in hand, there are also a variety of factors that can cause problems with sexual health.