Does Zoloft (Sertraline) Cause Erectile Dysfunction?

Sertraline, sold under the brand name Zoloft®, is a selective serotonin reuptake inhibitor (SSRI) that’s prescribed to treat depression. It’s also commonly used as a treatment for certain types of anxiety, obsessive-compulsive disorder (OCD) and other conditions. 

Used as prescribed, Zoloft can reduce the severity of the symptoms of depression and anxiety, letting you enjoy a higher quality of life.

Does Zoloft cause ED? Just like other SSRIs, Zoloft (sertraline) can and often does cause sexual side effects, including erectile dysfunction (ED).

In fact, research shows that between 25 and 73 percent of people who used antidepressants to treat depression, anxiety, and other conditions experience sexual side effects as a result of their medication.

Dealing with erectile dysfunction and other sexual side effects from Zoloft can be a frustrating process. Luckily, almost all sexual side effects caused by Zoloft and other SSRIs are treatable, with a variety of options available for reducing and managing your symptoms. 

Below, we’ve explained how medications such as Zoloft can cause sexual side effects such as erectile dysfunction.

We’ve also shared some practical techniques that you can use to prevent ED and stay sexually healthy while using Zoloft or similar medication.

Zoloft and Erectile Dysfunction: The Basics

• Sertraline, the active ingredient in Zoloft, is one of the most common SSRIs in the United States. It’s usually prescribed to treat depression, as well as anxiety disorders like social anxiety disorder (SAD) and panic disorder (PD).

• Zoloft is often prescribed off-label to treat eating disorders, generalized anxiety disorder (GAD) and premature ejaculation (PE). 

• As an antidepressant, Zoloft works by increasing serotonin levels. Modern SSRIs such as Zoloft have a lower risk of causing side effects than older medications for depression, such as tricyclic antidepressants (TCAs) or monoamine oxidase inhibitors (MAOIs).

• Like other antidepressants, Zoloft can cause sexual side effects, including difficulty with ejaculation and erectile dysfunction. However, recent research suggests that Zoloft has a lower risk of causing sexual side effects than other widely-used SSRIs.

• Not all sexual issues that occur while you’re using Zoloft are caused by Zoloft. According to Harvard Medical School, 35 to 50 percent of people with major depression experience sexual issues prior to treatment with medication and/or therapy.

• Most of the time, you can lower the severity of ED and other sexual performance issues by adjusting your dosage of Zoloft, taking a “drug holiday,” changing your habits or trying a different type of antidepressant drug. 

How Zoloft and Other SSRIs Cause Sexual Side Effects

Zoloft is one of several SSRIs your healthcare provider may prescribe if you have depression, obsessive-compulsive disorder, post-traumatic stress disorder (PTSD), or an anxiety disorder such as panic disorder or social anxiety. 

As an SSRI, Zoloft works by increasing serotonin levels in your brain and body. Serotonin is an important neurotransmitter that’s involved in regulating your moods, happiness, sleep cycle and feelings of anxiety.

Research suggests that low levels of serotonin may play a role in the development of numerous mental health disorders, including depression, anxiety and obsessive-compulsive disorder.

While Zoloft is generally effective as a treatment for depression and anxiety, it is associated with a range of sexual side effects. Commonly referred to as SSRI-induced sexual dysfunction, these side effects include:

• Delayed orgasm

• Difficulty ejaculating

• Decreased sex drive

• Erectile dysfunction

Currently, researchers aren’t aware of precisely why Zoloft and other SSRIs cause these sexual side effects. However, one popular theory is that the effects of SSRIs on serotonin may have an impact on sexual desire and performance.

For example, research suggests that the increased levels of serotonin caused by SSRIs such as Zoloft may affect production of similar neurotransmitters and hormones, including dopamine and testosterone.

Dopamine is an essential neurotransmitter that’s involved in reward-seeking behavior, as well as processes such as achieving orgasm.

Testosterone is an androgen hormone, or male sex hormone, that plays a vital role in regulating sexual response and arousal. 

Experts believe that by increasing serotonin levels, medications like Zoloft may affect production of other hormones, resulting in antidepressant-induced sexual dysfunction. 

While sexual side effects are common with SSRIs in general, research suggests that Zoloft has a lower risk of causing issues like erectile dysfunction than other medications for depression.

For example, studies have found that between 25 and 73 percent of people treated with SSRIs report sexual side effects.

However, data from clinical trials suggests that only two to eight percent of men who use Zoloft experience sexual side effects, with ejaculation difficulties the most common (reported by eight percent of men) and erectile dysfunction less common (reported by four percent of men).

Other Zoloft Side Effects

In addition to sexual performance issues such as erectile dysfunction, Zoloft and other SSRIs can potentially cause other side effects.

Most side effects of Zoloft are mild and transient, meaning they gradually become less severe as your body gets used to the effects of the medication. However, certain side effects of Zoloft may be more severe and/or persistent.

Other, non-sexual common side effects of Zoloft include:

• Nausea

• Diarrhea

• Tremor

• Dyspepsia (indigestion)

• Decreased appetite

• Hyperhidrosis (sweating)

It’s important to inform your healthcare provider if you experience any persistent or concerning side effects after starting treatment with Zoloft. 

Our full guide to SSRI side effects goes into more detail about the potential adverse effects of Zoloft and similar medications for depression and anxiety. 

How to Treat Erectile Dysfunction From Zoloft

Most of the time, sexual effects from antidepressants can be treated or made less severe with some changes to the way you use your medication.

If you start to develop erectile dysfunction or other signs of antidepressant-associated sexual dysfunction after taking Zoloft, it’s important not to make any changes without first talking with your healthcare provider. 

This is because stopping Zoloft and other antidepressants can cause withdrawal symptoms if they’re stopped abruptly, or if you suddenly reduce your dosage.

It’s also possible for you to experience a relapse of depression or anxiety if you suddenly stop taking your antidepressant medication.

To treat ED from Zoloft, your healthcare provider may recommend using one or several of the following techniques:

• Adjusting your dosage of Zoloft. Zoloft is prescribed at several dosages, from 25mg to 200mg per day. Some side effects, including sexual effects, may be more common when Zoloft is used at a high dosage.
  Your healthcare provider may recommend adjusting your dosage of Zoloft to reduce the severity of sexual side effects while still treating your mental health condition.

• Switching to a different SSRI. Although most SSRIs work in the same basic way, there are differences between each medication that could make one a more suitable choice for you than others.
  If you have sexual side effects that don’t improve after adjusting your Zoloft dosage, your healthcare provider may suggest switching to a different SSRI.

• Using bupropion (Wellbutrin®). Some prescription antidepressants, such as bupropion (Wellbutrin), are less likely to cause sexual side effects than others.
  Your healthcare provider may recommend switching from Zoloft to bupropion or a similar non-SSRI antidepressant if you have persistent side effects that don’t improve over time or with dosage adjustments. 

• Taking a temporary “drug holiday.” If your healthcare provider thinks it’s a safe option, they may suggest going on a “drug holiday” -- a day or two in which you stop taking your medication -- to avoid ED and other sexual side effects.
  This may help to lower the severity of ED and other sexual function issues by giving the medication to exit your body before sex.

• Using medication to treat ED. In some cases, your healthcare provider might suggest using prescription ED medication, such as a PDE5 inhibitor, to improve flow and make it easier to maintain an erection.
  Several medications are available to prevent erectile dysfunction, including sildenafil (the active ingredient in Viagra®), tadalafil (Cialis®), vardenafil (Levitra®) and avanafil (a new medication sold as Stendra®).
  Our guide to the most common ED medications goes into greater detail about how these medications work, their advantages, side effects and more. 

• Making changes to your habits. Some habits, such as being inactive, smoking, eating an unhealthy diet, living a stressful lifestyle or watching porn excessively, may also play a role in erectile dysfunction.
  Consider making changes to your habits and lifestyle to treat ED. Our guide to naturally protecting your erection goes into more detail about lifestyle changes that you can make for better erections and sexual health. 

The Bottom Line on Zoloft and Your Sex Life

If you have depression, anxiety or another psychiatric disorder, using medication like Zoloft can help to make your symptoms less severe and significantly improve your quality of life. 

Sexual side effects from Zoloft only affect a small percentage of users, but they can happen. If you notice any changes in your sex drive, erections or ability to enjoy sexual activity after using Zoloft, it’s important to let your healthcare provider know.

They may suggest adjusting your dosage of Zoloft, switching to a new antidepressant or taking other medication to improve your sexual response cycle and overall sexual performance.

In some cases, you may also benefit from using ED medication to improve blood flow and help you get and maintain erections more easily. 

Worried about sexual side effects from Zoloft? Our guide to managing sexual side effects from antidepressants goes into more detail about what you can do if you notice ED, a low sex drive or other sexual issues after starting treatment with an SSRI. 

You can also learn more about Zoloft and its active ingredient in our detailed guide to sertraline, which covers everything from how this medication works to its most common uses, side effects, potential interactions and more.