Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 9/17/2020
Sertraline, sold under the brand name Zoloft®, is a selective serotonin reuptake inhibitor (SSRI) that’s commonly prescribed to treat depression. It’s also used as a treatment for certain forms of anxiety, obsessive–compulsive disorder (OCD) and several other conditions.
If you’ve been prescribed a SSRI such as Zoloft, there’s a possibility that you could experience sexual side effects after you start using your medication. In fact, research shows that between 25 percent and 73 percent of people prescribed SSRIs experience sexual side effects.
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 like ED, as well as what you can do to manage SSRI-related erectile dysfunction and other sexual side effects.
Sertraline, the active ingredient in Zoloft, is one of the most common SSRIs in the US, with tens of millions of prescriptions written every year across the country.
While some men may experience ED and other sexual side effects after using Zoloft, these issues aren’t guaranteed to occur. Many people use Zoloft and other SSRIs for long periods of time without experiencing sexual side effects.
Zoloft is less likely to cause sexual side effects than many other SSRIs. Research has found that sertraline, the active ingredient in Zoloft, has a lower risk of causing sexual dysfunction than SSRIs such as paroxetine (sold as Paxil®).
If you develop sexual side effects after using Zoloft, you may be able to stop them by switching to a different type of antidepressant or by adjusting your dosage. However you should not stop or change medications without talking with your healthcare provider first.
ED isn’t the only sexual side effect associated with Zoloft and other SSRIs. Other side effects include a reduced libido, difficulty reaching orgasm and ejaculating and difficulty becoming sexually aroused.
Sexual side effects, including ED, aren’t always drug-related. According to the folks at Harvard Medical School, 30 percent to 50 percent of people with major depression experience sexual issues prior to treatment, meaning there could be a non-pharmaceutical cause to some sexual side effects.
Researchers aren’t aware of exactly why Zoloft and other SSRIs can cause erectile dysfunction and other sexual side effects. Currently, theories point towards the effects of SSRIs on serotonin — an important neurotransmitter — as potentially affecting sexual desire and performance.
Serotonin is an essential neurotransmitter — a type of chemical messenger that the body uses to communicate between nerve cells. Zoloft and other SSRIs work by increasing serotonin levels — an important action for treating depression and related conditions.
Experts believe that by increasing the availability of serotonin, Zoloft and other SSRIs can affect other hormones, including the hormones dopamine and testosterone.
Dopamine and testosterone both play key roles in sexual desire and performance. Testosterone is closely associated with sexual arousal, while dopamine plays an important role in orgasm and ejaculation.
Put simply, SSRIs may cause erectile dysfunction and other sexual side effects by affecting the specific hormones and neurotransmitters that make you feel aroused and allow you to perform sexually.
Interestingly, sertraline’s effects on orgasm and ejaculation are well known — so much so that it is often prescribed off-label as a medication for treating premature ejaculation.
If you notice sexual side effects after you start taking Zoloft, it’s important that you don’t reduce your dosage or stop taking your medication without first talking to your healthcare provider.
Stopping Zoloft suddenly or reducing your dosage without warning could cause you to develop antidepressant withdrawal symptoms. These can develop within a few days and can range from physical issues like dizziness and flu-like symptoms to anxiety.
It’s also possible for you to experience a relapse of depression if you suddenly stop taking your antidepressants.
Before making any changes, talk to your healthcare provider. To treat erectile dysfunction and other sexual side effects, they may recommend that you:
Adjust your dosage of Zoloft. Sertraline, the active ingredient in Zoloft, is prescribed at a range of different dosages. If you experience ED or other sexual side effects after you start using Zoloft, your healthcare provider may recommend lowering your dosage.
Switching to a lower dosage of Zoloft may help get rid of or reduce the severity of your sexual side effects while still treating your depression.
Use a different SSRI. Although most SSRIs are prescribed for the same purpose, there are differences between each medication that could make one a more suitable choice for you than others.
It’s far from uncommon to try several antidepressants before settling on the medication that suits you best. Your healthcare provider may recommend switching to a different SSRI, such as fluoxetine (sold as Prozac®) or escitalopram (sold as Lexapro®).
Use a different type of antidepressant. Certain antidepressants, such as bupropion (sold as Wellbutrin®), are less likely to cause sexual side effects than others, and are often prescribed to people who experience sexual side effects from SSRIs.
If you develop ED or other sexual side effects after starting Zoloft, switching to a different antidepressant may help. Bupropion (Wellbutrin) and mirtazapine (Remeron®) are often recommended as safer choices for men prone to ED from SSRIs.
Take a “drug holiday” to relieve side effects. If your healthcare provider thinks it’s a safe option, they may suggest that you take 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 reduce the severity of ED and other sexual side effects by giving the medication to exit your body before sex.
Use medication to treat ED. Erectile dysfunction medications like sildenafil (sold as Viagra® or generic Viagra), tadalafil (Cialis®), vardenafil (Levitra®) and avanafil (Stendra®) are highly effective and may be helpful for treating antidepressant-related ED.
Research shows that sildenafil, the active ingredient in Viagra, works well as a treatment for antidepressant-associated erectile dysfunction.
We’ve explained how these medications work in more detail in our complete guide to erectile dysfunction medications.
Consider other factors that may contribute to ED. Even if you currently take Zoloft, it’s possible that another factor, such as a physical health condition, stress or excessive use of pornopgraphy, could contribute to erectile dysfunction and other sexual issues.
Our guide to the causes of ED goes into more detail about the numerous factors that may contribute to erectile dysfunction, as well as what you can do to treat it.
Just like other SSRIs, Zoloft (sertraline) can and often does cause sexual side effects, including erectile dysfunction. Research shows that between 25 percent and 73 percent of people who use SSRIs experience sexual side effects, making these issues fairly common.
If you’re prescribed Zoloft or another SSRI and find it difficult to get and maintain an erection or reach orgasm, it’s best to talk to your healthcare provider about treatment options.
Depending on the severity of your depression, your specific side effects and other factors, they may recommend adjusting your dosage, changing to a different type of antidepressant, using a medication such as Viagra or taking other steps to improve your sexual performance.
Whatever you do, it’s important that you don’t suddenly stop taking Zoloft. Doing this may cause your depression to worsen and increase your risk of experiencing withdrawal symptoms.
Sertraline, the active ingredient in Zoloft, is a common SSRI that’s used to treat depression and several other conditions. Our Sertraline 101 guide goes into greater detail about how sertraline works, its uses, side effects and more.
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