Summary: Everyone knows antidepressants cause sexual dysfunction. Now a new study shows this problem comes mostly from lost feeling in the genitals. And that lost feeling seems to last. It is more likely to affect males.
These days, antidepressants are used for many conditions, not just depression. They are also used for OCD, panic attacks, chronic pain and even some gut problems. So they are among the most used drugs. Yet the proof for such wide use is thin, and they might cause severe side effects.
Today, more than 80% of these prescriptions are for SSRIs (selective serotonin reuptake inhibitors). They are often sold as safer antidepressants. So the use of fluoxetine, citalopram, sertraline and other SSRIs is rising.
But even newer antidepressants are not very safe. They can cause trouble sleeping, headaches, blurred vision, muscle and joint pain, and upset stomach. They may also cause some lasting, severe problems, like changes in mental health. More and more proof shows they also hurt sexual function. That can be a big worry for young adults.
These drugs are widely used, and it is well known that they cause sex problems in many people. Yet how it happens is unclear and poorly studied. Now a new study shows that the sex problems from long-term use come from reduced feeling in the genitals. What is worrying is that this lost feeling may last a long time, even after you stop the drugs.
In recent years, doctors have begun to see that sex problems from long-term SSRI use often come from something called persistent post-treatment genital hypoesthesia (PPTGH). Put simply, many people who used antidepressants say they stopped enjoying sex because they feel less.
This problem also happens with many other drugs used for mental health. So the researchers compared antidepressants with other drugs. They surveyed 2,179 young people aged 15 to 29. Of them, 574 reported less feeling in the genitals (genital hypoesthesia).
Overall, PPTGH showed up in 13.2% of people prescribed antidepressants. With other drugs, it showed up in just 0.9%. That gap is huge. There is some clear evidence that antidepressants cause lost genital feeling, which leads to sex problems.
These findings should not be a total surprise. Antidepressants are often used to treat premature ejaculation. What is worrying is that they may cause lasting changes in the body or brain that dull genital feeling.
These problems are mostly seen in males, though they can affect females too. Bigger studies are needed to learn how antidepressants affect sex in each gender.
Still, these findings matter. Antidepressants may significantly dull genital feeling. And the risk is 10 times higher in people prescribed these drugs than in people who are not.
Doctors must keep this in mind when they prescribe antidepressants, and they must tell patients about it. That matters even more because these drugs are used for far more than depression. They are used for stress, anxiety, phobias, chronic pain and many other problems. Talking with chronic pain specialists is key to seeing the full risks and benefits of these drugs.
Frequently asked questions
Can antidepressants cause genital numbness?
Yes. A 2024 survey links antidepressant use to lost genital feeling. That loss seems to drive much of the sex trouble these drugs are known for. Doctors call the lasting form persistent post-treatment genital hypoesthesia, or PPTGH. It is linked to long-term use of SSRIs, the group that includes fluoxetine, citalopram and sertraline. It is reported more often in males, though females are affected too.
How common is lasting genital numbness after antidepressants?
In the survey behind this article, 2,179 young people aged 15 to 29 answered questions about genital feeling. They came from sexual and gender minority youth in Canada and the US. Lasting numbness was reported by 13.2% of those who had been prescribed antidepressants. Among those who took other drugs, it was 0.9%. That is a large gap. Bigger studies in other groups are still needed.
Does genital numbness go away after stopping antidepressants?
Not always. The worrying finding is that the lost feeling can last long after the drug is stopped. That suggests the drug may cause lasting changes in the body or brain. So this risk belongs in the talk before a prescription is written. That is even more true when an antidepressant is offered for chronic pain, anxiety or stress instead of depression.
Source:
Pirani, Y., Delgado-Ron, J. A., Marinho, P., Gupta, A., Grey, E., Watt, S., MacKinnon, K. R., & Salway, T. (2024). Frequency of self-reported persistent post-treatment genital hypoesthesia among past antidepressant users: A cross-sectional survey of sexual and gender minority youth in Canada and the US. Social Psychiatry and Psychiatric Epidemiology. https://doi.org/10.1007/s00127-024-02769-0
Dr. Gurpreet Singh Padda, MD, MBA, MHP
