These medications have helped many people overcome feelings of depression and allowed them to get on with their lives. Thus, SSRIs have been rightfully dubbed a major advance in medicine. With simple once-a-day dosing and fewer side effects than older drugs, they've been embraced by physicians and patients alike -- so much so that some mental health experts complain that these "fashionable" drugs are sometimes given to people who don't really need them.
Men don't like to talk about it; neither do their partners. But loss of libido in men or inhibited sexual desire stresses a marriage more than any other sexual dysfunction, according to Barry McCarthy, co-author of Rekindling Desire: A Step by Step Program to Help Low-Sex and No-Sex Marriages.
Losing interest in sex may not be as common an occurrence for men as it is for women: It affects about 15% to 16% of men, and at least double that many women. "But when men lose interest in sex it scares them...
But even when SSRIs are prescribed to appropriate patients, they are not perfect. Recently, researchers have found that adverse sexual side effects may be much more common with these medicines than originally believed. So, if you're on an SSRI and you're suddenly having sex life problems -- an inability to get aroused or difficulty reaching orgasm, for instance -- the medicine might be to blame. And it's time to talk to your doctor about it.
Old Studies Versus Newer Studies
Some of the first studies of the SSRIs found that adverse sexual side effects (such as orgasm problems) occur in less than 10% of patients, according to Lawrence Labbate, M.D., Associate Professor of Psychiatry and Behavioral Sciences at the Medical University of South Carolina, Charleston. But, he points out, those studies relied on unprompted reporting -- patients who spoke up during a doctor visit or called their doctor on the phone when they noticed the sexual problems, so the number of people experiencing such problems was underrepresented.
In more recent studies, doctors specifically asked patients about libido or orgasmic difficulties, and found that they are present in nearly half of patients on an SSRI. Labbate reported this finding in the October 1999 issue of Psychiatric Annals.
Depression or Drugs to Blame?
Exactly how these drugs interfere with sexual desire isn't known. And depression itself, long considered a common cause of sexual dysfunction, may play a role, doctors concede.