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“Can you still come on antidepressants?”
Typing those words into Google (incognito mode, of course), I felt like a 13-year-old again, nervously searching “two girls kissing” on the family computer. Although the sensible part of my brain reminded me that neither starting antidepressants nor caring about my sex life was shameful, I still couldn’t shake the mild embarrassment that came from talking about them.
Six million people in the UK were taking antidepressants at the end of 2020 – nearly one in ten of us. Despite that, the effect these innocuous-looking pills have on intimacy is rarely discussed – even though it can be huge.
Like a lot of people across the world, the Covid-19 pandemic had wrecked my mental health, and my anxiety started affecting my work and personal relationships. I was too dependent on my friends, struggling to complete my work, and adding stress to the lives of the people I love the most. In late December (after yet another minor breakdown about something ridiculous) I came to the realisation that I couldn’t and shouldn’t just be trying to “deal with it”.
I came prepared for the side effects that come with starting to take sertraline: nausea, headaches, fatigue. These effects are supposed to go away after the first couple of weeks, and for me only lasted five days. What I didn’t come prepared for was how it would change my sex life.
It’s always been important to me to have a regular, fulfilling sex life. As well as the obvious enjoyment, I’ve found that it makes me feel better about my body and boosts my confidence – so when lockdown first hit back in March 2020 it was a no-brainer to move in with my boyfriend. When every single one of your hobbies is now illegal, I think it was fairly common to end up falling back on sex and masturbation to fill the long lockdown days. Losing that now felt like a terrifying risk.
A lot of people starting antidepressants also find that they can’t orgasm. It was definitely harder for me – although how much of that was because of the medication and how much was my stress about the issue I don’t know.
Although a search of the NHS site does show some information about the sexual side effects of antidepressants, they’re fairly vague: ‘low sex drive’ and ‘erectile dysfunction’. I wasn’t told anything about it by my (otherwise excellent) GP, hence the anxious internet searches.
However, after reaching out to another doctor I found that these side effects are well-known amongst medical practitioners. She added that these symptoms can persist even when you stop taking antidepressants, something rarely discussed – and something I wasn’t told when I started taking them.
So, what does this actually mean? For me, there were two noticeable changes. First, I was much sleepier and, because of that, less interested in sex. As a full-time student being sleep deprived is nothing new, but starting sertraline made me feel exhausted. I was used to exercising for a couple of hours a day, but now going to Tesco suddenly felt like an insurmountable challenge. When you’re this tired, putting in the effort to have sex becomes much less appealing than a nice long nap.
A lot of people starting antidepressants also find that they can’t orgasm. It was definitely harder for me – although how much of that was because of the medication and how much was my stress about the issue I don’t know. Thankfully I found ways to deal with the problem (thank you, vibrators) and have a patient partner who I knew I could talk to.
While scheduling sex isn’t the most erotic way of doing things, knowing what time of day your body is least affected by the medication is helpful.
However, for people with a lot of new partners this is a really difficult issue to tackle. It can feel uncomfortable to divulge intimate details about your mental health to one night stands or people you don’t know that well.
One of the best ways to get around this is to focus on sexual pleasure that isn’t just penetrative or focused on orgasm. Trying BDSM can be a great way to add variety – you don’t have to go all Christian Grey with whips and chains, but adding an element of sexual tension that’s detached from the act itself lets you experience the fun of sex without worrying about your orgasm. Regardless of whether you’re taking antidepressants or not, variety is, as they say, the spice of life.
It’s all about discovering what works for you. While scheduling sex isn’t the most erotic way of doing things, knowing what time of day your body is least affected by the medication is helpful. The side effects are much stronger for me in the morning, but by the evening I’m a lot more likely to fully enjoy it.
It would be a lie to say that starting sertraline didn’t negatively affect my sex life. That being said, with a few adjustments I know it’s more than possible to continue to have a fulfilling and enjoyable experience.
The most important thing is to listen to your body and communicate with your partner – and trying new things is always helpful. The positive impact sertraline has had on my life is much greater than its side effects – and it’s prompted me to learn some new tricks in the bedroom too.
Simone Fraser is a freelance journalist
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This article originally appeared on HuffPost UK and has been updated.