When your sex life suddenly feels different, it’s easy to take it personally. Maybe you don’t want sex as often as you used to. You want to be intimate, but your body isn’t responding the same way. You may have trouble getting or keeping an erection, vaginal dryness, difficulty becoming aroused, or trouble reaching orgasm.
Partners can notice these changes too. Without an explanation, one person may start wondering, Are they still attracted to me? Is something wrong with our relationship? Am I doing something wrong? But sometimes the answer has little to do with attraction or love. Your medication—or the health condition you’re taking it for—could be playing a role.
Sexual changes are possible side effects of several common medications. Health conditions such as diabetes, heart disease, high blood pressure, hormone changes, depression, and kidney disease can also affect sexual function. For Black adults, feeling comfortable enough to bring up sexual health with a medical professional can sometimes be another hurdle. Research has found racial differences in sexual-health conversations between patients and healthcare providers, while other studies point to trust and comfort as important parts of these discussions.
Still, you deserve answers. And you don’t have to choose between treating your health condition and having a satisfying sex life.
A change in sex drive is only one possibility. Medication-related sexual problems may include:
Mayo Clinic notes that medication-related sexual side effects can affect desire, lubrication, erections, orgasm, comfort, and satisfaction. The changes may be mild for one person and more noticeable for another. They can also change over time. That’s why it’s helpful to pay attention to what’s different for you instead of comparing your sex life with someone else’s.
Several types of medications have been linked with sexual changes.
Antidepressants are one of the better-known examples. Selective serotonin reuptake inhibitors, or SSRIs, are commonly used to treat anxiety and mood disorders but can cause lower sexual desire, difficulty reaching orgasm, and problems getting or keeping an erection. Common SSRIs include medications such as sertraline, fluoxetine, escitalopram, paroxetine, and citalopram.
This doesn’t mean everyone taking an antidepressant will have sexual side effects. It also doesn’t mean antidepressants are “bad.” These medications can be an important part of treating depression, anxiety, and other conditions. If you’re experiencing sexual side effects, tell the healthcare professional managing your medication.
High blood pressure itself can affect sexual function, and certain medications used to treat it may also cause problems. Mayo Clinic notes that some diuretics, also called water pills, and most beta blockers have been linked with sexual problems. For men, reduced blood flow can make getting an erection more difficult. Some blood pressure medicines may also lower sex drive.
Importantly, not all blood pressure drugs carry the same risk, according to guidelines published in the Journal of the American College of Cardiology: ARBs (such as losartan or valsartan) and the beta blocker nebivolol have a more favorable (sometimes even beneficial) profile for sexual function. That makes switching within or between classes a realistic option to discuss with your clinician, rather than stopping treatment because of sexual problems.
Uncontrolled high blood pressure can be dangerous, and high blood pressure itself may contribute to sexual difficulties. Talk with your healthcare provider about your options instead.
Other medications may also affect sexual function. The National Institute of Diabetes and Digestive and Kidney Diseases lists certain antihistamines, pain medicines, sedatives, hormone treatments, chemotherapy drugs, ulcer medicines, and other medications among possible contributors to erectile dysfunction. That doesn’t mean medication automatically causes your symptoms. It means it’s worth discussing.
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This is where things can get complicated. The medication you’re blaming may not actually be the entire problem. For example, depression itself can reduce sexual desire and affect erections, lubrication, and orgasm. Some antidepressants can cause similar problems. High blood pressure can affect sexual function, and so can some medications used to treat high blood pressure.
That’s why it’s important to talk with a healthcare professional rather than assuming you already know the cause. Sometimes the solution is to treat an underlying health problem—not change a medication.
Before your next appointment, think about the timeline. Ask yourself: When did I first notice this? Then think about what changed around that time. Did you start a new medication? Did your dose increase? Did you add another prescription or over-the-counter medicine? Did you begin experiencing symptoms of another health problem? Write it down. For example:
“I started this medication in March. About three weeks later, I noticed it was taking much longer to reach orgasm.”
Or:
“My dose increased two months ago, and since then I’ve had more trouble maintaining an erection.”
This is much more useful to your provider than simply saying, “Something feels off.” Keep track of any other changes too, such as fatigue, pain, sleep problems, hot flashes, mood changes, stress, vaginal dryness, or changes in erections. The medication may be involved, but it may not be the only factor.
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If you suspect your medication is affecting your sex life, your first thought might be, I’ll just stop taking it and see what happens. Don’t make that change without medical guidance. Depending on the medication, suddenly stopping treatment can cause withdrawal symptoms, allow the condition being treated to return, or create other health risks.
For example, Mayo Clinic notes that stopping antidepressant treatment because of sexual side effects can lead to depression returning. Instead, patients should work with their healthcare professional to find a treatment plan that manages both the condition and unwanted side effects. Your provider may have several options.
They might recommend waiting to see whether the side effect improves, changing the dose, adjusting when you take the medicine, switching medications, treating the sexual problem directly, or checking for another health condition. The right choice depends on the medication and your overall health.
You don’t need medical language to talk about sex. Start with exactly what you’ve noticed: “Since starting this medication, my sex drive has changed. Could the medication be causing it?”
From there, ask:
With antidepressants, for example, a healthcare provider may sometimes adjust the dose, change medications, or consider other treatment strategies depending on the person’s situation. Don’t change the dose or timing yourself. Ask first.
Talking about erections, orgasms, lubrication, or sexual desire can feel awkward—even with a doctor. But sexual health is health. You aren’t wasting your provider’s time by bringing it up.
Sexual-health communication isn’t always equal. One U.S. study found differences between Black and white women in discussions about sexual health with healthcare providers. Other research involving Black men has identified comfort, health knowledge, and trust as factors that can affect whether sexual-health conversations happen.
You deserve a healthcare professional who can talk about sexual health without making you feel ashamed, rushed, stereotyped, or dismissed. If you’re uncomfortable starting the conversation, try: “I have a side effect that’s affecting my sex life, and I’d like to talk about my options.” That’s enough to get started.
Sexual changes can easily create misunderstandings between partners. Someone experiencing lower desire may pull away because they’re embarrassed. Their partner may read that distance as rejection. A simple explanation can help. You might say: “I’ve noticed some changes since starting my medication. I’m going to talk with my doctor because this may be a side effect. This isn’t about how I feel about you.”
You don’t have to share every detail of your medical history. You decide how much information you’re comfortable sharing. A partner can support you without taking over the conversation or making decisions about your medical care.
When sexual performance changes, online supplements and products promising quick results can be tempting. Be careful. Some supplements may interact with prescription medications or be unsafe for certain health conditions. Mayo Clinic recommends discussing treatments for sexual side effects with a healthcare professional rather than relying on unregulated herbal products marketed for sexual function.
This is especially important if you have heart disease or take blood pressure medication. For example, certain prescription medicines for erectile dysfunction can interact dangerously with nitrates used for chest pain and cause a severe drop in blood pressure. “Natural” doesn’t automatically mean safe.
Changes in your sex life don’t automatically mean your relationship is failing, you’re getting old, or your partner is no longer attractive to you. Sometimes your body is responding to medication. Sometimes it’s responding to a health condition. Sometimes stress, depression, anxiety, menopause, relationship concerns, or several factors are working together.
Start by noticing what changed and when. Bring a complete medication list—including over-the-counter medicines and supplements—to your appointment. Ask whether the dose, timing, medication itself, or another health condition could be involved. Most importantly, don’t stop treatment on your own.
A sexual side effect deserves attention, but so does the health condition the medication is treating. The goal is to work with your healthcare provider to find the safest balance. And if your provider makes you feel embarrassed for asking? You are allowed to look for someone who will have the conversation respectfully. Your sexual health isn’t an embarrassing side topic.
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