Antidepressant use is associated with persistent loss of genital sensitivity

Antidepressant use is associated with sexual side effects, including reduced genital sensitivity that persists after the drug is stopped, according to a new Simon Fraser University study.

The study, published in Social Psychiatry and Psychiatric Epidemiologyshows that 13 percent of people who used antidepressants reported a decrease in genital sensitivity, compared with 1 percent of users of other psychiatric drugs.

It’s been off the radar for so long, mostly due to stigma, shame and embarrassment. For some, it resolves with time, but for many people, it doesn’t go away. I have spoken to someone who developed this syndrome at 33. He is 66 years old now and nothing has changed.”

Yassie Pirani, SFU graduate student and lead author of the study

Post-SSRI sexual dysfunction (PSSD) is an under-researched and under-reported syndrome of persistent sexual dysfunction caused by the use of SSRI and SNRI antidepressants, where sexual function does not return to normal after the patient stops using the drug.

“I’ve spoken to teenagers who have this and it’s devastating. There’s no way to put into words how painful this experience is for people. It’s not just about the numb genitalia – it’s about what it means to be in relationships, to be rendered impotent without your consent is serious harm.”

Pirani says disease is a spectrum. For some, it’s mild, their genitals feel less sensation, perhaps 80 percent of what it used to be. While in more severe cases, it is complete numbness.

The study was integrated into a larger survey (~9,600 predominantly LGBTQ youth in Canada and the US) that focused on mental health, conversion therapy, and other factors that shape gender and sexuality experiences during adolescence and early adulthood.

“This study reminds us that pharmacological interventions play a role in shaping youth’s sexual experiences, and improved understanding and education are urgently needed,” says Travis Salway, SFU associate professor in the School of Health Sciences and principal investigator of the study.

As part of the community survey, participants were asked if they had ever taken antidepressant medication and stopped and then experienced certain symptoms consistent with PSSD. Research on PSSD is complicated by the fact that many PSSD symptoms, such as low libido, can also be attributed to depression. However, genital numbness, known as genital hypoxia, is a major symptom of PSSD that is not associated with depression.

“There is no medical explanation for why people should feel numbness in their genitals due to depression or anxiety (or other common conditions for which SSRIs/SNRIs are prescribed),” explains Salway. “The incidence of genital hypothyroidism in those who had previously used antidepressants was more than 10 times greater than the incidence seen in those who had used another psychiatric medication (such as antipsychotics or tranquilizers).”

Part of the problem, as Pirani sees it, is an informed consent-accountability gap. While antidepressants are commonly prescribed to help people struggling with anxiety, obsessive-compulsive disorder, post-traumatic stress disorder, panic disorder, phobias, chronic pain, depression and other conditions, people are not warned about the dangers.

The findings highlight the need for stronger educational practices and warnings for patients and prescribers so that patients can decide for themselves whether the risk is worth it.