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Sertraline Sex Drive
Does Zoloft (Sertraline) Cause Erectile Dysfunction?
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Sertraline, sold under the brand name Zoloft®, is a selective serotonin reuptake inhibitor (SSRI) that’s commonly prescribed to treat depression . It’s also used as a treatment for certain forms of anxiety, obsessive–compulsive disorder (OCD) and several other conditions.
If you’ve been prescribed a SSRI such as Zoloft, there’s a possibility that you could experience sexual side effects after you start using your medication. In fact, research shows that between 25 percent and 73 percent of people prescribed SSRIs experience sexual side effects.
Dealing with erectile dysfunction and other sexual side effects from Zoloft can be a frustrating process. Luckily, almost all sexual side effects caused by Zoloft and other SSRIs are treatable, with a variety of options available for reducing and managing your symptoms.
Below, we’ve explained how medications such as Zoloft can cause sexual side effects like ED, as well as what you can do to manage SSRI-related erectile dysfunction and other sexual side effects.
Sertraline, the active ingredient in Zoloft, is one of the most common SSRIs in the US, with tens of millions of prescriptions written every year across the country.
While some men may experience ED and other sexual side effects after using Zoloft, these issues aren’t guaranteed to occur. Many people use Zoloft and other SSRIs for long periods of time without experiencing sexual side effects.
Zoloft is less likely to cause sexual side effects than many other SSRIs. Research has found that sertraline, the active ingredient in Zoloft, has a lower risk of causing sexual dysfunction than SSRIs such as paroxetine (sold as Paxil®).
If you develop sexual side effects after using Zoloft, you may be able to stop them by switching to a different type of antidepressant or by adjusting your dosage. However you should not stop or change medications without talking with your healthcare provider first.
ED isn’t the only sexual side effect associated with Zoloft and other SSRIs. Other side effects include a reduced libido, difficulty reaching orgasm and ejaculating and difficulty becoming sexually aroused.
Sexual side effects, including ED, aren’t always drug-related. According to the folks at Harvard Medical School, 30 percent to 50 percent of people with major depression experience sexual issues prior to treatment, meaning there could be a non-pharmaceutical cause to some sexual side effects.
Researchers aren’t aware of exactly why Zoloft and other SSRIs can cause erectile dysfunction and other sexual side effects. Currently, theories point towards the effects of SSRIs on serotonin — an important neurotransmitter — as potentially affecting sexual desire and performance.
Serotonin is an essential neurotransmitter — a type of chemical messenger that the body uses to communicate between nerve cells. Zoloft and other SSRIs work by increasing serotonin levels — an important action for treating depression and related conditions.
Experts believe that by increasing the availability of serotonin, Zoloft and other SSRIs can affect other hormones, including the hormones dopamine and testosterone.
Dopamine and testosterone both play key roles in sexual desire and performance. Testosterone is closely associated with sexual arousal, while dopamine plays an important role in orgasm and ejaculation.
Put simply, SSRIs may cause erectile dysfunction and other sexual side effects by affecting the specific hormones and neurotransmitters that make you feel aroused and allow you to perform sexually.
Interestingly, sertraline’s effects on orgasm and ejaculation are well known — so much so that it is often prescribed off-label as a medication for treating premature ejaculation .
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If you notice sexual side effects after you start taking Zoloft, it’s important that you don’t reduce your dosage or stop taking your medication without first talking to your healthcare provider.
Stopping Zoloft suddenly or reducing your dosage without warning could cause you to develop antidepressant withdrawal symptoms. These can develop within a few days and can range from physical issues like dizziness and flu-like symptoms to anxiety.
It’s also possible for you to experience a relapse of depression if you suddenly stop taking your antidepressants.
Before making any changes, talk to your healthcare provider. To treat erectile dysfunction and other sexual side effects, they may recommend that you:
Adjust your dosage of Zoloft. Sertraline, the active ingredient in Zoloft, is prescribed at a range of different dosages. If you experience ED or other sexual side effects after you start using Zoloft, your healthcare provider may recommend lowering your dosage. Switching to a lower dosage of Zoloft may help get rid of or reduce the severity of your sexual side effects while still treating your depression.
Use a different SSRI. Although most SSRIs are prescribed for the same purpose, there are differences between each medication that could make one a more suitable choice for you than others. It’s far from uncommon to try several antidepressants before settling on the medication that suits you best. Your healthcare provider may recommend switching to a different SSRI, such as fluoxetine (sold as Prozac®) or escitalopram (sold as Lexapro®).
Use a different type of antidepressant. Certain antidepressants, such as bupropion (sold as Wellbutrin®), are less likely to cause sexual side effects than others, and are often prescribed to people who experience sexual side effects from SSRIs. If you develop ED or other sexual side effects after starting Zoloft, switching to a different antidepressant may help. Bupropion (Wellbutrin) and mirtazapine (Remeron®) are often recommended as safer choices for men prone to ED from SSRIs.
Take a “drug holiday” to relieve side effects. If your healthcare provider thinks it’s a safe option, they may suggest that you take a drug holiday — a day or two in which you stop taking your medication — to avoid ED and other sexual side effects. This may help to reduce the severity of ED and other sexual side effects by giving the medication to exit your body before sex.
Use medication to treat ED. Erectile dysfunction medications like sildenafil (sold as Viagra ® or generic Viagra ), tadalafil ( Cialis ®), vardenafil (Levitra®) and avanafil ( Stendra ®) are highly effective and may be helpful for treating antidepressant-related ED. Research shows that sildenafil, the active ingredient in Viagra, works well as a treatment for antidepressant-associated erectile dysfunction. We’ve explained how these medications work in more detail in our complete guide to erectile dysfunction medications .
Consider other factors that may contribute to ED. Even if you currently take Zoloft, it’s possible that another factor, such as a physical health condition, stress or excessive use of pornopgraphy, could contribute to erectile dysfunction and other sexual issues. Our guide to the causes of ED goes into more detail about the numerous factors that may contribute to erectile dysfunction, as well as what you can do to treat it.
Just like other SSRIs, Zoloft ( sertraline ) can and often does cause sexual side effects, including erectile dysfunction. Research shows that between 25 percent and 73 percent of people who use SSRIs experience sexual side effects, making these issues fairly common.
If you’re prescribed Zoloft or another SSRI and find it difficult to get and maintain an erection or reach orgasm, it’s best to talk to your healthcare provider about treatment options.
Depending on the severity of your depression, your specific side effects and other factors, they may recommend adjusting your dosage, changing to a different type of antidepressant, using a medication such as Viagra or taking other steps to improve your sexual performance.
Whatever you do, it’s important that you don’t suddenly stop taking Zoloft. Doing this may cause your depression to worsen and increase your risk of experiencing withdrawal symptoms.
Sertraline, the active ingredient in Zoloft, is a common SSRI that’s used to treat depression and several other conditions. Our Sertraline 101 guide goes into greater detail about how sertraline works, its uses, side effects and more.
This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here .
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Sertraline for Premature Ejaculation: Does it Work?
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McMahon, C.G. (2007, April-June). Premature ejaculation. Indian Journal of Urology. 23 (2), 97–108. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2721550/ Chu, A. & Wadhwa, R. (2021, May 10). Selective Serotonin Reuptake Inhibitors. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK554406/ Number of sertraline hydrochloride prescriptions in the U.S. from 2004 to 2018. (2021). Retrieved from https://www.statista.com/statistics/781658/sertraline-hydrochloride-prescriptions-number-in-the-us/ Crowdis, M. & Nazir, S. (2021, July 1). Premature Ejaculation. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK546701/ Seidman, S. (2006). Ejaculatory dysfunction and depression: pharmacological and psychobiological interactions. International Journal of Impotence Research. 18, S33-S38. Retrieved from https://www.nature.com/articles/3901509 McMahon, C.G. (1998, September). Treatment of premature ejaculation with sertraline hydrochloride. International Journal of Impotence Research. 10 (3), 181-4, discussion 185. Retrieved from https://pubmed.ncbi.nlm.nih.gov/9788108/ Kim, S.W. & Paick, J.S. (1999, September). Short-term analysis of the effects of as needed use of sertraline at 5 PM for the treatment of premature ejaculation. Urology. 54 (3), 544-7. Retrieved from https://pubmed.ncbi.nlm.nih.gov/10475369/ Sertraline. (2020, April 15). Retrieved from https://medlineplus.gov/druginfo/meds/a697048.html Jing, E. & Straw-Wilson, K. (2016, July). Sexual dysfunction in selective serotonin reuptake inhibitors (SSRIs) and potential solutions: A narrative literature review. The Mental Health Clinician. 6 (4), 191–196. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6007725/ Henry, R. & Morales, A. (2003, August). Topical lidocaine-prilocaine spray for the treatment of premature ejaculation: a proof of concept study. International Journal of Impotence Research. 15 (4), 277-81. Retrieved from https://pubmed.ncbi.nlm.nih.gov/12934056/ Wang, W.-F., Wang, Y., Minhas, S. & Ralph, D.J. (2007, April). Can sildenafil treat primary premature ejaculation? A prospective clinical study. International Journal of Urology. 14 (4), 331-5. Retrieved from https://pubmed.ncbi.nlm.nih.gov/17470165/ InformedHealth.org. (2019, September 12). Premature ejaculation: What can I do on my own? Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK547551/ Mohee, A. & Eardley, I. (2011, October). Medical therapy for premature ejaculation. Therapeutic Advances in Urology. 3 (5), 211–222. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3199591/ Pastore, A.L., et al. (2014, June). Pelvic floor muscle rehabilitation for patients with lifelong premature ejaculation: a novel therapeutic approach. Therapeutic Advances in Urology. 6 (3), 83–88. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4003840/ Dorey, G., et al. (2005, September). Pelvic floor exercises for erectile dysfunction. BJU International. 96 (4), 595-597. Retrieved from https://bjui-journals.onlinelibrary.wiley.com/doi/abs/10.1111/j.1464-410X.2005.05690.x Althof, S.E. (2016, August). Psychosexual therapy for premature ejaculation. Translational Andrology and Urology. 5 (4), 475–481. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5001981/
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© 2022 Hims & Hers Health, Inc. All rights reserved. HIMS, HERS, H, and HIMS & HERS are trademarks of Hims, Inc.
Medically reviewed by Kristin Hall, FNP
Premature ejaculation (PE) is one of the most common forms of sexual dysfunction in men, with research suggesting that up to 39 percent of men are affected. If you’re dealing with premature ejaculation, you’re most certainly not alone.
Sertraline is an antidepressant. As you’d expect, it’s usually prescribed to treat depression and other psychiatric disorders. But did you know that it’s also used off-label to treat sexual function and performance issues like premature ejaculation?
Sertraline for premature ejaculation isn’t generally something most people think about, but the supporting evidence is there, and you should be aware of it.
If you’re one of the tens of millions of men in the United States affected by PE, using sertraline may help you to improve your sexual function and get greater control over your ability to reach orgasm and ejaculate.
Below, we’ve explained what premature ejaculation is, as well as what you might experience if you’re affected by PE. We’ve also explained what sertraline is, how it works as a PE treatment and how you can use it for better sexual performance and enjoyment.
Finally, we’ve shared a few other treatments for PE that you might want to consider, either with sertraline or on their own.
Premature ejaculation, or rapid ejaculation, is a common sexual disorder in men. Although it’s normal to reach orgasm a little earlier than you’d like to sometimes, men affected by PE find it difficult to have sex for a normal amount of time without ejaculating.
For the most part, PE is defined as an intravaginal ejaculatory latency time (IELT) of one minute or less, although some definitions view ejaculation within 60 to 90 seconds as “probable” PE.
In comparison, research suggests that the median intravaginal ejaculatory latency time is about five minutes.
In addition to short ejaculation time, premature ejaculation involves ejaculation before a person or their partner would like it to happen, with symptoms that persist for six months or longer and cause significant distress.
Premature ejaculation ranges from mild to severe. Mild PE is ejaculation that happens 30 to 60 seconds after penetration, while moderate PE occurs within 15 to 30 seconds of penetration. In cases of severe PE, ejaculation might occur almost immediately, or even before penetration.
Like other forms of sexual dysfunction, PE can be a lifelong problem that affects someone from their first sexual experience, or a situational issue that only occurs with certain partners or types of sexual stimulation.
Although the exact cause of premature ejaculation isn’t yet known, experts believe that a variety of factors may play a role. These include:
Mental disorders, such as depression or anxiety
Feelings of guilt or stress about sexual activity
Lack of confidence or poor body image
Unrealistic sexual expectations or sexual performance anxiety
A history of sexual repression or sexual abuse
Our guide to premature ejaculation goes into more detail about what PE is, how it might develop and the symptoms you may notice if you’re affected.
Sertraline is an antidepressant. You might have heard of it before as Zoloft®, the original brand name used by Pfizer to market this medication.
Sertraline belongs to a class of antidepressants called selective serotonin reuptake inhibitors , or SSRIs. It’s one of the most widely used antidepressants in the world, with millions of users in the United States and many more in other countries.
As an antidepressant, sertraline works by increasing levels of the neurotransmitter serotonin in the brain and body. Serotonin is involved in controlling certain aspects of your personality and mood, with research suggesting that it plays a role in the development of depression.
By boosting serotonin levels, SSRIs like sertraline can help to treat the symptoms of depression and other mood disorders.
Although it was originally developed as an antidepressant, sertraline is used to treat a variety of medical conditions. Today, it’s a common medication for treating obsessive-compulsive disorder (OCD) social anxiety disorder (SAD), posttraumatic stress disorder (PTSD) and panic disorder.
Sertraline is also prescribed off-label as a treatment for premature ejaculation. In fact, it’s one of the most widely used premature ejaculation pills on the market today.
Despite being best known for its antidepressant effects, sertraline works surprisingly effectively as a treatment for premature ejaculation.
In fact, over the years, numerous studies of sertraline have shown that it can extend intravaginal ejaculation latency time (IELT, or the average time during sexual intercourse that passes prior to a man reaching orgasm and ejaculating).
Some of these studies show significant increases in IELT in men with premature ejaculation who use sertraline.
For example, in one 1998 study published in the International Journal of Impotence Research, a group of men aged between 22 and 63 with premature ejaculation were treated with sertraline to assess its effects on sexual performance.
The men were given oral sertraline tablets and started the study at a dose of 25mg per day. By week three, the dosage was increased to 50mg of sertraline per day. At week six, it was further increased to 100mg of sertraline per day.
None of the men received any formal psychosexual therapy -- the only form of treatment was a daily dose of sertraline.
At the start of the study, the men had a mean ejaculatory interval of one minute, with a range of zero to five minutes.
With a 25mg daily dose of sertraline, the average ejaculatory interval of the men increased from one minute to 7.6 minutes, with a range of zero to 20 minutes. With a 50mg dose, the average ejaculatory interval increased to 13.1 minutes.
At a daily dose of 100mg of sertraline, the men’s average ejaculatory time was 16.4 minutes. In addition to the significant increase in average ejaculation time, the minimum ejaculation interval also increased, with a total range of seven minutes to anejaculation (inability to ejaculate).
During the study, side effects were limited. At the full dose of 100mg per day, the most common side effects were dyspepsia (indigestion), feelings of anxiety, transient drowsiness and anorexia, as well as erectile dysfunction and reduced libido.
These issues were re
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