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Is Zoloft (Sertraline) Causing Me Erectile Dysfunction Issues?

Zoloft (Sertraline) is a commonly prescribed antidepressant that has numerous side-effects. Happened to hear some stories about Zoloft causing Erectile Dysfunction (ED)? Whether your doctor has just prescribed Zoloft to you, or you’re experiencing ED after starting on Zoloft, this article will explain the relationship between Zoloft and ED and help you decide the next best course of action to take.

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What is Zoloft (Sertraline)?

Sertraline is a prescription medicine that is available as the brand-name drug Zoloft. It is an antidepressant medication belonging to a group of drugs called selective serotonin reuptake inhibitors (SSRIs), which are some of the most commonly prescribed and highly effective antidepressants available. 


Zoloft is used to treat depression, panic attacks, social anxiety disorder, post-traumatic stress disorder, obsessive-compulsive disorder, and premenstrual dysphoric disorder. The drug works by increasing the amount of serotonin (a natural substance in the brain), to help to restore mental health balance. 


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Does Zoloft cause Erectile Dysfunction?

If you’ve been prescribed Zoloft, it is important to know that sexual side effects can occur as a result of its consumption. The most common of these side effects include a decreased sex drive (libido), difficulty or inability to reach orgasm, and erectile dysfunction (ED). However, the exact prevalence rate of such sexual side effects are not known. Some studies reported up to 80% of SSRI-induced sexual side effects while past reports found that SSRI-associated sexual and erectile dysfunction occur at rates of 40% to 70%. Hence, issues such as ED are not a guaranteed occurrence after the consumption of Zoloft but some men do experience these side effects. 


There are numerous theories that account for how SSRIs result in these side effects, but in general, an increase in serotonin can dimininsh one’s sexual function. Some studies suggest that an increase in serotonin may affect hormones and neurotransmitters such as testosterone, which affects sexual arousal, and dopamine, which helps achieve orgasm. Another theory suggests that SSRIs may inhibit nitrous oxide, which is needed for the muscles in the penis to relax, allowing blood to flow into the penis to maintain an erection. 


However, the occurrence and severity of ED caused by Zoloft varies from person to person. For some, the side effects of Zoloft may also decrease over time as the body adjusts to the medication, but for others, the effects may continue to stay. 

What Is Erectile Dysfunction And How Does It Occur?

Erectile Dysfunction (ED) refers to the inability or difficulty to get or maintain an erection, even when sexually aroused. ED can happen when there is insufficient blood flow into the penis, when the penis cannot trap blood during an erection, or when nerve signals from the brain do not reach the penis. There are many possible causes of ED, including physiological, psychological reasons or a combination of both. 


Physiological causes include cardiovascular diseases, diabetes, obesity and aging. Blood flow to the penis is what makes for healthy, hard erections, and these conditions are directly affected by blood circulation in the body. Poor diet, physical health, certain medications, and alcohol consumption can also contribute to ED. 


Psychological causes of ED include depression, anxiety, and stress disorders. These can affect one’s overall mood, libido and sexual satisfaction. Emotional or relationship problems could also cause or worsen ED. 


ED is one of the top reasons why men who are prescribed Zoloft stop taking their medication. However, when evaluating ED, it is important to take into consideration its various possible causes. You should meet with your doctor to ensure a detailed evaluation is conducted. If you are taking Zoloft and experience sexual side effects, such an evaluation is necessary to ascertain that the symptoms you experience are indeed a result of Zoloft. 


In some cases, sexual difficulties may stem not from the consumption of Zoloft, but rather from the underlying depression. In fact, about 35% to 50% of people with untreated major depression experience some form of sexual dysfunction prior to any treatment. Hence, if your ED is caused by depression or anxiety, it may improve after Zoloft starts to take effect. If you’ve just started to take Zoloft, you should wait for a few weeks to see if your condition improves.


A thorough evaluation by your doctor regarding the cause of ED will include: 


  • Excluding ongoing or residual symptoms of depression, such as decreased sexual interest prior to treatment 
  • Excluding side effects from concurrent physical conditions, such as sexual dysfunction as a result of diabetes, cardiac disease, nerve disorders, hypertension, alcoholism and more

What Should I Do If I Experience Erectile Dysfunction After Taking Zoloft?

The best course of action to take would be to meet with your doctor. If you do experience ED after taking Zoloft, you should not stop taking the medication without your doctor’s approval. Sudden discontinuation may cause a relapse and result in increased morbidity, mortality, and chronicity attendant to major depression. You may experience one or more of the following withdrawal symptoms: irritability, nausea, dizziness, vomiting, nightmares, headaches, and/or paresthesias (prickling, tingling sensation on the skin).


Some possible solutions for Zoloft-induced ED that you can discuss with your doctor include:  


1. The “Wait And Observe” Approach 

Pharmacological agents like Zoloft do have an adaptation period for their unwanted effects. A study by the Spanish Working Group reported that 10% of people who took antidepressant agents experienced reversible side effects. For some men, their ED ceased after 2 to 8 weeks of starting on a new antidepressant.


2. Lowering The Dosage

In some cases, SSRI-induced sexual dysfunction may be related to the level of dosage  of the medication. In such circumstances, your doctor may lower your dosage to the minimal effective dose, which could reduce the drug’s effects on your sexual function. 


3. Introducing Drug Holidays Or Partial Drug Holidays

The antidepressant can be discontinued (holiday) or the dose decreased (partial drug holiday) for a brief period, with sexual activity scheduled at the end of the period. In a study with 30 outpatients, this approach was found to be successful with Zoloft, but less so with another antidepressant. However, this approach carries the risk of withdrawal symptoms or worsening anxiety, so be sure to discuss this option with your doctor beforehand. 

  1. Switching To A Different SSRI

In some instances, changing to a different SSRI antidepressant may help. The effects of SSRIs, even the occurrence of sexual side effects, can differ amongst the same group of medications. Some alternatives include Lexapro (escitalopram), Paxil (paroxetine), and Prozac (fluoxetine). 


  1. Switching To A Non-SSRI

Although SSRIs are commonly prescribed antidepressants, they are known to cause sexual side effects such as ED. Antidepressants such as Wellbutrin (bupropion) and Remeron (mirtazapine) can be useful alternatives. 


  1. Taking A Specific Taking A Specific Medication To Treat Your ED

For ED that is caused by an SSRI, taking medication such as generic Viagra (Sildenafil) or Cialis (Tadalafil) may help counter the issue. In a 6-week study trial, sildenafil was found to significantly improve ED in men with SSRI-associated ED, and administration of both medications together was successful without interrupting the antidepressant therapy. 


Oral medications such as Cialis and generic Viagra are often the first line of treatment for erectile dysfunction and have little side effects. They reverse ED by enhancing the effects of nitric oxide, promoting blood flow into the penis. For instance, generic Viagra (sildenafil) belongs to a class of drugs called phosphodiesterase type 5 (PDE5) inhibitors, and works by increasing blood flow to the penis in combination with sexual stimulation or arousal. It usually takes 30 to 60 minutes for generic Viagra to work for ED. The most common side effects include headaches, dizziness, and nausea, but many men also experience mild or no side effects. 


  1. Making Lifestyle Changes

Overall, a healthy lifestyle can also help manage your ED. This includes weight reduction, consistent exercise, smoking cessation, and treatment for substance use problems. Creating a healthy lifestyle for yourself can help improve your sense of wellbeing, overall health, and the health of physiological problems related to the sexual response cycle.


It is clear that you have a few options if you think your Zoloft prescription is causing ED. However, it is important to continue to take your medication until you speak with your doctor to discuss these options as well as your next steps. 


If you are unsure about the cause of your erectile dysfunction or would like to take medication for your ED, it is advisable that you consult a doctor. Here at Noah, doctors on our platform are best equipped with the knowledge to help you ascertain the root cause of your erectile dysfunction and can determine whether generic Viagra is right for you. They will be able to advise you on the best treatment suited for you, and can also prescribe you the right medication should you need it. 


References

Atmaca, M., 2020. Selective Serotonin Reuptake Inhibitor-Induced Sexual Dysfunction: Curent Management Perspectives. Neuropsychiatric Disease and Treatment, 16, pp.1043-1050. (Link)


Balon, R., 2006. SSRI-Associated Sexual Dysfunction. The American Journal of Psychiatry, 163(9), pp.1505-1509. (Link)


Corliss, J., 2019. When an SSRI medication impacts your sex life. Harvard Health Publishing. Retrieved December 22, 2021. (Link


Fava, M., et al., 2006. Efficacy and Safety of Sildenafil in Men With Serotonergic Antidepressant-Associated Erectile Dysfunction: Results From a Randomized, Double-Blind, Placebo-Controlled Trial. The Journal of Clinical Psychiatry. 67(2), pp.240-246. (Link)


Jing, E., & Straw-Wilson, K., 2016. Sexual dysfunction in selective serotonin reuptake inhibitors (SSRIs) and potential solutions: A narrative literature review. The mental health clinician, 6(4), pp.191–196. (Link)

Michael Bihari, M. D., 2020. Is your antidepressant making your sex life miserable? Verywell Mind. Retrieved December 22, 2021. (Link)

Montejo A.L., et al., 2001. Incidence of Sexual Dysfunction Associated with Antidepressant Agents: A Prospective Multicenter Study of 1022 Outpatients. Journal of Clinical Psychiatry, 62(3), pp.10-21. (Link

Murdock, J., & Aungst, C., 2021. Which antidepressants are least likely to cause erectile dysfunction? GoodRx. Retrieved December 22, 2021. (Link

National Alliance on Mental Illness., 2020. Sertraline (Zoloft). NAMI. Retrieved December 22, 2021. (Link)

Nurnberg, H.G., Duttagupta, S., 2004. Economic Analysis of Sildenafil Citrate (Viagra®) Add-on to Treat Erectile Dysfunction Associated With Selective Serotonin Reuptake Inhibitor Use. American Journal of Therapeutics, 11(1) , pp.9-12. (Link)

Rothschild, A. J., 1995. Selective serotonin reuptake inhibitor-induced sexual dysfunction: Efficacy of a drug holiday. The American Journal of Psychiatry, 152(10), 1514–1516. (Link)


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Published On
January 10, 2022

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