Can Zoloft Cause Erectile Dysfunction?

Sexual dysfunction occurs in 25 percent of men on SSRI antidepressants

By
Michael Bihari, MD

Michael Bihari, MD, is a board-certified pediatrician, health educator, and medical writer, and president emeritus of the Community Health Center of Cape Cod.

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Michael Bihari, MD
Medically reviewed by
Medically reviewed by Steven Gans, MD on April 06, 2020

Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.

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Steven Gans, MD
Updated on September 17, 2020
Depressed man
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Sexual side effects are estimated to occur in over 50% of men on SSRI therapy. In fact, sexual dysfunction is one of the main reasons that men who are being treated for depression stop taking their medications. Although delayed orgasm is most common, erectile dysfunction According to medical studies, erectile dysfunction (ED) can occur in men who are taking an SSRI.

If you are having problems, meet with your doctor to discuss whether it would be safe to:

  • Lower the dose of your Zoloft: A lower dose may continue to help your depression, but relieve your ED.
  • Switch to a different SSRI: Sometimes, changing to a different SSRI antidepressant can help. You may have to go through several months of trial and error. Some options include Lexapro (escitalopram), Paxil (paroxetine), and Prozac (fluoxetine).
  • Switch to a non-SSRI: Although most of the medications that are used to treat depression can cause sexual dysfunction, Wellbutrin (bupropion) and Remeron (mirtazapine) are less likely to cause ED.
  • Take a specific medication to treat your ED: In some men with ED that is caused by an SSRI, taking a medication such as Cialis (tadalafil), Levitra (vardenafil), or Viagra (sildenafil) may help. 

A word of caution: Do not abruptly stop taking your Zoloft; this can cause uncomfortable withdrawal symptoms and a potential return of your symptoms.

Other Drugs That Can Cause Erectile Dysfunction

Erectile dysfunction can be caused by other drugs besides antidepressants, including some medications that are used to treat high blood pressure, many medications that are used to treat psychiatric disorders, and some medications that are used to treat an enlarged prostate and prostate cancer.

There is a long list of drugs that can contribute to ED. Some examples of medications reported to cause sexual side effects include:

  • Clonidine
  • Methyldopa
  • Thiazide diuretics
  • Spironolactone
  • Beta blockers
  • Digoxin
  • Gemfibrizol
  • Lithium
  • Tricyclic antidepressants
  • Corticosteroid
  • GnRH agonists
  • Estrogens
  • Progesterone
  • Methotrexate
  • Cocaine
  • Marijuana
  • Ethanol
  • 5α-reductase inhibitors
  • Calcium-channel blockers

If you are taking any medication, talk to your pharmacist or physician to see if erectile dysfunction is a known side effect.

Medical Conditions That May Cause ED

ED is also commonly observed in people with the following conditions:

  • Diabetes
  • Benign prostatic hyperplasia
  • Rheumatoid arthritis
  • Obesity
  • Depression
  • Anxiety
  • Excessive Stress
  • Severe cardiovascular disease
  • An injury to the spinal cord

ED is also associated with smoking, as well as with men who have undergone radiation treatment or surgery for the treatment of prostate cancer.

What to Know Before Talking With Your Doctor

ED is a complicated problem and multiple factors may be triggering it. For example, if you have high blood pressure and diabetes and take various medications that contribute to ED, all of those things could be causing ED. 

The bottom line: There's nothing normal about ED. In other words, people don't automatically develop ED as they age. So don't think that it's something that you have to live with it. It's a common health problem and you don't need to feel embarrassed by it. Let your primary care physician or a specialist (like a cardiologist or psychiatrist) know that this is something that's bothering you, and then you can discuss all the possible remedies so you can find the relief that you deserve. 

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Article Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Clayton AH, Croft HA, Handiwala L. Antidepressants and sexual dysfunction: mechanisms and clinical implications. Postgrad Med. 2014;126(2):91-9. doi:10.3810/pgm.2014.03.2744

  2. Higgins, A, Nash, M, Lynch, AM. Antidepresant-associated sexual dysfunction: Impact, effects, and treatment. Drug Healthc Patient Saf. 2010;2:141.150. doi:10.2147/DHPS.S7634

  3. Zainol, M, Sidi, H, Kuma, J, Das, S, Ismail, SB, Hatta, MH, Baharuddin, N, Ravindran, A. Co-morbid erectile dysfunction (ED) and antidepressant treatment in a patient - A management challenge? Curr Drug Targets. 2019;20(2). 182-191. doi:10.2174/1389450118666170315110902

  4. Nurnberg HG, Duttagupta S. Economic analysis of sildenafil citrate (Viagra) add-on to treat erectile dysfunction associated with selective serotonin reuptake inhibitor use. Am J Ther. 2004;11(1):9-12. doi:10.1097/00045391-200401000-00005

  5. Biebel MG, Burnett AL, Sadeghi-nejad H. Male Sexual Function and Smoking. Sex Med Rev. 2016;4(4):366-375. doi:10.1016/j.sxmr.2016.05.001

  6. Gaither TW, Awad MA, Osterberg EC, et al. The Natural History of Erectile Dysfunction After Prostatic Radiotherapy: A Systematic Review and Meta-Analysis. J Sex Med. 2017;14(9):1071-1078. doi:10.1016/j.jsxm.2017.07.010

Additional Reading

  • Kloner, R. ”Erectile Dysfunction and Hypertension.”International Journal of Impotence Research. 2007 19:296-302.

  • McVary KT. Sexual Dysfunction. In: Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. eds. Harrison's Principles of Internal Medicine, 19e. New York, NY: McGraw-Hill; 2015.
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