Can Zoloft Cause Erectile Dysfunction?

Sexual dysfunction occurs in 25 percent of men on SSRI antidepressants

Depressed man
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Sexual dysfunction (which can include problems getting and maintaining an erection, decreased libido, delayed ejaculation, and lack of orgasm) is a common side effect of selective serotonin reuptake inhibitors or SSRIs, a class of antidepressant medications that includes Zoloft (sertraline).

In fact, sexual dysfunction is one of the main reasons that men who are being treated for depression stop taking their medications. According to medical studies, erectile dysfunction (ED) can occur in up to 25 percent of 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: Changing your depression medication may also change the sexual side effects. 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) is 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 possible harmful side effects.

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, most medications that are used to treat psychological disorders (such as anxiety and schizophrenia), and some medications that are used to treat an enlarged prostate and prostate cancer.

Here is a long list of drugs that can contribute to ED:

  • Clonidine
  • Methyldopa
  • Thiazide diuretics
  • Spironolactone
  • Beta blockers
  • Digoxin
  • Gemfibrizol
  • Lithium
  • Tricyclic antidepressants
  • Corticosteroid
  • GnRH agonists
  • Estrogens
  • Progesterone
  • Methotrexate
  • Cocaine
  • Marijuana
  • Ethanol
  • 5α-reductase inhibitors
  • Clonidine
  • 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 listed above so you can find the relief that you deserve. 

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Article Sources

  • 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.