Dr. Goldstein explains how anti-depressants can have an effect on a woman's sexual function.
So antidepressants are widely used. Depression sadly is a common problem, and antidepressants raise a chemical in the brain called serotonin which really helps women’s depression. The problem is serotonin is the ultimate inhibitor of sexual function. It stops interest. Arousal is affected adversely. Certainly orgasm is made much more difficult.
So it’s a problem to use SSRIs in women who are sexually interested and sexually active. It’s probably the most common reason people get off SSRIs when they need them for depression. There is a caveat to depression in women. We recognize that there can be chemical imbalances causing depression. What we don’t, for whatever reason, there’s no sort of reflex reaction. “I have depression. Let me check that I don’t have medical problems causing the depression.”
Low thyroid or even high thyroid, thyroid disorders can be a medical reason for depression. Low testosterone can be a very important medical reason. It’s so easy to correct low testosterone, so you don’t have to go on the depression medication.
We have so many women who are on the birth control pill, whose testosterone values are low. A part of the side effects of low testosterone is to have depression. Then they go to the doctor’s office. They maintain their birth control pill; then they add an SSRI to the problem. Both agents are counterproductive in sexual functions, and there are millions of people in this ship taking both agents.
Had the depression been identified as being low testosterone, the birth control pill could have been switched to a non-hormonal contraceptive. The depression would have gone away, and the sexual function would be improved and still there would be contraception covered.
About Dr. Goldstein, M.D.:
Dr. Irwin Goldstein is Director of San Diego Sexual Medicine at Alvarado Hospital, the Secretary of the International Society for the Study of Women’s Sexual Health, a former President of the Sexual Medicine Society of North America and a Clinical Professor of Surgery at University of California at San Diego.
Dr. Goldstein has been involved with sexual dysfunction research since the late 1970s. His specialties include penile microvascular bypass surgery, surgery for dyspareunia, physiologic investigation of sexual function in men and women, and diagnosis and treatment of sexual dysfunction in men and women.