Many medications can dramatically affect our relationships, our sexual response, and our feelings and attitudes to others. We tend to think of these as brain effects, but they are more likely to be changes driven by our bodies. Our medicines can alter the way we smell or how we smell others, and this can impact on how attractive we seem to them or they seem to us. A virus can make us want to cuddle up to people we know well and avoid people we don’t know so well, while anti-inflammatory drugs can do just the opposite.
Many drugs can cause an emotional numbing that leads to a lack of concern for or feeling for others – our partners, parents or children and even lead to people walking out on marriage which they regret later when they have stopped the drug. This may be expressed in terms of a change of personality. On the other hand, a drug can give us the dutch courage to walk out on a relationship we perhaps should be leaving.
Besides the romance of relationships, our medicines can significantly alter our sexual responses. Serotonin is more primitive than androgens or estrogens and it affects our libido, our orgasms, the mechanics of sexual acts in all kinds of ways that even the most lurid pornography doesn’t cover.
Regulators, companies and those who usually provide information on the medicines we take all too often quite deliberately do not mention these effects and make it clear that this is because they do not want to deter us from taking our medicines. This raises profound questions as to why all these people are essentially getting us to live the lives companies want us to live rather than helping us to use company products to live the lives we want to live.
In addition, the sexual and relationship effects of these drugs, like the violence they can induce, affect not just the person on treatment but our partners and others also.
Finally, there is an extra dimension to all this which is that many of the drugs we take also affect fertility, and national fertility rates are falling in most Western countries. Antidepressants can cause sperm counts to plummet in men, double miscarriage rates in women, and in addition to birth defects triggered in the first trimester of pregnancy, many drugs and vaccines can trigger third trimester problems leading to pre-eclampsia and preterm births, both of which can have long lasting health consequences for women and their children.
Sexual side effects can sometimes persist indefinitely after stopping medications – or in some cases can worsen upon stopping the medication. These conditions are:
- Post-SSRI sexual dysfunction (PSSD) after stopping SSRIs, SNRIs, and related antidepressants.
- Post-finasteride syndrome (PFS) after stopping finasteride, a treatment used for hair loss.
- Post-retinoid sexual dysfunction (PRSD) after stopping isotretinoin, a retinoid used in the treatment of acne.
Featured blog posts
Below is a selection of blog posts about sex and relationships which help to illustrate the issue.
Accutane: 30 Years of Trading our Sex Lives for Clear Skin
This post about the acne treatment, isotretinoin, continues to be one of our most popular blog posts.
His Chemicals, My Imbalance: A Story about Love
“Throughout his medication, the ‘you’re beautiful’ statements slowly stopped. And so did the sex.”
A PSSD Story
“So I went along to my GP hoping he would see that citalopram was the most likely cause … He said “you will get better, when you decide to get better”.”
Doctor faces Marriage-Buster: What should s/he do?
“Several weeks later, John announced that he no longer loved Jane enough to stay married to her.”
Xarelto and Sex
Someone describes experiencing ongoing sexual difficulties are using rivaroxaban, an anticoagulant medication. It’s part of a new group of medications that go by various names: new oral anticoagulants (NOACs), direct oral anticoagulants (DOACs), or target-specific oral anticoagulants (TSOACs). They are increasingly being used to replace the older warfarin.
Post Minoxidil Syndrome
“Not only had my natural erections ceased, but now almost all pleasurable genital sensation had been reduced to what I can only describe as wearing several layers of clothing over my genitals at any given time.”
Our peer-reviewed articles
In 2014, we were the first group to report on persistent sexual dysfunction after stopping isotretinoin in the medical literature, and the first group to draw parallels between sexual dysfunction after stopping antidepressants, finasteride, and isotretinoin. See 120 Cases.
We updated this case series in 2018 and introduced the name post-retinoid sexual dysfunction (PRSD). See 300 Cases.
In 2019, we published a qualitative study on the experiences of PSSD patients when engaging with healthcare professionals. This highlighted some of the difficulties that patients often experience when trying to seek help for their condition.
In 2022, our data helped to create formal diagnostic criteria for PSSD and related conditions.
In 2024, we discussed the obstacles to accurately quantifying the incidence and prevalence of PSSD.
PSSD resources
Post-SSRI Sexual Dysfunction
Learn about this condition.
PSSD Literature
A list of academic literature involving PSSD.
Media Articles
A selection of media articles about enduring sexual dysfunctions
PSSD Doctors & Specialists
A list of medical professionals who are familiar with PSSD.
Petitions
In 2018, RxISK successfully petitioned regulators in Europe and Canada to get warnings added to medication labels about sexual dysfunction that persists after stopping SSRI and SNRI antidepressants. We submitted a petition, patient reports, documentation from healthcare professionals, and anonymized data from 298 RxISK Reports. You can read more in the following blog posts:
- EMA Acknowledges Persistent Sexual Dysfunction After SSRIs & SNRIs
- Health Canada warns about Persistent Sexual Dysfunction after SSRIs & SNRIs
We also submitted the petition to the Food and Drug Administration (FDA) with an offer to supply details of patients who were willing to be contacted for interview. Other than two standard acknowledgement letters, there has been no further response. The petition can be viewed along with accompanying documents and comments on FDA’s website using this link. One of the commenters has since committed suicide.
In the same year, we submitted a petition to FDA about isotretinoin calling for warnings to be added for sexual dysfunction while taking the medication and after stopping. There has been no further response other than standard acknowledgement. It can be viewed on FDA’s website here.
RxISK Prize
Thanks to generous donations, we’ve been able to establish a RxISK Prize of $100,000 USD to be awarded to anyone who can provide a cure for PSSD, PFS or PRSD.
PSSD Research Fund
Our PSSD Research Fund was launched in 2022 with the aim of better understanding the biology of the condition and hopefully finding treatments. We welcome your donations.
Drug search
Enter the name of a medication in the box below to see a list of adverse events related to sex and relationships that have been reported to the Food and Drug Administration (FDA).
We have more tools to look up adverse event reports on our Drug Search page.
In addition, you might also want to enter the name of a drug or side effect in the website search box at the bottom of the page. This will search our website for any related content.
Other side effects
Check out our other zones:
Are you experiencing a drug side effect?
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