What we know about sexual function after antidepressants

In May, a 23-year-old conference panelist spoke into a microphone and described a devastating condition that she said stemmed from her use of antidepressants: complete loss of sexual and emotional function.

Her genitals were numb and she could no longer feel love for her mother, connection with friends or pleasure in music, she said.

It’s called post-SSRI sexual dysfunction, Lauren Friedman told people gathered at a Washington, D.C., hotel for the Make America Healthy Again Institute’s Mental Health and Overmedicalization Summit.

“Before this, I was a super emotional, empathetic, loving, caring, Sylvia Plath-reading and -resonating girl,” she said. “The day I woke up with this injury, I quite literally felt my soul leave my body.”

Video of Friedman’s comments took off on social media. Podcaster Joe Rogan winced on his podcast as he discussed her testimony. Clips of her speaking about her condition continued to go viral, prompting alarm on conservative podcasts and in news articles.  

Into July, video of her testimony continued to gain nearly a million views on X. 

Friedman is not the first person to describe sexual side effects from SSRIs, antidepressants that increase the brain’s levels of serotonin, an essential neurotransmitter that affects mood. For many, SSRIs, including Zoloft (sertraline), Prozac (fluoxetine), and Lexapro (escitalopram), are effective treatments for anxiety, depression and obsessive compulsive disorder. And low libido, erectile dysfunction and difficulty reaching orgasm are common side effects. 

But Friedman’s complaint stood apart because she described persistent physical and neurological symptoms long after she stopped taking the drugs. 

 The term “post-SSRI sexual dysfunction,” or PSSD, emerged in online chat groups in the early 2000s and first appeared in scientific literature in 2006. Some researchers have linked other classes of antidepressants known to cause sexual side effects — SNRIs (serotonin and norepinephrine reuptake inhibitors) and TCAs (tricyclic antidepressants) — to the condition.

Although reports of similar experiences date back to the 1990s, there is little research into the subject. 

It isn’t an official diagnosis recognized by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, or DSM, a handbook that outlines the symptoms of various psychiatric conditions. Nor is it recognized in the World Health Organization’s equivalent diagnostic manual, the International Classification of Diseases. 

Friedman’s comments went viral at a time when U.S. Health and Human Services Secretary Robert F. Kennedy Jr. has made it clear he wants to curb the nation’s rates of antidepressant use. About 16.6% of U.S. adults reported using them in 2025, and 3.6% of kids in 2023. Kennedy has linked the medications to a number of societal ills, including mass violence, although data does not support that.

Evidence of PSSD comes largely from individual case reports rather than any large-scale studies. That means it’s hard to know a lot about it, including its prevalence and cause.

Sparse data prompts call for more research

In 2022, a group of researchers led by Dr. David Healy, a psychiatrist, professor and vocal critic of SSRIs and the pharmaceutical industry, proposed diagnostic criteria that included three-plus months of  lost genital sensation, reduced sexual desire, erectile dysfunction and inability to orgasm. Cases can vary in severity and some resolve on their own. 

The PSSD Network, an Australia-based advocacy group formed in 2022 that has been pushing for more research into the condition, says on its website that some people also experience non-sexual effects like ones that Friedman described: feeling emotionally numb, disinterested and disconnected from others.

Although some of these symptoms are also associated with depression and anxiety — symptoms that may return after a person stops taking an antidepressant — reports of lasting genital numbness are not.

It’s this symptom that a PSSD Network spokesperson described as being the condition’s hallmark red flag. 

Most studies into PSSD have not been designed to assess the status of a patient’s underlying conditions such as depression, anxiety, trauma or pain for which antidepressants were prescribed, said Dr. Jonathan Alpert, psychiatrist and professor at the Albert Einstein College of Medicine. 

“The existing body of literature is small and of variable quality,” Alpert said.

The studies that do exist show there may be a correlation between these medications and the symptoms, but “the evidence is weaker with respect to causation,” said Dr. Michael Ziffra, psychiatrist and associate professor at Northwestern University. The specific mechanism by which these types of drugs would cause long-term damage is also uncertain.

How common is this? We don’t know. 

The lack of research into this condition means we also don’t have a good idea of how common these long-term side effects might be. 

“Presently, our best understanding is that this is an uncommon experience for the vast majority of patients taking SSRIs,” Ziffra said. Based on his clinical experience, sexual side effects disappear for most people within a few weeks or months after patients stop the drugs. 

Spokespeople from the PSSD Network pointed to two studies that may give insight. 

One study reviewed the medical records of men in Israel and found increased prescriptions for erectile dysfunction medications among those who had taken serotonin-boosting antidepressants (SSRIs, SNRIs or TCAs) compared to those who hadn’t. 

But when researchers looked closer at the 866 men in the study who took an antidepressant, only four patients or (0.46% of the sample) met the specific conditions for PSSD — erectile dysfunction that starts after getting on an antidepressant, but persists even after having stopped taking it.  

Another study, based on a voluntary online survey of LGBTQ+ youth in Canada and the U.S. found a higher number. Among 2,179 people, 13.2% of those who said they had used antidepressants in the past reported persistent loss of sensation in their genitals compared to 0.9% of users of other psychiatric drugs. 

But there are some potential confounding variables here. For example, a quarter of the survey sample had received some kind of gender-affirming hormone treatment, which in itself can impact sexual function. The survey also showed that those who had used sedatives or experienced severe depression were more likely to report numbness. 

“While online forums have suggested a high prevalence, other research approaches have generally suggested a very low prevalence that has not conclusively disentangled these side-effects from the underlying conditions for which antidepressants are prescribed,” Alpert said. 

Healy said he believes the condition’s prevalence has been hard to track in part because people were embarrassed to describe their symptoms and clinical trials lacked sufficient follow-up about sexual symptoms after people discontinue the drug. 

But everyone agrees that more research is the answer.

Some health agencies have acknowledged the risk, but not formally recognized the condition

In response to advocates and limited data, some regulatory bodies abroad, such as the European Medicines Agency, have added SSRI/SNRI drug pamphlet warnings of possible persistent sexual side effects.

The DSM-5’s section on substance/medication-induced sexual dysfunction includes a similar disclaimer. “In some cases, serotonin reuptake inhibitor–induced sexual dysfunction may persist after the agent is discontinued.” 

In 2018, Healy’s company, Data Based Medicine Ltd., submitted a citizen’s petition to the U.S. Food and Drug Administration, requesting that additional warnings be added to SSRIs and other antidepressant product labels.

“There is not yet consensus with respect to how strong the causality is, and what the underlying biological mechanisms would be,” Ziffra said. “Many in the medical community agree that more research is needed to better characterize this phenomenon.” 

Alpert said that patient reports can be vital to understanding the risk and benefits of treatments, even before rigorous research can deliver conclusive proof: “For this reason, reports of persisting sexual side-effects after exposure to SSRIs — though complicated by potential confounding factors — are being taken seriously.” 

Future research may prove a stronger link between the drug and these effects, Ziffra said, but he cautioned against people taking drastic measures to quit their antidepressants out of concern that there is a connection.

“I don’t think anyone taking an SSRI right now should be alarmed, but if they have concerns,” he said, “they should talk to their doctor.”