Sex Therapy · Assessment
Medication Sexual Side Effects
It's chemistry, not attraction
SSRIs, SNRIs, some blood-pressure medications, opioids, and hormonal contraceptives can significantly change desire, arousal, and orgasm. This isn't in your head. Naming the effect, tracking it, and bringing it back to the prescriber is often the single biggest lever.
Medications you're currently taking that might be relevant
Medications, roughly when started, and any sexual change you noticed after starting
What specifically has changed
- Desire is flatter / less present
- Arousal is harder to build
- Genital sensation is muted
- Orgasm takes much longer, or won't come
- Orgasm is present but feels less intense
- Erectile function changed
- Lubrication dropped
Script for talking to the prescriber
You can bring this up. It's their job to hear it.
Try: "Since starting [medication], I have noticed [specific effect]. It matters to me. Can we talk about options — a dose adjustment, timing, adding bupropion, a drug holiday if safe, or switching class?" Prescribers who dismiss this are undertrained on sexual side effects; a second opinion is reasonable.
What to hold steady while working the problem
- This is a chemistry issue, not a values or attraction issue
- Prioritize non-goal touch — sensate focus works well here
- Longer runways, more direct stimulation, less pressure on peak
- Communicate with a partner so it doesn't get read as rejection