A Guide to Lexapro Sexual Side Effects

If you’ve been diagnosed with major depressive disorder (MDD) or generalized anxiety disorder (GAD), your healthcare provider may prescribe the antidepressant medication Lexapro^® to help treat your symptoms.

Lexapro is a safe and effective medication for most people. However, like other antidepressants, it can cause side effects, including some that may affect your sexual health and function.

Below, we’ve talked about the sexual side effects of Lexapro, including issues such as reduced sex drive and difficulty reaching orgasm. We’ve also explained why Lexapro sexual side effects occur, as well as how prevalent they are among Lexapro users.

Finally, we’ve shared some tips and techniques to help you maintain optimal sexual health while you’re using Lexapro or similar antidepressant medications. So, if you've ever searched "Lexapro inability to climax female" or “how to get your sex drive back on Lexapro," these are the answers you're looking for.

Lexapro is a brand name for the ingredient escitalopram. It’s a selective serotonin reuptake inhibitor (SSRI) antidepressant that works by increasing serotonin activity throughout your brain and body.

Serotonin is a naturally occurring chemical called a neurotransmitter. Researchers believe it plays an important role in regulating moods, happiness, and anxiety, as well as aspects of the sleep-wake cycle.

Low serotonin activity is associated with an increased risk of certain mental illnesses, including depression, anxiety, and obsessive-compulsive disorder (OCD).

By increasing serotonin activity, escitalopram may help to reduce the severity of depression and anxiety symptoms and improve your emotional balance. 

As an SSRI, Lexapro is less likely to cause side effects and drug interactions than older classes of antidepressants, such as tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs).

However, Lexapro users can still experience side effects. Most of these side effects are mild and transient, meaning they’ll fade away over time. 

Common side effects of Lexapro include: 

• Nausea

• Fatigue

• Insomnia

• Flu-like symptoms

• Constipation

• Indigestion

• Abdominal pain

• Somnolence (drowsiness)

• Rhinitis (nasal congestion)

• Changes in appetite

• Increased sweating

Lexapro can also cause side effects that affect your sexual functioning, including a low level of sexual desire and anorgasmia (delayed, infrequent, or absent orgasms).

In men, Lexapro may cause other forms of sexual dysfunction, such as ejaculation disorder (difficulty ejaculating).

These side effects are often referred to as antidepressant-induced sexual dysfunction — a form of sexual dysfunction related to the use of psychotropic medications.

What Causes Lexapro Sexual Side Effects?

Experts aren’t yet aware of precisely why Lexapro and other antidepressants cause sexual side effects. However, research suggests that it’s likely related to their effects on serotonin, which is involved in the human sexual response.

More specifically, the increase in serotonin activity caused by Lexapro and similar medications is thought to affect testosterone and dopamine — a hormone and a neurotransmitter that are closely involved in sexual arousal and function.

These changes could affect your level of interest in sex, as well as your ability to climax during sexual activity. 

Sexual side effects from Lexapro are very common. Most research suggests that about half  of people who take Lexapro experience sexual issues.

According to a review of studies, between 28 percent and 75 percent of both men and women who take an SSRI experience some side effects related to sexual desire and performance.

Lexapro Sexual Side Effects in Men vs. Women

Sexual side effects from Lexapro are more common in men than in women. Nine to 14 percent of people prescribed Lexapro reported experiencing ejaculation disorder in clinical trials, with three percent reporting erectile dysfunction (ED).

That said, two percent of women prescribed Lexapro also reported experiencing menstrual disorders, such as cramps, prolonged menstrual periods, or heavy menstrual bleeding.

It’s worth noting that many of the sexual issues mentioned can occur as a result of depression and anxiety, not solely because of antidepressant treatment with Lexapro.

A review published in the journal Women’s Health noted that many sexual health issues, such as reduced sexual desire and lack of arousal, are associated with depression and anxiety. The authors also noted that pain during sex is approximately 10 times more common in women with a previous diagnosis of anxiety than in the general population.

If you’re prescribed Lexapro and develop sexual side effects, it’s important to let your healthcare provider know. 

Sometimes, sexual side effects from antidepressants can be improved by making changes to the way you use your medication. For instance, your healthcare provider may adjust your dosage or suggest using your medication at a different time.

If you have persistent side effects, your healthcare provider may suggest switching to a different antidepressant that’s less likely to affect your sex life. 

While it’s best to consult your healthcare provider before making any changes, below are some things they may suggest.

1. Talk to Your Doctor About Adjusting Your Dosage

Lexapro is prescribed at a range of different dosages. For example, it’s normal to take Lexapro at a dosage of 5 mg to 20 mg per day to treat major depressive disorder. If you typically use a high dose of Lexapro and have sexual health issues, your healthcare provider may lower your daily dose. 

It’s important to follow your healthcare provider’s instructions if you’re prescribed Lexapro. You may be instructed to closely check yourself for depression or anxiety symptoms after changing your dosage. 

Don’t reduce your dosage or stop taking Lexapro without consulting with your provider first, as this may cause you to develop withdrawal symptoms.

2. Change Your Dosage Schedule

If you notice that your sex drive seems to decrease shortly after you take your medication, you may want to try changing the time of day that you take Lexapro.

It’s okay to take Lexapro in the morning or at night. Assuming you usually have sex before you go to bed, switching to a pre-sleep dosage schedule may help to reduce the severity of sexual side effects from Lexapro and make having sex easier.

Taking Lexapro at night may also help reduce other side effects, such as nausea and fatigue.

3. Wait for Side Effects to Improve

It’s not uncommon to experience side effects when you first begin taking antidepressants, only to have them gradually fade away over the course of a few months.

If you’ve recently started taking Lexapro and feel like your sex drive is weaker or it takes longer for you to climax, your healthcare provider might recommend waiting for several weeks to see if your side effects improve on their own. Unfortunately, sexual side effects are less likely to go away with time compared to some of the other early side effects like nausea and headache.

Waiting can also be helpful if you don’t notice any improvements from your antidepressant, as it usually takes two to four weeks for many antidepressants to start working effectively.

4. Ask About Switching Antidepressants

If adjusting your Lexapro dosage, changing the time that you take your medication, and waiting for side effects to decrease don’t produce any real improvements in your sexual function, your healthcare provider may suggest switching antidepressants.

It’s normal to try several antidepressants before finding one that offers the right combination of improvements and acceptable side effects. Many people with depression switch medications more than once before settling on an antidepressant that feels right for them. 

Your healthcare provider may suggest trying a different SSRI, like:

• Citalopram (Celexa^®)

• Fluoxetine (Prozac^®)

• Fluvoxamine (Fluvox^®)

• Sertraline (Zoloft^®)

• Paroxetine (Paxil^®)

Your provider may also suggest trying a serotonin and norepinephrine reuptake inhibitor (SNRI), which impacts both serotonin and norepinephrine, another neurotransmitter. Examples include desvenlafaxine (Pristiq^®), duloxetine (Cymbalta^®), and venlafaxine (Effexor^®)

Another option a healthcare professional may suggest trying is an atypical antidepressant such as mirtazapine (Remeron^®) or bupropion XL (sold as Wellbutrin XL^®).

Bupropion is well known for its positive effect on sexual function, with several studies showing that it can produce improvements in sexual health in people prone to sexual issues from other 

medications that treat depression. Adding bupropion to Lexapro or other SSRI usually leads to an improvement in sexual side effects and often makes them go away completely. 

Our Lexapro vs. Wellbutrin guide provides more information about how these two medications differ, as well as the effects that Wellbutrin can have on your sexual health and well-being. 

If you’ve ever looked up tips for dealing with sexual dysfunction from antidepressants, you may have come across recommendations to take a “drug holiday.”

A drug holiday is a break from taking your medication. Drug holidays can last for several days or stretch out over a period of weeks or months. The idea is that allowing the drug to clear out from your system may help to stop side effects and improve your quality of life.

While taking a drug holiday might seem like a good idea for dealing with sexual side effects, it isn’t recommended with Lexapro for several reasons.

Stopping Lexapro suddenly can cause withdrawal symptoms, including:

• Sudden mood changes

• Agitation and irritability

• Nausea

• Confusion

• Difficulty sleeping

These symptoms are referred to as antidepressant discontinuation syndrome, and they’re common with SSRIs.

Abruptly stopping treatment with Lexapro to take a drug holiday could also increase your risk of dealing with recurrent depression symptoms. 

If you want to stop taking Lexapro, it’s important to connect with your healthcare provider first. They can help you to safely stop taking your medication by gradually tapering your dosage to reduce your risk of withdrawal symptoms or a relapse of depression. 

For most people, Lexapro is a safe, effective medication that makes dealing with the symptoms of depression and anxiety easier.  

Like other antidepressants, Lexapro can cause sexual side effects. Here’s what to keep in mind about Lexapro and sexual side effects:

• Some sexual side effects of Lexapro include a reduced level of desire for sex and difficulty reaching orgasm.

• It’s often possible to treat adverse sexual effects by adjusting your Lexapro dosage or taking your medication at a different time of day.

• If you have persistent sexual side effects from Lexapro, your healthcare provider may add a second medication, such as bupropion, to reverse the sexual side effects or prescribe a different medication to help you manage your depression or anxiety.

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