Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 6/21/2022
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 you 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 amongst 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.
Lexapro is a brand name for escitalopram, an antidepressant that works by increasing serotonin levels in your brain and body.
Serotonin is a naturally-occurring chemical called a neurotransmitter. Experts believe that it has an important role in regulating your moods, happiness and levels of anxiety, as well as aspects of your sleep-wake cycle.
Low serotonin levels are associated with an increased risk of certain mental illnesses, including depression, anxiety and obsessive-compulsive disorder (OCD).
By increasing serotonin levels, 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, many Lexapro users still experience side effects while using their medication. Most of these side effects are mild and transient, meaning they’ll fade away over time. However, certain side effects of Lexapro may be more persistent and bothersome.
Common side effects of Lexapro include:
Rhinitis (nasal congestion)
Changes in appetite
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.
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 production of other important hormones.
More specifically, the increase in serotonin levels caused by Lexapro and similar medications is thought to affect testosterone and dopamine — two hormones that are closely involved in sexual arousal and function.
These changes in hormone levels could affect your level of interest in sex, as well as your ability to climax during sexual activity.
Sexual side effects from Lexapro aren’t very common. Most research suggests that only a small percentage of people who take Lexapro experience sexual issues, with rates varying based on whether Lexapro is used to treat depression or generalized anxiety disorder.
In clinical trials of Lexapro in people with major depressive disorder, three percent experienced a reduction in their sex drive, with two percent reporting anorgasmia.
Sexual side effect rates were slightly higher amongst people who used Lexapro to treat anxiety disorders. In a clinical trial of people prescribed Lexapro for generalized anxiety disorder, seven percent reported a decreased libido, while six percent reported anorgasmia.
Two percent of people prescribed Lexapro also reported experiencing menstrual disorders, such as cramps, prolonged menstrual periods or heavy menstrual bleeding.
In men, sexual side effects from Lexapro are more common. For example, nine to 14 percent of people prescribed Lexapro reported experiencing ejaculation disorder in clinical trials, with three percent reporting erectile dysfunction (ED).
It’s worth noting that many of these issues can occur as a result of depression and anxiety, not solely because of antidepressant treatment with Lexapro.
For example, 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 about them.
Most of the time, sexual side effects from antidepressants can be improved by making changes to the way you use your medication. Your healthcare provider may adjust your dosage, suggest using your medication at a different time or suggest waiting until your sexual health improves.
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.
Lexapro is prescribed at a range of different dosages. For example, it’s normal to take Lexapro at a dosage of 10mg to 20mg 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 it.
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 ever reduce your dosage or stop taking Lexapro without consulting with your provider first, as this may cause you to develop withdrawal symptoms.
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 to make other side effects, such as nausea and fatigue, less of a problem.
It’s far from 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.
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.
If adjusting your Lexapro dosage, changing the time that you take your medication and waiting for side effects to disappear 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 or switching to an antidepressant such as bupropion XL (sold as Wellbutrin XL®).
Bupropion is well known for its positive effect on sexual function, with severalstudies showing that it can produce improvements in sexual health in people prone to sexual issues from other antidepressants.
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 wellbeing.
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, irritability, nausea, confusion and 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 let your healthcare provider know 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, including a reduced level of desire for sex and difficulty reaching orgasm. It’s often possible to treat these adverse 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 prescribe a different medication to help you manage your depression or anxiety.
You can also learn more about dealing with depression, anxiety and other mental health issues using our free mental health resources and content.