post-ssri sexual dysfunction: anti-depressants side effects hurting intimate experiences
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though women have higher rates of depression, the prevalence of pssd remains unknown.
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anti-depression medications are known to cause upset stomach and weight gain, but what has scientists alarmed is the lesser-known side effect of sexual dysfunction that persists long after the patient stops taking the medication.
a growing number of patients have reported genital numbing and pleasure-less orgasm after they stop using the common anti-depressant selective serotonin reuptake inhibitors (ssri). the condition is known as post-ssri sexual dysfunction, or pssd.
“any pleasurable sensation that we typically get from our lips being touched, or other sensitive parts of our body, were completely gone,” emily grey, director of the canadian post-ssri sexual dysfunction (pssd) society, said of the sexual symptoms.
“my emotions dulled. and, specifically, romantic love? i don’t feel that anymore,” said grey, who began to experience symptoms five years ago after she stopped taking an ssri. since then, she has connected with others experiencing similar symptoms.
“very little is known about this condition [pssd] and how best to manage it.” said dr. lori brotto, a psychologist and researcher at the university of british columbia. “it can be extremely distressing to individuals.”
dr. brotto was recently awarded a grant to study sexual health and genito-pelvic pain, including working to learn more about pssd.
around the world, medical recognition of the disorder was established only a few years ago. with greater case reports from patients using this type of medication, the criteria for pssd diagnosis now includes symptoms such as genital numbing, decreased genital and organismic sensation, decreased sexual desire, erectile dysfunction and, for some, genital pain. also present are emotional symptoms such as brain fog, emotional blunting and sensory impairment.
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a common complaint from patients is that healthcare providers ridicule them or dismiss their reported symptoms, so many opt to suffer in silence.
grey attempted to get help from health care providers for her pssd, but it was frustrating. she decided she would remain silent no longer.
“no one should have their sexuality chemically stripped from them,” grey said. but it’s still hard when sexuality and mental health remain taboo topics, even in a health setting.
“they are not always very receptive to being frank about your sexuality as a part of a functioning human body,” she adds. “it’s a good thing that it affects men and women, because if it only affected women, then it wouldn’t be investigated with the same vigour.”
as a therapist, yassie pirani started hearing about pssd from clients, and, as word spread amongst patients, she began supporting more and more of them as they navigated the health system to try and get answers and grieve what they have lost. she has become one of the few practitioners with expertise in pssd.
“that’s a common experience for people. if they go to get medical help, typically they’ll be told that this is a delusional disorder. they might be prescribed antipsychotics. people weren’t being believed and they’ll be trivialized and ridiculed, and it was a re-traumatizing experience for sufferers,” she said. “now it’s harder for doctors to deny this exists… things are shifting and it’s more talked about in the medical community.”
the canadian pssd society advocates for greater research as the condition is poorly understood and reliable medical interventions do not yet exist. canadians suffering from pssd share their stories and experiences, shedding light on how pssd can impact people across ages, genders and ethnicities, and even those without depression. dr. brotto’s four-year grant will enable collaboration with groups like the sex information and education council of canada (sieccan) and people suffering from pssd.
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another collaborator on the project, dr caroline pukall, a psychologist at queen’s university and canada research chair in sexual health, explores sexual disorders and, earlier this year, launched a
study to understand people’s experiences with pssd.
like pirani, pukall heard about pssd less than a decade ago from a patient. the patient reported that while her depression had improved, she had begun to experience changes in her sex life after she had stopped taking ssris.
though women have higher rates of depression, the prevalence of pssd remains unknown. a study earlier this year estimated the risk of pssd was less than 0.5 per cent, but the study reported cases in men, demonstrating another area where women are often overlooked in research.
health care providers will often counsel patients on drug side effects, including sexual side effects and assess treatment, including switching medications that may not be working. since pssd occurs after patients stop taking their pills, monitoring or managing the condition has additional challenges. pssd can also occur for people taking drugs that target serotonin reuptake inhibitors such as irritable bowel syndrome, anxiety, or menopause-related symptoms.
a survey is underway to understand people’s experiences with pssd, to learn more about how health care providers and researchers can develop support. many mourn the loss of an enjoyable sex life, future fertility and identity as a person. preliminary findings from pukall’s research suggest an association between pssd symptom-related grief and anxiety; the more grief people experience about their pssd symptoms, the higher their anxiety.
with limited treatment options, research from people struggling with sexuality after physical injuries or sexual violence can shed light on supports that may help people with pssd to explore remaining possibilities for closeness in intimate relationships. still, it remains a challenge for those suffering from pssd to come to terms with losing a part of themselves.
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ayeshah haque is a fellow in journalism and health impact at the university of toronto.
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