I originally thought of this blog entry as “Where, Oh Where, Did My Orgasm Go?” I had in mind a comic riff on that most notorious downside of antidepressants: sexual dysfunction (SD). I was going to regale you with anecdotes of my many frustrating, fumbling, ultimately heroic efforts to achieve sexual satisfaction against the seemingly insurmountable odds posed by the little green-and-yellow pill. I’m single and often solitary, by the way, so for this blog I’m going to talk about solitary sex.
Like the time I lay in bed for over an hour, sweating, swearing, starting, and stopping but refusing to yield in my bull-headed determination to reach orgasm. I was Sisyphus pushing the boulder of arousal up the hill—and not getting anywhere near the peak.
I kept on, long past the hope of any pleasure. I was disgusted with myself—and a little alarmed—that I couldn’t even masturbate successfully. What a loser. It was also weird to be concentrating so hard on the details of arousal, analyzing every toe-fluttering tingle like a scientific experiment. I tried again the next night, and the next, playing every conceivable sexual fantasy in my collection until finally … could it be? … a miraculous … infinitesimal … pffft.
Sexual dysfunction definitely has its comic side, but it’s also a leading cause of skipping doses and ditching antidepressants entirely. Not surprisingly, some people have zero tolerance for letting medicine monkey around with their sex lives—even though the symptoms are often temporary.
As it has been for me and my anorgasmia. In my experience this can’t-come syndrome usually hits a few weeks after I start a new antidepressant and then lifts after a month or less. I had it worse with Prozac than with Zoloft, but studies comparing the drugs that work this way have shown that they are all equally hard (or in the matter of erectile dysfunction, soft) on your sex life.
For plenty of unlucky men and women, chasing the big O in vain can last much longer. So I can’t complain too much. Mostly I’ve been able to bring the matter to a satisfactory close in a perfectly respectable time—not that anyone was counting. (They are counting in some studies of antidepressant-related SD, in which male subjects are actually given stopwatches to record at home what researchers prissily refer to as their intravaginal ejaculation latency time.) If the quality of my orgasm has come to seem less intense than in my pretreated days, how much can you really ask for from an orgasm anyway? (That’s my stiff upper lip talking.)
Of course, you might be one of the really lucky depressed people who never become an SD statistic. But that’s increasingly unlikely.
As of 1995, according to the Prozac label, only 4% of more than 10,000 patients using the drug in clinical trials had reported decreased libido.
Although as late as 2003 some drug labels were still sneakily stating that only 15% of users had sexual side effects, everybody and their grandmother knew about it. A huge study in 2002 came up with an overall incidence of 37%, but given what a doozy of a problem SD is to define, let alone discuss with your doctor, it has been estimated that about twice that number of antidepressant-takers get blindsided by SD.
Remarkably the curse of SD has made barely a dent in the humongous sales of these drugs. One reason may be that the symptoms aren’t especially serious: They’re a loss of pleasure rather than a gain of pain. Another reason may be that plenty of depressed people already have sexual problems.
Still, the number of Americans walking around with symptoms of SD—whether they’re as specific as vaginal dryness or as nebulous as sheer long-term lack of interest—is pretty staggering. In 2004 a federal report estimated that 10% of U.S. women and 4% of U.S. men were popping these pills. Do the math and it’s clear that for a considerable minority of Americans (and their partners) sex has become even more fraught and frustrating than ever. But boy, can we ever meet deadlines at work.
Next week: SD is even more annoying when you’re having sex with someone else.
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