Zoloft (Sertraline) Sexual Side Effects: What They Are & How to Manage Them

What Is Zoloft (Sertraline) & How Is it Used?

Zoloft (sertraline) is a medication used to treat a variety of mental health disorders including depression (MDD), obsessive-compulsive disorder (OCD), panic disorder (PD) post-traumatic stress disorder (PTSD), premenstrual dysphoric disorder (PMDD), and social anxiety disorder (SAD).¹ It can also be used as an off-label treatment for binge eating disorder, body dysmorphic disorder, bulimia nervosa, and generalized anxiety disorder.² An off-label use is when a medication is used for a non-FDA-approved indication based on the professional judgment of a prescriber.

Zoloft is a selective serotonin reuptake inhibitor (SSRIs) and works in the body to increase the activity of serotonin in the body.¹ In the nervous system, serotonin helps control a person’s mood, personality, and sleep-wake cycle. By targeting this chemical in the body, Zoloft works to improve symptoms.²

Your doctor will consider prescribing you Zoloft if the symptoms of your diagnosis are interfering with your daily life and have been present for a significant amount of time. Zoloft can be the first step in treatment or can be used after trying other non-medication-based treatments like cognitive behavioral therapy (CBT). It is also one of the first medications used for depression and social anxiety.

What Causes Zoloft Sexual Side Effects?

Zoloft works to increase the availability of serotonin. Unfortunately, the increased levels of serotonin present throughout the entire body can cause side effects that affect sexual functioning. Negative sexual side effects can also be caused by Zoloft’s interruption of other regulation activities in the body. The presence of negative sexual side effects seems to be dose-related and reversible.³ This means the higher the dose of Zoloft you take, the more likely you are to experience negative sexual side effects.

Zoloft Sexual Side Effects

The sexual side effects of Zoloft can include decreased libido, erectile dysfunction, ejaculation disorder, and male sexual dysfunction.¹ The exact amount of people experiencing sexual side effects is hard to estimate since sexual side effects can be difficult to discuss. In original studies with Zoloft, anywhere from 4% to 8% of those taking the medication experienced negative sexual side effects.¹ Since then, studies have reported varying rates of sexual side effects for those taking SSRI medications, with rates being anywhere from 25 – 75%.⁴

Compared to other Zoloft side effects, sexual side effects seem to be less common.¹ It has been reported that sexual side effects are one of the main reasons people choose to stop taking an SSRI like Zoloft.⁴

Common Sexual Side Effects of Zoloft for Women

Some sexual side effects that can occur in women include discomfort during intercourse, delayed orgasm, decreased libido, and decreased sexual satisfaction.^1,3 These sexual side effects can make treatment with Zoloft more difficult and can make feelings of depression and anxiety worse.

These symptoms can also have negative effects on relationships and sexual partners.⁵ Most often sexual side effects will continue until there is a change in medication type or dose, or the side effect is addressed and treated. Only a small number of patients see sexual side effects go away on their own.⁴

Common Zoloft sexual side effects for women include:

• Delayed orgasm
• Decreased sexual satisfaction
• Decreased libido

Common Sexual Side Effects of Zoloft for Men

Some sexual side effects that can occur in men include ejaculation disorder or failure to ejaculate, decreased libido, erectile dysfunction, and sexual dysfunction.¹ These side effects can be troublesome for self-esteem and interpersonal relationships.⁴

Sexual side effects can also interrupt therapy with Zoloft and make feelings of depression and anxiety worse.⁵ Most often sexual side effects will continue until there is a change in medication type or dose, or the side effect is addressed and treated.

Common Zoloft sexual side effects for men include:

• Decreased libido
• Erectile dysfunction
• Failure to ejaculate
• Ejaculation disorder

How to Cope With Sexual Side Effects of Zoloft

Side effects from medications are often unpleasant and sexual side effects from Zoloft are no exception. The good news is that there are many options for dealing with the sexual side effects while still treating your mental health disorder. If you do experience sexual side effects

while taking Zoloft, it is important to alert your prescribing doctor right away. They will help to track the improvement or worsening of symptoms and identify potential solutions with you.

A good first step is trying psychotherapy to help you adjust and cope with these effects, especially with a sensitive topic. If you have difficulty finding a therapist in your area, online therapy options may be helpful. Other ways to help cope with sexual side effects from Zoloft include having your doctor adjust your dose or change your medication.³

Wait and See

Sexual side effects from Zoloft are due to changes in chemical activity throughout the body that help treat various mental health disorders. Some patients report that waiting for the body to adjust can be enough to stop sexual side effects. Each person is different, and most will not see a change in sexual side effects with this method.^4,6

Adjust Your Dose

Lowering your dose of Zoloft can help reduce sexual side effects.⁶ The goal is to find the minimum dose at which you still find benefit from Zoloft with regard to your mental health treatment.⁴ It will be very important to do this only under the guidance of your prescriber. Adjusting your dose without supervision can cause antidepressant withdrawal symptoms or other complications.

Consider Switching Antidepressants

Zoloft is known to be one of the most likely SSRI medications to cause sexual side effects. Switching antidepressants to a lower-risk SSRI or a different type of medication altogether can reduce or eliminate sexual side effects. It is important that this decision happens with your doctor’s supervision. Deciding which medication to switch to and how to switch are all important decisions that carry risk.⁵

Questions to Ask Your Health Team About Zoloft Sexual Side Effects

Keeping an open line of communication with your health team is very important when it comes to sexual side effects from Zoloft. Strategies to deal with the side effects can have risks and should only be initiated under the supervision of your doctor. If you think any side effect is serious or life-threatening, you should call an emergency hotline or 911. Before starting Zoloft, you and your healthcare team should have a plan on how to deal with sexual side effects and anything else that may come up.

Questions to ask your care team about the sexual side effects of Zoloft include:

• How long will it take for me to adjust to taking Zoloft?
• Am I at risk for more severe symptoms if I am already taking other depression or anxiety medications?
• What is the best Zoloft dosage to ensure fewer side effects?
• When should I reach out to you if I am experiencing sexual side effects?
• Is there anything I should tell my therapist about this new medication?
• When should I expect to experience sexual side effects?
• What are my options to deal with sexual side effects?
• I have a history of sexual problems; will this affect my risk for sexual side effects?

In My Experience

Sexual side effects from taking Zoloft are a risk for everyone that starts treatment. In my experience, being open with your doctor from the beginning is the best way to prepare for possible side effects. It is important, even with sensitive topics like changes in sexual functions, to always clearly communicate with your doctor. This strategy can make sure that taking Zoloft does not impact your treatment or your mental health negatively. Being educated about sexual side effects from Zoloft is the first step to properly managing them.

For Further Reading

• When an SSRI Impacts Your Sex Life
• How to Get Prescribed Zoloft: Everything You Need to Know
• Zoloft For Anxiety: Effectiveness, Dosage, & More
• Which Antidepressants Are Without Sexual Side Effects?
• Can Medications Cause Sexual Side Effects
• Zoloft Side Effects First Week: What to Expect