Greater patient education needed around antidepressants which may reduce genital sensitivity, SFU study finds

The use of antidepressants is associated with sexual side effects including reduced genital sensitivity that persists after stopping the medication, a new Simon Fraser University study finds.

The study, published in Social Psychiatry and Psychiatric Epidemiology, indicates that 13 per cent of people who used antidepressants reported a reduction in genital sensitivity, compared to one per cent of users of other psychiatric medications.

“It’s gone under the radar for so long, largely due to stigma, shame and embarrassment,” says Yassie Pirani, an SFU alumnus and lead author on the study. “For some, it resolves with time, but for a lot of people, it doesn’t go away. I’ve spoken with somebody who developed this syndrome at age 33. He’s 66 years old now and nothing’s changed.”

Post-SSRI sexual dysfunction (PSSD) is an under-researched and under-reported syndrome of persistent sexual dysfunction caused by SSRI and SNRI antidepressant use, where sexual function does not return to normal after the patient stops using the medication.

“I’ve talked to teenagers who get this and it’s devastating. There’s no way to under to state how harrowing an experience this is for people. It’s not just about the numb genitals – it’s about what it means for having relationships, to be rendered impotent without your consent. It is a serious harm.”

Pirani says the illness is a spectrum. For some, it’s mild, their genitals feel less sensation, maybe 80 per cent of what used to be. While in more severe cases, it’s complete numbness.

The study was nested within a larger survey (~9,600 mainly LGBTQ young people in Canada and the U.S.) that focused on mental health, conversion therapy, and other factors that shape experiences related to gender and sexuality during adolescence and early adulthood.

“This study reminds us that pharmacological interventions play a role in shaping the sexual experiences of youth, and improved understanding and education is urgently needed,” says Travis Salway, an SFU associate professor in the Faculty of Health Sciences and the study’s principal investigator.

As part of the community survey, participants were asked if they’d ever taken antidepressant drugs and stopped and subsequently experienced a number of PSSD-compatible symptoms. Research regarding PSSD is complicated by the fact that many PSSD symptoms, like low libido, can also be attributed to depression. However, genital numbness, known as genital hypothesia, is a primary symptom of PSSD that is not associated with depression.

“There’s no medical explanation for why people should experience numbness in their genitals due to depression or anxiety (or other common conditions for which SSRIs/SNRIs are prescribed),” Salway explains. “The frequency of genital hypothesia in those who had past use of antidepressants was more than 10 times greater than the frequency that we saw in those who had used another psychiatric medication (such as antipsychotics or sedatives).”

Part of the problem, as Pirani sees it, is an informed consent-accountability gap. While antidepressants are commonly prescribed to help people struggling with anxiety, obsessive-compulsive disorder, post-traumatic stress disorder, panic disorder, phobias, chronic pain, depression and other conditions, people aren’t being warned of the risks.

The findings underscore the need for more robust patient and prescriber education practices and warnings so that patients can decide for themselves if the risk is worth it.