Sexual Side Effects of Zoloft

By Sarah Malka, MD
Medically reviewed
November 11, 2021

Zoloft (sertraline) is a first-line treatment that helps many people cope with many mental health conditions, including depression and anxiety.

But the medication, along with other selective serotonin reuptake inhibitors (SSRIs), can also cause unwanted sexual side effects. 

As with any medication, it’s important to note that not every person will experience the same side effects when taking Zoloft.

For that reason, it’s important to discuss both the benefits and potential side effects with your doctor or psychiatrist to find the right fit for you.

If you are taking Zoloft or another SSRI and are finding sexual side effects (or any side effects, for that matter) to be an issue, reach out to your provider to see if a change in medication or dosage might be helpful.

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What is Zoloft?

Zoloft is an FDA-approved brand name of the generic antidepressant medication called sertraline.

It belongs to a class of drugs called selective serotonin reuptake inhibitors, or SSRIs.

Other SSRI medications include fluoxetine (Prozac), paroxetine (Paxil), fluvoxamine (Luvox), citalopram (Celexa), and escitalopram (Lexapro).

These types of medications work by increasing the amount of the chemical serotonin available in the brain and body, and they are only available by prescription.

Zoloft is most commonly prescribed in the treatment of the following health conditions:

  • Major depressive disorder (MDD)
  • Obsessive-compulsive disorder (OCD)
  • Panic disorder
  • Premenstrual dysphoric disorder (PMDD)
  • Posttraumatic stress disorder (PTSD)
  • Social anxiety disorder
  • Generalized anxiety disorder (GAD)

The standard dose of Zoloft will range between 25-200mg daily depending on your condition, health, severity of your symptoms, and other personal health factors.

If your provider chooses to prescribe it to you, be sure to take the medication only as directed.

Don’t take more or less of it than prescribed and don’t take it for a longer or shorter period of time than suggested.

If you would like to stop taking Zoloft or change medications for any reason, speak with your provider first, who can help you wean off the medication safely.  

According to the National Alliance on Mental Illness, your sleep quality, energy level, or appetite may start to show signs of improvement in the first one to two weeks of taking Zoloft.

For others, it may take 4-8 weeks for the medication to start taking effect, or to reach maximal effect. 

Sexual Side Effects of Zoloft

Like many medications, Zoloft can cause side effects, including headache, nausea, diarrhea, and dry mouth.

Notably, Zoloft and other antidepressants may also cause sexual side effects, including decreased libido and difficulty with orgasm.

In many cases, these side effects wear off within a few weeks of starting the medication.

For others, the side effects may continue for as long as you’re taking it.

Low Libido

One of the common sexual side effects of Zoloft is low libido, or decreased sexual appetite.

Though researchers aren’t clear on how Zoloft affects libido, current theories point to how the medication’s effect on the neurotransmitter serotonin can affect the brain’s communication with other hormones essential for sexual arousal and appetite.

Erectile Dysfunction

Another possible sexual side effect when taking Zoloft is erectile dysfunction (ED), or difficulty getting and maintaining erections. 

Others

Other possible sexual side effects of Zoloft use include:

  • Delayed or painful ejaculation
  • Difficulty reaching orgasm
  • Penile anesthesia (loss of sexual sensation in the penis)
  • Decrease or loss of sensation in the vagina and nipples
  • Pain during sex
  • Persistent genital arousal
  • Nonpuerperal lactation (unrelated to pregnancy or breastfeeding)
  • Priapism (prolonged erection of the penis)
  • Reduced sperm count

Managing Sexual Side Effects of Zoloft

Not everyone on Zoloft will experience sexual side effects.

Still, it’s important to know the potential for sexual side effects when starting Zoloft or another SSRI.

If you’ve just started taking Zoloft and you’re experiencing one or more of the possible sexual side effects, many providers will advise you to wait a few weeks to see if the side effects subside.

If after waiting several weeks you continue to experience sexual side effects, reach out to your provider, who may recommend one of the following management solutions:

  • Lowering the dose: If you’ve started to experience these side effects after beginning to take a higher dose, your doctor or provider may recommend lowering the dose to reduce the risk or frequency of sexual side effects. Keep in mind that it isn’t safe to alter your medication dosage without the help and guidance of a professional, so be sure to consult your provider before making changes.
  • Switching to another antidepressant: If Zoloft causes unwanted sexual side effects no matter the dose, your provider may recommend trying another antidepressant with less potential for sexual side effects, like another SSRI, an SNRI (venlafaxine or duloxetine), or bupropion (Wellbutrin), depending on your specific mental health symptoms.
  • Adding another medication: Adding a second antidepressant or another medication may help to counter the sexual side effects. This may include another antidepressant like bupropion (Wellbutrin), or for those with erectile dysfunction, the addition of a medication approved to improve sexual function, like sildenafil (Viagra) or tadalafil (Cialis). 
  • Therapy: Though you may notice a change in sexual function after starting Zoloft, it may not necessarily be a side effect of the medication. If your provider suspects the changes to be psychological, they may recommend therapy to help address the root of the sexual problem.
  • Stopping medication: In some cases, you and your provider may decide that it’s best for you to stop taking medication altogether. It’s important to work with your doctor or health care provider to stop the medication safely, otherwise you may be at risk of withdrawal symptoms, including nausea, vomiting, cramps, diarrhea, loss of appetite, and lightheadedness.

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When to See a Doctor

When starting any medication, it’s helpful to know what to expect.

If you’re starting Zoloft, experiencing some side effects within the first two weeks of starting the medication is completely normal. 

Though sexual side effects are possible when taking Zoloft, it’s also possible that sexual changes you experience are a symptom of your depression or anxiety, and not a side effect of the medication.

Keeping an open dialogue with your doctor or provider will help to identify the root cause of your sexual symptoms and how best to treat or mitigate these changes.

Additionally, you should reach out to your provider if you experience any of the serious side effects of Zoloft, including suicidal thoughts, worsening depression and anxiety, manic episodes, hallucinations, or severe physical side effects, or if Zoloft isn’t working to alleviate your depression or anxiety. 

How K Health Can Help

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Frequently Asked Questions

Can Zoloft permanently alter your libido?
No. The sexual side effects associated with Zoloft and other antidepressants resolve once you stop taking the medication. If you wish to stop taking Zoloft, make sure you speak to your provider, who can help you safely wean off the medication without experiencing withdrawal symptoms.
Will Zoloft make you last longer in bed?
Zoloft can cause a delay or difficulty in achieving orgarms, but it should not be taken for that purpose. A rare but possible sexual side effect of Zoloft is priapism, or a prolonged erection of the penis. Priapism is a serious side effect that can be painful and potentially cause permanent damage. If you experience an erection that lasts longer than 4 hours, seek medical attention right away.
Do all antidepressants have sexual side effects?
No, not all antidepressants have sexual side effects. Some examples of antidepressants with the lowest rate of sexual side effects include bupropion (Wellbutrin), mirtazapine (Remeron), and vilazodone (Viibryd).
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Sarah Malka, MD

Dr. Sarah Malka is a board certified emergency medicine physician with K Health. She completed her residency at Harvard Medical School.