Lexapro Side Effects in Women: Periods, Libido and When to Call
For women on Lexapro, the menstrual cycle and sex drive are where side effects can differ; the rest are mostly the same as for men. Here is what the FDA label, research and women on r/lexapro describe.
By withClaro Editorial · 2026-10-23 · 5 min read
Medical review pending. Written by the Claro editorial team from the FDA label and published studies.
Key takeaways What is different for women on Lexapro is the menstrual cycle and sexual side effects; nausea, trouble sleeping and sweating affect women and men alike. In the FDA trials, 3% of women on Lexapro reported a lower sex drive and 3% trouble reaching orgasm, against 1% or less on placebo. In 100 r/lexapro threads, changes to periods or PMS were what women raised most often. Escitalopram has also been studied as a treatment for premenstrual mood symptoms, so cycle-related mood can shift either way on it. On this page
What 96 women on r/lexapro said about side effects What are the most common side effects of Lexapro? Does Lexapro lower sex drive in women? Can Lexapro affect your period? Which Lexapro side effects pass, and when should you call? What should you tell your prescriber about Lexapro side effects? Where women on Lexapro (escitalopram) notice something different is around the menstrual cycle and in sex drive. Otherwise it causes mostly the same side effects in women as in men. Both are common reasons people quietly stop treatment, and both are worth a conversation first.
What 96 women on r/lexapro said about side effects
We read 100 recent threads on r/lexapro, comments included, about periods, PMS, sex drive and side effects, and 96 people wrote as women about their own experience. We picked threads about women's experiences, so these numbers show what women talk about, not how often each side effect happens. Our count did not separate cycle changes that got better from those that got worse, so it can't say how many found PMS easier.
Changes to periods or PMS were what women raised most: 41 of the 96. Another 15 described a lower sex drive or trouble reaching orgasm; the rest wrote about other side effects.
What women described Of 96 women Changes to their period or PMS 41 Lower sex drive or trouble reaching orgasm 15
Period changes took many forms: a period arriving early, a heavier flow, a missed period, or worse mood in the days before. One woman on r/lexapro wrote:
it’s a lot heavier than usual
Another described the sexual side of it:
It takes me a while to finish and a while to even "get going"
If your cycle seems to change, note the day of your cycle next to your mood and symptoms. After two or three cycles, you and your prescriber can see whether there is a pattern.
What are the most common side effects of Lexapro?
For most side effects, women and men are alike: nausea, trouble sleeping and sweating come up in both, and nausea is the most common early on. In the FDA trials for depression, 15% of adults on Lexapro had nausea, against 7% on placebo, and in the anxiety trials 18% against 8%. What women have on top of that is the menstrual cycle, and sexual side effects look different for them.
The NHS also lists headaches, sweating, dizziness, sleepiness or restlessness, trouble sleeping, weight and appetite changes, and a lower sex drive. Most ease after a couple of weeks, though some last longer. Note when a side effect started, so you can tell whether it is fading. Weight change is one that tends to stay, as covered in Lexapro and weight gain .
Most of these fade as the medication settles in, which usually takes a few weeks on Lexapro .
Does Lexapro lower sex drive in women?
It can. Across the FDA's placebo-controlled trials, 3% of women on Lexapro reported a lower sex drive, against 1% on placebo, and 3% had trouble reaching orgasm, against under 1%. In the anxiety trials, trouble reaching orgasm was 6% of women against under 1%. In the same depression trials, men reported sexual side effects more often, so the figures for women are small.
Trial numbers likely undercount it, since few people bring up sex unless asked, and the label says there are no studies designed to measure it. For some women these effects ease in the first weeks; for others they last while they take Lexapro. There is little data either way, which is a reason to raise it rather than put up with it or stop quietly. Whether to change the dose or the medication is a decision for you and your prescriber, so raise it early and say which part has changed.
Dose changes are your prescriber's call, and how Lexapro doses compare explains the usual range.
Can Lexapro affect your period?
Some women notice changes. A 2012 study of 1,432 women found period problems in 24.6% of those on antidepressants, against 12.2% of those who were not. The researchers judged about one in seven women on antidepressants had a period problem caused by the medication.
The study, from three centers in Turkey, relied on women's own reports. It grouped antidepressants together, so it gives no figure for Lexapro alone, but the drugs most linked to period problems were paroxetine, venlafaxine and sertraline, not escitalopram. In the FDA anxiety trials, menstrual disorder was reported by 2% of all participants on Lexapro against 1% on placebo; the label gives no separate figure for women.
Mood before your period can shift either way. Escitalopram has been studied as a treatment for severe premenstrual mood symptoms. A 2008 trial in 151 women gave it only in the two weeks before each period, not daily, for three cycles; 20 mg worked clearly better than 10 mg, though many women improved on placebo too. A small 2025 study of 27 women, on the same before-period schedule, found it eased premenstrual irritability and anger. Neither tested the daily Lexapro most people take, so they don't tell you what your cycle will do on it. Track symptoms by day of your cycle, so a pattern is easy to show.
Which Lexapro side effects pass, and when should you call? Clinical section: medical review pending
Some side effects fade within weeks, some tend to stay, and a few need a call the same day. Sorting them helps you decide whether to wait or speak up. The clinical view:
Most early side effects of antidepressants ease within the first weeks, while a few tend to last and are worth raising.
Side effects that often pass include nausea, an upset stomach, headache, sleep changes and feeling restless. Sexual side effects, weight change and feeling emotionally flat tend to stay while you take the medication. A change of dose or medication often helps with these, so mention them instead of putting up with them.
Call your prescriber the same day, or get urgent care, if you notice:
new or worse thoughts of suicide or self-harm, especially early on, after a dose change, or in young people agitation, heavy sweating, fever, muscle twitching or confusion, which can be signs of serotonin syndrome unusual bleeding or bruising a sudden burst of energy, little need for sleep, racing thoughts or unusual risk-taking What should you tell your prescriber about Lexapro side effects?
Tell your prescriber what you have noticed, when it started and how much it gets in your way. That helps them weigh waiting against a dose change or a different medication. It helps to tell them:
Which side effects you have, and when each one started. Any change to your period: timing, flow, spotting or a missed period. Whether mood or anxiety shifts on certain days of your cycle. Changes in sex drive or orgasm, even if it feels awkward. Any pregnancy plans or menopause symptoms. If you have thoughts of suicide or self-harm, call your prescriber the same day. In the US, call or text 988, or find a crisis line near you .
Download on the App Store Period changes and dips in sex drive are easy to forget by the time you see your prescriber. The withClaro app lets you log mood, energy, sleep and side effects each day, linked to your dose, and turns it into a report for your prescriber.
Frequently asked questions Can Lexapro make PMS worse? For some women, yes: on r/lexapro, worse mood in the days before a period was one of the cycle changes women described. If your worst days come before your period, track them for two or three cycles and bring that to your prescriber.
Can Lexapro affect your appetite? Yes, in either direction. In the trials, 3% of adults reported a smaller appetite, against 1% on placebo, and some people find appetite grows over months. Mention a lasting change at your next appointment.
How long does Lexapro fatigue last? Tiredness often eases within a few weeks as your body adjusts. If it lasts or gets in your way, ask your prescriber about the dose or the time you take it.
Can Lexapro cause a missed period? Some women report it, and studies link antidepressants with period changes. Other causes, such as pregnancy, need ruling out first. Tell your prescriber or doctor if your period is late or changes.
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Sources LEXAPRO (escitalopram) prescribing information, US Food and Drug Administration via DailyMed, revised April 2024 NHS. Side effects of escitalopram Uguz F, et al. Antidepressants and menstruation disorders in women: a cross-sectional study in three centers. General Hospital Psychiatry, 2012 NHS. Common questions about escitalopram 988 Suicide and Crisis Lifeline r/lexapro: Lexapro and periods r/lexapro: For many women on this sub, it's evident that Lexapro doesn't seem to help all that much with PMDD r/lexapro: Did anyone’s libido decrease after starting lexapro? r/lexapro: 24F dosage increase killing my libido r/lexapro: Lexapro for PMDD? r/lexapro: This is crazy Eriksson E, et al. Escitalopram administered in the luteal phase exerts a marked and dose-dependent effect in premenstrual dysphoric disorder. Journal of Clinical Psychopharmacology, 2008 Gröndal M, et al. The effects of intermittent escitalopram treatment on impulsivity and inattention in women with premenstrual irritability and anger. Psychological Medicine, 2025 Claro articles are for self-monitoring and educational purposes only. They are not a medical device, therapist, or diagnostic tool, and do not replace care from your prescribing clinician. If you are in crisis, contact your care team, emergency services, the Samaritans (UK: 116 123), or the Crisis Text Line (US: text HOME to 741741).