Lexapro Sexual Side Effects: How Common They Are and What Helps
Lower sex drive and delayed orgasm are the most common, with delayed ejaculation and erection problems in men, and they often don't ease without a change.
By withClaro Editorial · Medically reviewed by Dr. Jason Tan , Consultant Psychiatrist · 2026-11-09 · 9 min read
Key takeaways The most common Lexapro sexual side effects are lower sex drive and delayed or absent orgasm, plus delayed ejaculation in men. The FDA label's trial figures are low, and the label itself says they likely undercount the problem. In 90 Reddit threads about sex on Lexapro, more people still had the problem than said it eased. Sexual problems are common in depression before any medicine, so how sex was beforehand matters. A lower dose, a different medicine or an added one are options to discuss with your prescriber, without stopping on your own. On this page
How common are sexual side effects on Lexapro? Do Lexapro sexual side effects go away, according to people on Reddit? Was the psychiatrist right about Lexapro and sex? Is it Lexapro or the depression? Why does Lexapro affect sex drive, and can it increase it? How do you fix sexual side effects on Lexapro? What to tell your prescriber about sexual side effects on Lexapro The most common Lexapro sexual side effects are lower sex drive and a delayed or absent orgasm. Men may also have delayed ejaculation or weaker erections. In the trials in the FDA label, 12% of men had ejaculation problems, against 1% on placebo. The label adds that these figures likely undercount the real rate.
Anita Clayton, MD, is a psychiatry professor at the University of Virginia who studies sexual side effects of antidepressants. She discussed them on Psychiatric Times' Brain Trust podcast in September 2026. We checked her claims against the Lexapro label and clinical trials. Most hold up, and a few go further than the data.
How common are sexual side effects on Lexapro?
Women on Lexapro most often report lower desire and trouble reaching orgasm, while men most often report delayed ejaculation. The FDA label pools its placebo-controlled trials by sex. The gaps over placebo look small there, and the label says these figures likely undercount the problem, because patients and doctors may be reluctant to discuss sex.
Side effect Lexapro Placebo Women: lower sex drive 3% 1% Women: no orgasm 3% under 1% Men: delayed ejaculation 12% 1% Men: lower sex drive 6% 2% Men: erection problems 2% under 1%
Asking people directly gives much higher numbers. In a 2001 Spanish study of 1,022 people, SSRIs and venlafaxine affected 58% to 73%. That study covered fluoxetine, sertraline, fluvoxamine, paroxetine and citalopram, but not escitalopram.
A 2010 review put the range at 25% to 73% of people on an SSRI. In a 2009 meta-analysis, escitalopram raised the rate over placebo, while bupropion and mirtazapine did not.
Before your next appointment, write down which part changed: desire, arousal or orgasm. For more on the female side, see how Lexapro affects women in particular .
Do Lexapro sexual side effects go away, according to people on Reddit?
Most who said how it went still had them, but some said they eased on Lexapro
For most people who said how it went, the problem had not gone away while they were still taking Lexapro. We read 90 recent Reddit threads about sex on Lexapro, comments included. Between the posts and the replies, 267 people wrote about their own experience.
Of those 267, 215 said Lexapro affected their sex life, and 46 said sex was unaffected or better. Of 142 people who said how it went over time, 93 still had the problem on Lexapro. Another 37 said it eased without stopping the drug. People with a problem are more likely to post, so read this as what people shared, not how often Lexapro does it.
One person on r/lexapro wrote:
My libido was always pretty low, but being on lexapro has made it non-existent.
Another, also on r/lexapro, noticed a change after the first weeks:
I experienced this myself at the start of the treatment, but it seems to have stabilized now.
People could name more than one change, so the rows add up to more than 215:
What changed People, of 215 Lower sex drive 120 Delayed or no orgasm 101
If it has lasted more than a few weeks, raise it at your next appointment rather than waiting.
Was the psychiatrist right about Lexapro and sex?
Clayton was right on the big picture. Some of her numbers sit at the top of the range or rest on her own practice. She co-authored the vortioxetine trial and one of the bupropion trials in this table. She also said she once advised a bupropion maker.
What Clayton said What the research found Does it hold up? About 70% of people on SSRIs get sexual problems 58% to 73% when asked directly in 2001; 25% to 73% across studies in a 2010 review. The Lexapro label shows 2% to 12%, which the label says likely undercount Partly. 70% is the top of the range for SSRIs as a group About 70% of people with depression already have sexual problems before treatment, within 30% to 80% In vilazodone trials, half of men and two thirds of women had them before treatment. Many untreated people had lower interest in 1999 Yes in direction; 70% is near the top Standard antidepressants, especially SSRIs, add to sexual problems The label warns that SSRIs, including Lexapro, may cause them. SSRIs were above placebo in the 2009 meta-analysis Yes Serotonin is the strongest brake and overrides the dopamine and noradrenaline behind desire and arousal Serotonin nerve endings inhibit dopamine and norepinephrine pathways involved in desire and arousal Matches reviews; a working model, not measured in people Vortioxetine caused fewer sexual problems than escitalopram, even in people moved off another SSRI In 2015, 447 people with sexual problems on an SSRI were moved to one or the other for 8 weeks. Both groups improved, vortioxetine by 8.8 points against 6.6. Funded by its makers Yes, in one sponsored trial; the gap was small and sex improved on escitalopram too Bupropion doesn't just spare sex, it improves it No different from placebo in the 2009 meta-analysis. Helped as an add-on at the higher dose in a 2013 Cochrane review Partly. Sparing yes. We did not find her data on bupropion alone improving sex Bupropion can be added to an SSRI that works; 150 mg a day failed, 300 mg is needed Cochrane found 150 mg twice a day beat placebo, once a day did not. In her 2004 trial of 42 people, only desire and frequency improved. A 2011 trial in 218 women helped. That trial and a trial in men, later retracted, came from the same author, Safarinejad Partly. Once a day did not help. The benefit at the higher dose rests mostly on Safarinejad's trials Sildenafil helps arousal problems on an antidepressant, in women and men In men, 54.5% were much improved, against 4.4% on placebo. Women saw a small benefit in a 2008 trial. Cochrane found the effect unclear in women Yes for men; one trial with a small effect in women Birth control pills can lower desire; changing them cleared the problem in young women on SSRIs Most women on hormonal birth control notice no change in libido, a few notice less or more, in a 2012 review Partly, since it is true for some women. We found no study of the pill with SSRIs; the cases are her experience
Her main point was that antidepressants add to a problem many people already have. She said:
And then standard antidepressants can further contribute to sexual dysfunction, especially the SSRIs.
On bupropion she went further than the trials we found:
we certainly found improvements in sexual functioning with bupropion
Bring this table to your appointment if you want to ask about any of these options.
Is it Lexapro or the depression?
Often it is both, and women are more likely to start with a problem. In vilazodone trials, 68% of women and 50% of men had sexual problems before any treatment. A 1999 study looked at 134 people with depression and no medicine. Over 40% of men and 50% of women reported lower interest. The label's most common ones on Lexapro are delayed ejaculation in men, and lower desire and no orgasm in women.
For young women, she named another cause:
But even birth control pills can cause sexual dysfunction.
A 2012 review found most women on hormonal birth control notice no change in libido, while a few notice less.
Write down how sex was before the depression, before Lexapro and now, so your prescriber can tell the causes apart. Note whether the change is in desire or in orgasm and ejaculation. To compare Lexapro with other options, see which antidepressants have the fewest sexual side effects .
Why does Lexapro affect sex drive, and can it increase it?
Lexapro raises serotonin, and serotonin dampens sexual response. A 2010 review describes serotonin nerve endings that inhibit the dopamine and norepinephrine pathways involved in desire and arousal. This is a working explanation drawn from studies, not something measured directly in people on Lexapro.
Clayton described the effect this way:
So if your serotonin is really up and really inhibiting, you're really going to have a problem all the way through because you won't really have the same level of arousal and pleasure.
One man on r/lexapro said his sex drive went up as performance anxiety eased. He wrote:
If anything, it increased my sex drive. I think any performance anxiety I had without the medication subsided
Others on r/lexapro said their desire came back as their mood lifted. One of them wrote:
I had zero sex drive before and lexapro seems to be bringing it back because I just feel better over all I guess.
If your desire rises or drops sharply, note the date and your dose, and mention it at your next visit.
How do you fix sexual side effects on Lexapro?
Most of the options studied keep you on an antidepressant rather than stopping it. Don't skip doses or stop Lexapro on your own, because the label warns that stopping suddenly can cause withdrawal symptoms. The 2013 Cochrane review found no trials of drug holidays.
Sexual side effects are common with many antidepressants and often do not ease on their own, so they are worth raising.
They include lower desire, difficulty with arousal, and delayed or absent orgasm. Depression itself also lowers desire, which can make the cause hard to pin down.
Your prescriber can discuss a lower dose, a medication less likely to cause them, or an added treatment. For most people sexual function returns after stopping. If it does not, tell your prescriber.
Medical review Medically reviewed by Dr. Jason Tan, Consultant Psychiatrist, on 27 October 2026, this section only. Next review: 27 October 2027.
Trials back some of these options. In a 2015 trial that compared a move to vortioxetine with escitalopram, vortioxetine did slightly better. As an added medicine, bupropion helped only at the higher of the two doses tested in the Cochrane review.
For men with erection problems, sildenafil helped in a 2003 trial, and Cochrane found the same for sildenafil and tadalafil. In women, the evidence for sildenafil is weaker. Ask your prescriber or pharmacist before adding anything, and list every medicine you take. If bupropion comes up, see what taking Lexapro and Wellbutrin together is like .
What to tell your prescriber about sexual side effects on Lexapro
Your prescriber can only weigh sex against your mood if they know what changed and when. You can bring it up first. These points give your prescriber what they need to pick an option:
Which part changed, whether desire, arousal, erection or lubrication, orgasm or ejaculation. How sex was before Lexapro, and before the depression if you remember. The week it started and the dose you were on. Whether Lexapro is helping your mood or anxiety. Your birth control, blood pressure medicines and anything else you take. What matters most to you to keep, and whether you would rather lower the dose, change medicine or add one. The withClaro app has a daily check-in for mood, energy and sleep, and tracks side effects against your dose. Your entries become a report you can share with your prescriber. Add a short note on sex, so the timing is clear at your visit.
Download on the App Store Sexual side effects are easier to raise when you can show when they started and on which dose. The withClaro app lets you log mood, energy and sleep each day, track side effects against your dose, and share a report with your prescriber.
Frequently asked questions Is ED from Lexapro permanent? The label lists erection problems in a small share of men in its trials. If they continue on Lexapro or after stopping, tell your prescriber. Note when it started and on which dose, and ask about a change or an added treatment.
Is it normal to have difficulty ejaculating while taking Lexapro? It is the most common sexual side effect in men in the label's trials, and it is mostly a delay in ejaculation. Tell your prescriber if it bothers you, and say whether desire changed too.
Does Lexapro have fewer sexual side effects than Zoloft? We found no head-to-head trial. Escitalopram and sertraline were both above placebo in the 2009 meta-analysis. If one SSRI affected you, ask your prescriber whether a drug from another group fits better.
Can a lower dose of Lexapro help sexual side effects? A lower dose is one option your prescriber can discuss. Don't cut the dose yourself. Ask your prescriber whether a lower dose would still control your symptoms.
How to increase sex drive when on antidepressants? Start by finding out whether the drug, the depression or something else is behind it. Then ask your prescriber about the dose, a different medicine or an added one.
Related articles
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