Post-SSRI Sexual Dysfunction Treatment: What Doctors Try

There is no approved treatment for PSSD yet. Doctors treat each symptom on its own, and some people improve over months.

By withClaro Editorial · Medically reviewed by Dr. Jason Tan, Consultant Psychiatrist · 2026-11-09 · 10 min read

Post-SSRI Sexual Dysfunction Treatment: What Doctors Try

Key takeaways

No FDA-approved treatment for PSSD exists, so doctors treat erection, desire and orgasm problems one at a time.
Erection pills and bupropion have the best evidence for sexual side effects while people are still on an antidepressant. Neither has a controlled trial after stopping.
Sexuality educator Sue Goldstein's main points hold up. Her claims about scarred erectile tissue go beyond published evidence.
In 93 Reddit threads, far more people said their symptoms stayed after stopping than said they lifted. People who stay unwell post more.
Bring a dated list of symptoms to your appointment, and ask for a referral to a sexual medicine specialist.

There is no approved post-SSRI sexual dysfunction treatment yet, so doctors treat each symptom on its own. Erection problems, low desire and weak orgasm each have options borrowed from other conditions. None has been tested properly in PSSD, though some people describe improvement over months.

Sue Goldstein discussed PSSD in a March 2024 episode of the Sex and Psychology Podcast, hosted by social psychologist Dr. Justin Lehmiller. She is a sexuality educator and clinical research manager at a sexual medicine clinic in San Diego. She is not a doctor, and says so in the episode. We check her claims against FDA labels and published studies, and add what people on Reddit said about their own course.

PSSD stands for post-SSRI sexual dysfunction. Under criteria an international group published in 2022, the core sign is changed genital sensation after stopping an SSRI or SNRI. The problem has to last at least three months after the last dose. Lower desire, erection problems and weaker orgasm often come with it.

Is there a treatment for post-SSRI sexual dysfunction?

A 2026 review in the International Journal of Risk & Safety in Medicine looked at the research on treating PSSD. So far it consists of case reports and small open studies without a placebo group. The largest treatment series we found followed 13 men in Italy.

That 2022 study looked back at men treated mostly with vortioxetine, itself a serotonin-acting antidepressant, often alongside supplements. Three men took bupropion, with mixed results. Most improved on an erectile function score over 12 months, but there was no comparison group. The authors write that no effective treatment is available yet. Goldstein described what her clinic does instead:

You just have to go after each symptom because we can't treat the PSSD per se.

Before an appointment, write each symptom on its own line, since each one may be treated differently.

What do doctors try for each PSSD symptom?

Doctors borrow treatments that help sexual side effects while a person still takes an antidepressant, or that help other sexual problems. Erection pills, bupropion and two desire medicines approved for women are the main ones. None has a trial in people whose symptoms continued after stopping, so the evidence comes from other groups.

Approach	Where the evidence comes from	Tested in PSSD?
Sildenafil or tadalafil	Men with erection problems while on an antidepressant	No
Bupropion	People with sexual side effects while on an antidepressant	Only in three men in one small series, with mixed results
Flibanserin or bremelanotide	Women with low desire not caused by a medication	No
Low-intensity shockwave therapy	Men with ordinary erectile dysfunction	No

For women

For women, the evidence is thinner than for men. Flibanserin (Addyi) and bremelanotide (Vyleesi) are approved for women with acquired low desire. Both labels exclude low desire caused by a medication, so using them for PSSD is off label. Bremelanotide works on melanocortin receptors in the brain, not on serotonin and dopamine.

A 2013 Cochrane review looked at women with sexual side effects on an antidepressant. Bupropion at higher doses was the most promising option studied, while the benefit of sildenafil was unclear. Goldstein says her clinic also checks hormones in women. Ask your doctor about a referral to a gynecologist with sexual medicine training.

For men

For men, the best evidence is for erection pills called PDE5 inhibitors. In the 2013 Cochrane review, sildenafil and tadalafil beat placebo for men with erection problems on an antidepressant. Goldstein's clinic uses a daily low dose of tadalafil. Her clinic also gives flibanserin or bremelanotide to men, although neither label covers men.

Another option she named is low-intensity shockwave therapy. A 2026 abridged Cochrane review of 21 trials found it may slightly improve ordinary erectile dysfunction, with low certainty. Men whose erection problems came from a medication were left out of that review. A urologist with sexual medicine experience can say which options fit your case. For how bupropion compares with other antidepressants, see sexual side effects of Wellbutrin.

How well do Sue Goldstein's PSSD claims hold up?

Most of her main points hold up, and the condition itself is recognized. The US label for Prozac says sexual problems occasionally persist after stopping. Her claims about specific treatments and tissue damage go further than published evidence. Several rest on her own clinic's data, which has not yet appeared as a full paper.

What Goldstein said	What the research found	Does it hold up?
There is no treatment for PSSD itself, only for each symptom	No FDA-approved treatment exists. The largest treatment series had 13 men and no control group	Yes
Flibanserin and bremelanotide act on serotonin and dopamine, are approved for women and can be given to men	Both are approved only for women. Flibanserin acts on serotonin and dopamine receptors, bremelanotide on melanocortin receptors	Partly. The mechanism is right for flibanserin only. For men and for PSSD, use is off label
Daily tadalafil helps erections	Sildenafil and tadalafil beat placebo in men with erection problems while on an antidepressant	Partly. Tested on the drug, not after stopping
Low-intensity shockwave therapy turns on stem cells and regenerates erectile tissue	For ordinary erectile dysfunction, a slight benefit with low certainty	Not shown for PSSD
Sexual side effects don't always go away once you stop	The Prozac label says they occasionally persist after stopping	Yes, though it is uncommon
PSSD is not in the ICD-10	A definition and a coding term exist, but regulators have yet to adopt them	Yes, as of 2026
Young men with PSSD have erectile tissue like men aged 65 to 70	A 2025 conference abstract from her clinic on 43 men found ultrasound changes similar to older men	Partly. One clinic, no full paper, and we found no mouse study
PSSD is a biological change, not the old problem returning	The 2022 criteria require normal sexual function before the drug. The mechanism is unknown	Plausible, not established
No one knows how common it is, and women are likely affected as often	The rate is undetermined. Reports come from about three times as many men as women	First half yes. The second is her opinion
There is no link to dose, and it has followed seven days of use	Reports include people who took a drug for under two weeks	Partly. No study has tested dose

Her strongest point is that stopping does not always end the problem. She put it this way:

everyone assumes once you're off the medication, those side effects go away. And that is a fallacy.

On dose, published reports back the short exposures she describes. In a 2018 analysis of 300 reports, 15 people had taken an antidepressant for under two weeks. Whether a higher dose or longer use raises the risk has not been studied. She said:

There is no dosage relation. We have seen patients who took it for seven days. We've seen patients who've been on it for 10 years.

Several of her points rest on what her own clinic has seen. Ask any specialist how they measure improvement and what results they have seen in PSSD.

Does PSSD go away, according to people on Reddit?

Most people who described life after stopping said the symptoms stayed

We read 93 recent threads on r/PSSD, r/antidepressants and the subreddits for single drugs, comments included. Between the posts and the replies, 196 people wrote about their own sexual function on an SSRI or SNRI. Of those who said what happened after stopping, far more said the problems stayed than said they lifted.

What happened over time	People
Still there after stopping	57
Went away after stopping	16
Still there, still on the drug	12
Eased while still on the drug	8
Didn't say	93

The table covers the 186 people who described a sexual side effect. Each person counts in one row only. People whose symptoms don't lift are more likely to post on r/PSSD, so threads like these lean toward the hard cases. Not everyone counted here would meet the formal PSSD criteria, which need three months or more after stopping.

Lower desire was the most common complaint, named by 82 of the 186. Genital numbness and delayed or absent orgasm came next, with 43 people each, and erection problems with 30. Another 7 people said their sex life was unaffected or even better.

Recovery after stopping did come up. One person on r/antidepressants, replying in a thread about genital numbness on Zoloft, wrote:

No, I had genital numbness and stopped taking it and mine came back after about 2 months

For others it has lasted years. One person on r/PSSD wrote:

I’ve been dealing with PSSD for 15 years with no improvement.

Only 34 of the 186 named anything that helped, and no single approach stood out. If your symptoms began on an antidepressant, note when each one started and whether it changed after stopping. That timeline is what a specialist will ask for first.

Is PSSD permanent?

No one can say yet, because no study has measured how often or how fast PSSD lifts. The 2022 criteria require symptoms for at least three months after stopping and set no upper limit. In the 2018 analysis of 300 reports, 17 people said symptoms had lasted 10 years or more. That count covers antidepressants and two other drug groups.

Improvement after many months does get reported. One person on r/PSSD wrote:

After eleven months feeling in genitals came back.

The same person wrote that the numbness returned after their doctor advised going back on an antidepressant.

Because no one can predict your course, keep a dated note of each symptom. Slow changes over months are easier to see on paper than from memory.

How common is PSSD, and does it affect women?

No one knows the true rate, and the few estimates differ widely. A 2023 Israeli study of men aged 21 to 49 put the risk at about 1 in 216 men treated with these antidepressants. It counted only men whose erection problems led to a prescription for an erection pill, so it misses other symptoms.

A 2025 survey covered sexual and gender minority youth in the US and Canada. It found lasting genital numbness in 13.2% of past antidepressant users. That group is not typical, and the survey relied on self-report.

Data on women is scarce. In the 2018 analysis of reports, 170 men and 49 women had taken an antidepressant. Goldstein believes women are affected as often but seek help less. We found no study that compares the two, and she was frank about the gaps:

So I don't think we really have any idea how common it is, because as I say, we are a unique clinic and we're seeing this population.

If you are a woman with these symptoms, name them plainly at your appointment. Ask for a gynecologist with sexual medicine training if your doctor has none.

What if sexual side effects started while you're still on an antidepressant?

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.

How often this happens depends on how people are asked. In a 2001 Spanish study of 1,022 people asked directly, rates on SSRIs and venlafaxine ranged from about 58% to 73%. When you raise it, say which part changed and when it started. For how this plays out on one common drug, see sexual side effects on Prozac.

What should you tell your prescriber about sexual changes after stopping?

Specifics help a doctor take PSSD seriously and choose the right referral. Goldstein and host Justin Lehmiller note that some psychiatrists put these symptoms down to a problem the person had before, or to depression returning. The 2022 criteria require normal sexual function before the drug. A clear before-and-after timeline helps separate those from a change that started with the medication.

It helps to tell them:

Which antidepressant you took, the dose and for how long.
When you stopped, and whether you stopped at once or gradually.
How sex worked before you started, including morning erections or natural lubrication.
What changed and when: desire, arousal, erection or lubrication, orgasm, pleasure.
Any genital numbness, named on its own, since it is the core sign in the 2022 criteria.
Other changes, such as feeling emotionally flat or thinking more slowly.
What you have tried already, and what happened.
A request for a referral to a urologist or gynecologist with sexual medicine experience, and to a sex therapist.

Long-lasting sexual problems can weigh heavily on mood. If you're having thoughts of harming yourself, contact emergency services or a crisis line straight away. In the US, call or text 988. In the UK, call Samaritans on 116 123. Elsewhere, find a crisis line near you.

Short daily notes show a pattern that memory tends to blur, especially over months. The withClaro app tracks side effects over time and turns the record into a report for your doctor.

Download on the App Store Sexual changes after stopping an antidepressant can shift slowly, and dates matter to a specialist. The withClaro app lets you log mood, energy, sleep and appetite each day, track side effects and share a report with your doctor.

Frequently asked questions

Does Wellbutrin help PSSD?

It has not been tested properly in PSSD. Bupropion, sold as Wellbutrin, helped some people with sexual side effects while they were still on an antidepressant. In a small 2022 series of men with PSSD, three took it and results varied, with no comparison group. Ask your prescriber whether it suits your symptoms and your mood.

Can PSSD happen after one pill?

Reports suggest very short exposure can be enough. The 2022 criteria say PSSD may follow exposure as brief as several days. A 2018 analysis included a report after a single dose. If you stopped early and still have symptoms after three months, raise them with your doctor.

Do supplements help PSSD?

Supplements have only been tried in one small 2022 series of men with PSSD, alongside other treatments and with no comparison group. Show your pharmacist the label of anything you plan to take before you start it.

Are sexual side effects worse on SNRIs than SSRIs?

Not clearly. In the 2001 Spanish study, the rate on venlafaxine, an SNRI, was about the same as on SSRIs. If sexual side effects matter to you, ask your prescriber which medications are less likely to cause them.

Can you prevent PSSD?

No tested way exists, because the cause is not known. Before starting an antidepressant, ask about sexual side effects. If they appear, tell your prescriber early rather than waiting.

Is PSSD real?

Yes, it is recognized, though how often it happens is unknown. The 2022 criteria describe it in detail. If a doctor dismisses your symptoms, bring your timeline and ask for a sexual medicine referral.

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Sources

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).

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