Antidepressant medications can be life-changing and play an important role in supporting mental and sexual wellbeing, especially when used alongside other therapeutic interventions like talk-based therapy.

For many people, selective serotonin reuptake inhibitors (SSRIs) reduce symptoms of depression and anxiety, helping them reconnect with daily life. But like all medications, SSRIs can have side effects — and these are not always discussed at the time the medication is prescribed. One of the most common, and most distressing, is difficulty with sexual functioning.

This can affect anyone, but this blog will focus on men and penis-owners. They frequently report challenges with erections when taking SSRIs. This can feel confusing and even shame-inducing. You may wonder: “Is this me? Is it my relationship? Or is it the medication?” Your body and mind may suddenly not respond in the way they used to. The good news is: you’re not alone and understanding the role of SSRIs can help you find the right path forward.

Why SSRIs Affect Erections

Erections are not just about the genitals — they are a mind–body response involving the brain, hormones, nervous system, blood flow, and psychological state. SSRIs work by increasing serotonin in the brain. While this helps regulate mood, higher serotonin can also:

Dampen dopamine activity – Dopamine is a key “reward” neurotransmitter linked to arousal, motivation, and pleasure. Less dopamine signalling can mean less sexual excitement.
Interfere with nitric oxide pathways – Nitric oxide helps blood vessels relax, allowing more blood flow into the penis. SSRIs can disrupt this, leading to softer or shorter-lasting erections.
Delay orgasm and ejaculation – Many people experience longer time to orgasm (sometimes called delayed ejaculation) or difficulty reaching orgasm at all.
Reduce genital sensitivity – Some report feeling “numbness” or reduced arousal, which makes it harder to become or stay erect.

Psychological and relational layers

Medication side effects don’t happen in isolation. They can interact with other biopsychosocial factors, such as:

Anxiety about performance – Worrying about losing an erection often makes it harder to sustain one.
Mood changes – While SSRIs lift depression, they can also flatten emotional intensity, which may spill into sexual experiences.
Relationship dynamics – If sex becomes stressful or avoided, partners may feel disconnected, which further reduces arousal.
Self-esteem – Struggles with erections can affect confidence and lead to withdrawal from intimacy.

Ways SSRIs can also support erections

It’s important to remember that not all the effects of SSRIs are negative. For some people, improving mood and stabilising mental health can actually create positive flow-on effects for sexual connection, including:

Feeling more able to relax and connect – reduced anxiety can open more space for intimacy.
Greater self-acceptance and confidence – when mood improves, body image and self-esteem often do too.
Fewer negative thoughts – less rumination can mean fewer distractions during sex.
Less trauma activation – emotional regulation can make it easier to feel safe in intimate moments.
More capacity to express needs and wants – reduced distress can create room for clearer communication.

What can help

If SSRIs are affecting your erections, you don’t have to suffer in silence. There are options:

Talk to your prescribing doctor – Never stop or adjust medication on your own. A doctor can review dosage, timing, or explore alternatives (such as switching to a different antidepressant with fewer sexual side effects).
Therapy support – Psychological support can help address performance anxiety, rebuild confidence, and find new ways of connecting sexually.
Explore other forms of intimacy – Focusing only on penetration and erections can create pressure. Pleasure, connection, and closeness can be found in many other ways.
Lifestyle factors – Exercise, sleep, reducing alcohol, and stress management can all support erectile function.

Final thought

If SSRIs are affecting your erections, it doesn’t mean something is wrong with you — it means your body is responding to a medication that changes brain chemistry. This side effect is common, valid, and an opportunity to get to know your body’s new way of functioning.

The first step is recognising it and reaching out for support. With the right medical advice, therapeutic strategies, and relational care the next chapter of pleasure and mental wellbeing will emerge.

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