I have a problem climaxing while on anti-anxiety meds

February 8, 2006 9:43 AM

Having a problem climaxing while on anti-anxiety meds. Any suggestions?

I have tried various anti-anxiety medications and I always seem to have a problem climaxing while having sex with my fiance. Once I am off them it returns to normal in a few days but then I have panic attacks again. Naturally my fiance thinks its her fault and is upset. The other day we went for over an hour and while she climaxed five times, I got nothing. I often come extremely close. I am at the top the hill but rather than plunging down I slowly cost. I can still climax when I, um, touch myself but I believe that is becasue I can adjust what I am doing very specifically in a way that is not possible while having sex.

So....any suggestions? New positions (we have tried the usual)? Different meds (I have tried Zoloft, Celexa, Xanax, Prozac)? Please help...

posted by anonymous to health & fitness (18 comments total)

Just to be clear, you're unable to climax with any of the meds you listed? It's unusual for the side effects to be that consistent over a spectrum of drugs.

In any case I have no direct suggestions for you, other than to search around the web using the (rather unfortunate) medical term "ejaculatory incompetence".
posted by tkolar at 9:56 AM on February 8, 2006

When I was on Paxil (for a year, a few years back) I couldn't come at all -- didn't try the other drugs you mention. Sex was still nice though. Afaik it's a frequent side effect so reassure your gf and remind her of the benefit to her of you lasting and lasting...
posted by anadem at 10:11 AM on February 8, 2006

remind her of the benefit to her of you lasting and lasting...

I doubt she needs reminding...
posted by alby at 10:35 AM on February 8, 2006

Couple suggestions:

1. Perhaps you can teach your fiance to, ahem, touch you in a way makes you climax?

2. Next time you see your doctor, ask if it's feasible for you to take Wellbutrin (I forget its generic name) as well as what other med you are on. A friend of mine had the same problem as you, and his doc prescribed Wellbutrin to counter the sexual side effects of the other med he was taking.

Good luck!
posted by luneray at 10:44 AM on February 8, 2006

That is, as tkolar pointed out, a weird cross-section of drugs to have exactly the same symptoms with. Prozac's an SSRI, Xanax is a tranq, etc. Is it possible that you had these effects with one medication, and now it's psychosomatic? (Yes, I understand, makes no practical difference in terms of what's happening, but makes a huge difference when it comes to treatment).

And, uh, maybe I'm a total pervert, but... why can't you just masturbate to orgasm, while your fiancee watches, and participates in other ways? Also, have you explained to her that it's not her fault? The very fact that you have no problem when you're off the meds should scream that loud and clear to her. This is something she needs to understand, otherwise you're going to be left spending all your time trying to reassure her, rather than actually dealing with the issue.

Have you discussed this issue with your physician and your shrink (if they're different people)? If not, you should. They may be able to find a different medication to combat your anxiety, or try lower doses of existing meds.

IANAD, btw.
posted by dirtynumbangelboy at 11:14 AM on February 8, 2006

All those drugs you listed, with the exception of Xanax, are SSRIs, which usually have sexual side effects. You need a different class of drug...Wellbutrin, Effexor, and Remeron are less likely to cause sexual side effects. Surprisingly, you can take Wellbutrin with you current medication and for many people, it negates the sexual side effects of the SSRIs.

Disclaimer: I'm not a doctor, but I've tried them all these medications in addition to the ones you mentioned.
posted by lunalaguna at 11:17 AM on February 8, 2006

Serzone is another drug less likely to cause sexual side effects. You have many options.
posted by lunalaguna at 11:21 AM on February 8, 2006

Another one for wellbutrin, which has no sexual side effects. I am not sure how it is for anxiety though.
posted by _zed_ at 11:30 AM on February 8, 2006

You can try having sex before taking your med.
posted by semmi at 12:02 PM on February 8, 2006

I've been in this situation from the girl's side. More than once, actually. (More than one boy; boys changing meds.)

You need to sit down and talk to her. NOT in the bedroom. Explain that it's not her, it's the meds. Tell her that you need some different stimuli to climax; that standard penetrational intercourse isn't enough. Really, if you're sleeping together, she should know that by now. All of my boys were very clear about what might/might not happen before we got into bed the first time.

Show her how you touch yourself the next time you're in bed. Ask her to help you. I asked one boy to show me how he did it, then I did it for him. (The look on his face...but I digress.) She will need to be willing to use her hands (and maybe her mouth) on you. Penetrational intercourse is the ideal, but it's no-one's "fault" that you (or she) don't actually climax during it.

Note: I'm good at what I do, and it often takes a few tries for me to be able to "get through" the meds. It may take practice for her to be able to get you to climax. It may take even longer for the both of you to get to the point where you can climax while inside her. You may never get to that point. That's OK.

Another approach is to talk to your doctor. See if you can try a slightly lower dose of the meds, one that will control the anxiety but still allow for climax.
posted by jlkr at 12:20 PM on February 8, 2006

Serzone is another drug less likely to cause sexual side effects. You have many options.

Just fyi, Serzone (as a brand name) has been taken off the market, but its generic (nefazodone) is still available for the time being. I've been on Serzone/nefazodone for years and have had very little by way of side effects.
posted by scody at 12:28 PM on February 8, 2006

LunaLaguna is right (from my experience). I was on Lexapro 10 mg with nearly zero sex drive. My doctor added 150 mgs of Wellbutrin per day, and in less than a week, I was back in business. Unfortunately, after a few weeks, the Wellbutrin started triggering my anxiety again. I found that taking the Wellbutrin every 2 days created a nice balance. Though I'm not sure this is medically sound advice, it worked for me.
posted by TG_Plackenfatz at 12:34 PM on February 8, 2006

It's called anorgasmia and is a dirt-common problem with brain-meds.

Based on my experience, I say "enjoy it." With a bit of practice (and perhaps a bit of pot) you'll find that instead of the male single-emptying-orgasm, you can get female omg-it-never-ends! orgasms.

I can completely understand why it's bothering you: the cumshot is one helluva thing. But the trick is to understand that it isn't the only thing: multiple orgasm is one helluva thing in its own right. They're vastly different, yet equally satisfying in their own way.

And the best reason for learning to love it: your partner is going to have the most incredible sex ever in her life.
posted by five fresh fish at 12:38 PM on February 8, 2006

Some degree of sexual dysfunction with SSRI's seems to be damn near universal. Unfortunately, it's something that behavioral measures are hard-pressed to alleviate much.

However, there are plenty of pharmacological tricks that can help. Although bupropion (Wellbutrin) is widely used for SSRI sexual dysfunction, the fact that you are using medication for anxiety, rather than depression, makes Wellbutrin a less attractive choice. It is a stimulating antidepressant and lots of people experience greater anxiety while taking it. The same problem exists with Ritalin, which is another common adjunct med. for sexual dysfunction. Remeron might be a decent choice.

Additionally, buspirone (BuSpar) (another drug for anxiety) and cyproheptadine (Periactin) (antihistamine) are meds that help a significant number of people with your problem, and have the added benefit of being unlikely to aggravate your anxiety.

There are a few other things that work for some people--talk to your psychiatrist (or whoever is managing your medication) to see whether a new medication, alone or with an SSRI, would be useful. Believe me, it's an incredibly common problem, and your doctor will have heard it all before and will have a variety of things to try.
posted by feathermeat at 1:01 PM on February 8, 2006

what I have done in your place:
- done the deed before taking the medication
- dropped the dosage by 5-10mg for the day in question (requires advance notice of gettin' freaky)
- taken half the dosage before the deed and half later (if you think there might be a chance of humpin)
- skipped for a day
- held my breath while doing the deed (works sometimes)

all of these have worked for me to various degrees on SSRIs. They may not all be medically advisable, but if you're into self-medicating... a doctor did tell me that skipping a day really made no overall difference, though you might feel a little different for the day. I would agree in my case.
posted by baklavabaklava at 1:45 PM on February 8, 2006

It sounds like you're definitely having miscommincation issues. I mean, c'mon, what reasonable person wouldn't be understanding of your situation? If she's blaming it on herself it sounds like she is having some of her own issues that aren't really your responsibility.

The only suggestion I can give is to try moving in different ways. If you can climax at all on the meds, then I think there is hope.... Maybe you can ask her to like, let you take over for a session or three to experiment in using her like you would use your hand. Heh, I'm not suggesting doing it this way forever, but just a few times until you get used to moving differently. It seems to me that a lot of guys might shortchange their ability to experience pleasure because they're soooo into pleasing the woman that that is sort of the #1 priority, whereas their own pleasure is either kind of vicarious or #2. Not to sound overly graphic I guess, but you can try shallower thrusts at different angles, circling (like around the vaginal walls), variations of combinations of shallow and deep thrusts... I don't know exactly what works for you, but it might be worth a try.
posted by mojabunni at 6:32 PM on February 8, 2006

A very similar question was asked a couple of years ago.

As the lady in question in the previous thread, I might have more to say, but first I will go to sleep.
posted by librarina at 10:38 PM on February 8, 2006

You can try having sex before taking your med

This only works on drugs that don't build up in your system.
posted by weirdoactor at 12:49 PM on February 9, 2006