“Let’s Talk About Sex, Doc”: How to Bring Sexual Concerns to a Psychiatrist

This blog post was reviewed and approved for publication by Abena Apraku M.D., a Board-certified psychiatrist at Apraku Psychiatry.

Sex can be wonderful - but things don't always go to plan. One potential obstacle to sexual wellness can be psychiatric medications. While such medications have the power to be life-changing, they can also carry side effects, including sexual ones. Managing these side effects is crucial to effective treatment, and the first step is to have a conversation with a psychiatrist.

​So it's time to talk about sex! And to warm things up, let's start with a little sing along to that famous tune by Salt-N-Pepa:

Let's talk about sex, baby
Let's talk about you and me
Let's talk about all the good things
And the bad things that may be
​

Why It's Important to Discuss Sexual Side Effects of Psychiatric Medications

Mental health medications can be life-changing, helping individuals manage symptoms that otherwise interfere with daily activities, work, and relationships. By reducing symptom intensity, medications promote stability and control, allowing patients to participate more fully in their lives.

At the same time, healthy sexual expression is an essential aspect of many people's lives and an integral part of their mental health. So here's the dilemma: psychiatric medications can come with side effects, and that can sometimes include sexual ones.

Sexual side effects are often unreported due to a lack of awareness or inhibitions discussing sex. Some patients may not realize that their medication is causing sexual side effects or may feel uncomfortable raising concerns with their psychiatrist. Others may fear that changing medication may lead to symptom relapse.

Proactively discussing sexual side effects with your psychiatrist is important to mitigate potential risks while maximizing the benefits of treatment. By being aware of potential sexual side effects, individuals can address concerns early on, enhancing treatment outcomes and improving overall quality of life. So take control of your mental health and sexual well-being, and don't hold back!

Key Points on Discussing Sexual Side Effects with a Psychiatrist

• Mental health medications can have sexual side effects that often go unreported
• Preparing to talk about sexual side effects can make the conversation more productive
• Treatment options for mitigating sexual side effects include medication adjustments and therapeutic interventions
• Open and honest communication with your psychiatrist is crucial to address sexual side effects and enhance overall quality of life

Understanding Sexual Side Effects of Psychiatric Medications

Are you interested in learning more about sexual side effects related to psychiatric medications?

Sexual side effects can be quite common among individuals taking psychiatric medications. These side effects may include decreased libido, difficulty achieving or maintaining an erection, difficulty achieving orgasm, and decreased vaginal lubrication. However, these side effects can often be effectively managed with the help of your psychiatrist.

Various types of medications used to treat mental health conditions can cause sexual side effects. These may include antidepressants (such as SSRIs, SNRIs, TCAs, and MAOIs), antipsychotics, mood stabilizers, and anxiety medications (such as benzodiazepines). Knowing this can help you be aware of the potential side effects you may experience while taking these medications.

While the exact cause of sexual side effects is not fully understood, it is thought to be related to the medications' effects on neurotransmitters in the brain, such as serotonin and dopamine. Additionally, some medications (such as female oral contraceptives) may also affect hormones, such as testosterone. Other non-pharmacological factors include anxiety, depression, and relationship problems.

By discussing these concerns with your psychiatrist, you can work together to find the best treatment options that minimize side effects while maximizing mental health benefits. The first step is to raise your concerns with your psychiatrist.

Preparing to Talk About Sex

Talking about sexual side effects can be challenging, but preparing for the conversation can help make it more productive. Here are some strategies for preparing to discuss sexual side effects with your psychiatrist.

• Identify Your Emotional Response: Before discussing sexual side effects with your psychiatrist, reflect on your emotions surrounding the issue. Are you feeling embarrassed, frustrated, or anxious about the conversation? Consider writing in a journal to process your emotions. Acknowledging and understanding your emotional response can help manage feelings, allowing you to approach the conversation with a clearer mindset and increased self-awareness.
• Write Down Your Specific Concerns: Consider composing a detailed list of sexual side effects that you are experiencing. Describe each side effect and its frequency, severity, and any changes over time. Reflect on the impact these side effects may be having on your daily life, relationships, and emotional well-being. Have you attempted any coping strategies, and have they worked? By creating a comprehensive list, you will be more confident discussing sensitive topics with your psychiatrist and provide them with the necessary information to offer appropriate guidance, support, and expertise.
• Address the Issue Gradually: To ease into the discussion of sexual side effects during your appointment, consider starting with general symptoms before moving to specific concerns. This approach can make the conversation less intimidating and help you feel more at ease. For example, while it’s totally fine to say “I’ve been having a hard time with reaching orgasm”, one can also say "I'm experiencing difficulty reaching a climax" or even "sex has been less enjoyable for me lately."
• Utilize Written Communication: If you're still uncomfortable discussing sexual side effects verbally, consider messaging your psychiatrist with your concerns. This method allows you to take your time and carefully craft your message without the pressure of an in-person conversation. Be sure to mention that you would like to discuss the issue further during your next appointment. By providing your psychiatrist with a written account of your concerns, they will have the opportunity to prepare for the conversation and offer expert guidance and support.

By using these strategies, you can provide your psychiatrist with necessary information and receive expert guidance and support.

Treatment Options for Mitigating Sexual Side Effects

Medication adjustments may help alleviate sexual side effects. Examples of adjustments may include reducing the dosage of a medication likely to cause sexual dysfunction, switching to a medication with milder side effects, or adding a medication to counteract the side effects. Alternative treatment options may include supplements like SAM-e, Maca root, ginseng, or gingko biloba. Discuss the potential benefits and risks of each treatment option with your psychiatrist to determine the best approach for your specific needs.

Therapeutic interventions can help mitigate sexual side effects of psychiatric medications. Behavioral therapy, couples therapy, and cognitive-behavioral therapy (CBT) may address underlying psychological factors that contribute to sexual dysfunction, such as anxiety or depression. Therapy can also introduce techniques to improve sexual function and increase sexual arousal.

Treating sexual dysfunction caused by psychiatric medications is not a one-size-fits-all approach. Finding the right treatment that works for you may take time and patience. Crucially, open and honest communication with your psychiatrist is key in this process. Together, you can establish a treatment plan that enhances your overall quality of life.

Conclusion: Discussing Sexual Side Effects

Discussing sexual concerns with your psychiatrist is important to ensure that you receive the best possible treatment. Sexual side effects from psychiatric medications are unfortunately quite common, but often go unreported and undertreated due to lack of awareness or inhibitions discussing sex.

Strategies can help guide your conversations with a psychiatrist about sex. By identifying your own emotional responses around sex, writing down specific concerns, addressing the issue gradually, and utilizing written communication, you can prepare for the conversation and provide your psychiatrist with the necessary information to offer appropriate guidance, support, and expertise.

Treatment options for mitigating sexual side effects may include medication adjustments, alternative treatments such as supplements, and therapeutic interventions such as behavioral therapy and cognitive-behavioral therapy. It is important to discuss the potential benefits and risks of each treatment option with your psychiatrist to determine the best approach for your specific needs.

Finding the right treatment that works for you may take time and patience, but open and honest communication with your psychiatrist is crucial in this process. By working together to establish a treatment plan that enhances your overall quality of life, you can address sexual side effects related to psychiatric medications and improve your mental health and well-being.

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This blog post is brought to you by Apraku Psychiatry.

Apraku Psychiatry is a private practice offering video appointments with Board-certified psychiatrists licensed in multiple states. More blog articles can be found here. To schedule an appointment with one of our psychiatrists, patients can complete the online booking form.