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Sexual Problems and Depression

Without sex we wouldn’t be on this planet. Although sex is a part of human lifecycle, especially in our country many people still find it a taboo to discuss about sex and its problems. However in western countries, it is common for people to start talking or learning about sex during puberty. 

Our sex drive and sexual pleasure are impacted by our physiology, psychology, societal expectations and the interactions between these domains. Sex drive is complex and is affected by physical and emotional aspects.  Sex is not just for procreation- it should also be pleasurable for every person involved in it. 

What is the link between Sex & Depression?

Depression affects sex because of biology. Brain is a highly sensitive sex organ as, sexual desire starts from brain and works its way down. It starts with chemicals in the brain called neurotransmitters. Neurotransmitters communicate between your brain and your sex organs. The problem with depression and other mood disorders is the brain circuits that communicate using these chemicals don’t function properly and gets imbalanced. As a result sexual desire is low or missing and can also reduce pleasurable feelings.  

When your brain thinks of sexual desire, your body responds by increasing blood flow  to the sex organs. Increased blood flow triggers arousal through erection or vaginal lubrication. 
Many men and women with depression complain of having low or no sexual desire and that puts a tremendous strain on intimate relationships. 

How does depression affect sex?

Depression can affect every aspect of your life including sex. Low self esteem, feelings of hopelessness and physical fatigue can lower your libido. 

Depression can also lead to :
 
• Anorgasmia or trouble having an orgasm 
• Erectile dysfunction.

Types of Depression
 
• Persistent depressive disorder 
• Psychotic depression
• Major depression
• Bipolar disorder
• Postpartum depression (occurs in women after having a baby)
• Seasonal affective disorder (occurs during the winters)
• Depression coupled with anxiety disorders

Symptoms in Gender Differences

Both men and women can face difficulties with initiating and enjoying sex because of depression. However there are difference in the way depression affects men and women. 
Both men and women having problems with sexual health can worsen feelings of worthlessness and other depression symptoms. This can further worsen depression and sexual dysfunction. 

Women – Higher rate of depression in women is due to hormonal changes. Hence women’s risk of depression may increase.

• Before and during menstruation
• After childbirth
• Due to work pressure
• During perimenopause and menopause

Women experience persistent bluesy feelings that can make them feel less confident and less worthy. These feelings drastically affect overall sex life. As they grow old, physical factors also make sex less enjoyable and even painful. Changes in vaginal wall make sexual activity undesirable. Lower level of estrogen disrupts natural lubrication. Such factors are depressing for women and it is necessary for them to seek help from sexual consultants or doctors to find a solution. 

Men – Symptoms of depression like anxiety, low self-esteem and guilt are common causes of erectile dysfunction and men are more likely to lose interest in sexual activities during depression and might not find sex very appealing.  Anti-depressants are directly related to impotence. Delayed orgasm or premature ejaculation may also occur. 

Risk factors

It is not just the depression that affects sexual health. In fact anti-depressants, the most common forms of medical treatment for depression can have unwanted sexual side effects. 

The most common are:

• Monoamine oxidase inhibitors (MAOI)
• Serotonin and norepinephrine reuptake inhibitors (SNRI)
• Selective serotonin reuptake inhibitors (SSRI)
• Tetracyclic and tricyclic medications

Treatment Options

Treating depression is one way to overcome sexual dysfunction. Feeling good again will help you get back to normal sex life. One should consult doctor under such circumstances. If the primary health care provider determines that sexual dysfunction is side effect of anti-depressant, then you may be shifted to a different medication. 

Beside additions and adjustments within conventional depression treatment, there are other steps you can take to improve overall sexual health:

• Take anti-depressant dose after engaging in sex
• Consult your doctor to add medication for sexual function(Viagra for men)
• Exercise regularly to improve mood and physical well-being
• Talk to your partner about how your depression is affecting your sexual health, which can help alleviate feelings of guilt and worthlessness.

Point of view

Treating depression can cause issues with sexual health, but there is hope in resolving both the issues. Treating one can help the other. Finding right balance needs time and patience. You should not self medicate or alter medications without consulting your healthcare professional. While depression and sexual dysfunction can go hand in hand, it is also important to know that there are also other factors which can cause problems in sexual health. 

For more on the diagnosis and treatment of Sexual problems and Depression 

Please consult online at Vivan Hospital.

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