Lexapro Sexual Side Effects: What to Expect and What You Can Do
Author:
Blossom Editorial
Jun 2, 2026
Lexapro (escitalopram) is one of the most commonly prescribed antidepressants in the United States. It is FDA-approved for major depressive disorder and generalized anxiety disorder and is generally well tolerated by many people.
But like many Selective Serotonin Reuptake Inhibitors (SSRIs), Lexapro can affect sexual function. While these effects are more common than many people realize, they are often underdiscussed in healthcare settings.
Sexual side effects are also one of the more common reasons people stop taking Lexapro or consider changing medications. Even so, many people feel uncomfortable bringing them up, and healthcare providers do not always ask about them directly.
This guide explains the sexual side effects Lexapro may cause, how common they are, why they occur, how long they may last, and which treatment options may help.
Key Takeaways
Sexual side effects, including decreased libido, delayed orgasm, and arousal difficulties, are among the most common side effects of Lexapro. Studies that directly ask people about sexual symptoms report rates ranging from 36% to 70%.
These effects can be linked to the way serotonin inhibits your brain’s sexual response pathways. They are often dose-dependent and may improve after the medication is adjusted or discontinued under medical supervision.
Several treatment options may help, including dose adjustments, switching medications, or adding another medication. Any medication changes should always be discussed with your prescriber first.
What Sexual Side Effects Does Lexapro (Escitalopram) Cause?
Lexapro belongs to the class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). These medications increase serotonin levels in the brain, which can help improve symptoms of anxiety and depression. However, serotonin also affects the brain’s sexual response system, which is why SSRIs can cause sexual side effects in some people.
According to the FDA prescribing information for Lexapro, use of SSRIs (such as Lexapro) may lead to the following sexual side effects:
Decreased libido
Delayed ejaculation
Difficulty or inability to reach orgasm (anorgasmia)
Erectile dysfunction
Reduced genital sensation or lubrication difficulties
How Common Are Escitalopram Sexual Side Effects?
Sexual side effects are among the most underreported side effects in antidepressant studies.
Many clinical trials rely on spontaneous reporting, meaning participants only report side effects if they choose to mention them. And because sexual symptoms can feel uncomfortable or personal to talk about, rates are often underestimated.
When researchers use structured questionnaires that directly ask about sexual function, reported rates tend to increase significantly. A well-known study published in the Journal of Clinical Psychiatry showed that direct questioning revealed rates of SSRI-related sexual dysfunction ranging from 36% to more than70%.
Another comprehensive review published in the Journal of Clinical Psychopharmacology also suggests that escitalopram may have a somewhat more favorable sexual side effect profile than some older SSRIs. However, these effects can still be clinically significant for many people.
Why Does Lexapro Cause Sexual Side Effects?
Lexapro’s sexual side effects are related to how serotonin interacts with the brain's sexual response pathways. While increased serotonin can improve mood and reduce anxiety, it can also interfere with dopamine signaling and other systems involved in sexual desire and arousal.
Dopamine helps drive desire to do things, motivation, pleasure, and even sexual desire. Serotonin can suppress some of these pathways, which may lead to reduced libido, delayed arousal, or difficulty reaching orgasm.
Research also suggests serotonin may affect nitric oxide signaling, which plays a role in genital blood flow and physical arousal. Experts consider these effects a known consequence of how SSRIs work rather than a specific side effect of Lexapro.
Lexapro Sexual Side Effects by Gender
Sexual side effects from Lexapro can affect men and women differently.
In men, commonly reported side effects include delayed ejaculation, reduced libido, and difficulty reaching orgasm. While generally less common, some men also report erectile dysfunction.
Lexapro side effects in women include reduced libido, difficulty reaching orgasm, reduced genital sensation, decreased lubrication, and difficulty with arousal. Despite several researchers suggesting how common sexual side effects from SSRIs are in women, they often remain understudied.
How Long Do Lexapro Sexual Side Effects Last?
For some people, sexual side effects may improve during the first few weeks as the body adjusts to the medication. For others, symptoms may persist throughout treatment, especially at higher doses.
Sexual side effects also tend to persist longer than some other common Lexapro side effects, such as nausea or insomnia. Research suggests these symptoms are often dose-dependent, meaning they may become more noticeable at higher doses.
The European Medicines Agency has formally recognized post-SSRI sexual dysfunction (PSSD), a condition in which sexual side effects continue after the medication is fully stopped. PSSD is usually rare, but if you’re concerned about it, it’s recommended that you discuss it with your prescriber before starting treatment.
What Can You Do About Lexapro Sexual Side Effects?
Several evidence-supported strategies may help manage Lexapro’s sexual side effects.
Talk to Your Prescriber First
This is an important step, and one many people tend to avoid. Sexual side effects can affect your quality of life and relationships, and healthcare providers may not know you are experiencing them unless you bring them up.
Many people are surprised to learn that there are often multiple options available for improving sexual side effects without completely stopping treatment.
Dose Reduction
Lexapro's sexual side effects are often dose-dependent. And reducing the dose may help improve symptoms for some people while still maintaining antidepressant benefits.
Lexapro's usual dosing range (10–20 mg) is relatively narrower than some other SSRIs, but dose adjustment can still be helpful.
Adding Another Medication
In some cases, prescribers may add a second medication to help reduce sexual side effects while continuing the antidepressant.
Bupropion (Wellbutrin) is among the most studied options for SSRI-related sexual dysfunction. Because it works differently from SSRIs and affects dopamine pathways, it may help counter some of the sexual side effects linked to serotonin.
A review published in the Journal of Clinical Psychiatry suggests that bupropion can be an effective add-on to help with sexual side effects. It may help increase the sexual libido as well as the frequency of engaging in sexual activity when compared with a placebo.
Switching Medications
Switching to an antidepressant with a different mechanism may also help. For example, bupropion is one of the most frequently recommended alternatives when sexual side effects are a major concern.
Other antidepressants, including mirtazapine and vortioxetine (Trintellix) may also have a lower risk of sexual side effects for some people.
A psychiatrist can help evaluate which alternative is best suited to address your symptoms based on your treatment history.
When to Seek Help
Sexual side effects can feel frustrating, isolating, and difficult to talk about. But they are common, and help is available.
If Lexapro is affecting your quality of life or relationships, Blossom Health’s board-certified psychiatric providers can help you explore treatment options and find an approach that feels sustainable for you. Learn more or schedule a virtual appointment.
Medical Disclaimer
This article is for educational purposes only and does not constitute medical advice. The information provided should not replace consultation with a qualified healthcare provider. Individual responses to medications can vary significantly, and what applies to one person may not be the same for another.
Always consult with your doctor or pharmacist before making any decisions about medication changes, discontinuation, or interactions with other substances. If you’re experiencing concerning symptoms or side effects, please seek professional help from a healthcare provider.
In case of a medical emergency, contact your local emergency services immediately or call 911. For mental health emergencies, contact the National Suicide Prevention Lifeline at 988.
Sources
FDA. (October, 2023). Lexapro (escitalopram) prescribing information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/021323s058lbl.pdf
Montejo, A. L., Llorca, G., Izquierdo, J. A., & Rico-Villademoros, F. (2001). Incidence of sexual dysfunction associated with antidepressant agents: a prospective multicenter study of 1022 outpatients. Spanish Working Group for the Study of Psychotropic-Related Sexual Dysfunction. The Journal of clinical psychiatry, 62 Suppl 3, 10–21. https://pubmed.ncbi.nlm.nih.gov/11229449/
Serretti, A., & Chiesa, A. (2009). Treatment-emergent sexual dysfunction related to antidepressants: a meta-analysis. Journal of clinical psychopharmacology, 29(3), 259–266. https://doi.org/10.1097/JCP.0b013e3181a5233f
Balon R. (2006). SSRI-associated sexual dysfunction. The American journal of psychiatry, 163(9), 1504–1664. https://doi.org/10.1176/ajp.2006.163.9.1504
Clayton, A. H., Warnock, J. K., Kornstein, S. G., Pinkerton, R., Sheldon-Keller, A., & McGarvey, E. L. (2004). A placebo-controlled trial of bupropion SR as an antidote for selective serotonin reuptake inhibitor-induced sexual dysfunction. The Journal of clinical psychiatry, 65(1), 62–67. https://doi.org/10.4088/jcp.v65n0110 https://pubmed.ncbi.nlm.nih.gov/12625442/
European Medicines Agency. (February 20, 2019). Serotonin and norepinephrine reuptake inhibitors, selective serotonin reuptake inhibitors and other antidepressants and persistent sexual dysfunction. https://catalogues.ema.europa.eu/sites/default/files/document_files/Antidepressants.pdf
National Institute of Mental Health. (December, 2023). Mental Health Medications. https://www.nimh.nih.gov/health/topics/mental-health-medications
Landy K, Rosani A, Estevez R. Escitalopram. [Updated 2023 Nov 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557734/
Cipriani, A., Furukawa, T. A., Salanti, G., Chaimani, A., Atkinson, L. Z., Ogawa, Y., Leucht, S., Ruhe, H. G., Turner, E. H., Higgins, J. P. T., Egger, M., Takeshima, N., Hayasaka, Y., Imai, H., Shinohara, K., Tajika, A., Ioannidis, J. P. A., & Geddes, J. R. (2018). Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. Lancet (London, England), 391(10128), 1357–1366. https://doi.org/10.1016/S0140-6736(17)32802-7
