Lexapro (escitalopram) is one of the most commonly prescribed antidepressants for treating depression and anxiety disorders. According to the U.S. Centers for Disease Control and Prevention, women (15.3%) are more than twice as likely to take antidepressants than men (7.4%). Women also experience depression and anxiety disorders at roughly twice the rate of men (10.4% vs 5.5%), making SSRIs like Lexapro an important treatment option for women.
While this selective serotonin reuptake inhibitor (SSRI) can be highly effective in improving mental health, understanding the potential side effects, including those that may affect women specifically, is essential for making informed treatment decisions and managing your care effectively.
Key Takeaways
Side effects are common but usually temporary: Most Lexapro side effects, like nausea, headaches, and fatigue, are mild and typically improve within the first few weeks of treatment, though some effects, particularly sexual side effects, may persist for the duration of treatment.
Sexual function changes: Research shows that while men report higher rates of sexual side effects from SSRIs, women tend to experience sexual dysfunction differently, particularly difficulty with arousal and changes in sexual desire.
Pregnancy and breastfeeding considerations: Women who are pregnant, planning pregnancy, or breastfeeding face important decisions about Lexapro use, as the medication passes into breast milk. Some studies suggest SSRI exposure in late pregnancy carries a modest (less than two-fold) increase in the risk of postpartum hemorrhage, requiring individualized risk-benefit discussions with healthcare providers.
What Is Lexapro?
Lexapro is the brand name for escitalopram oxalate, an SSRI antidepressant that works by increasing the availability of serotonin in the brain. The FDA approved Lexapro in 2002 for treating major depressive disorder in adults and adolescents 12 years and older, and for generalized anxiety disorder in adults.
The medication is typically taken once daily and comes in tablet form (5mg, 10mg, and 20mg) or as an oral solution. Most adults start with 10mg daily though some begin at 5 mg to minimize side effects. The dose may be increased gradually, typically after at least one week, depending on response and tolerability.
Lexapro is considered one of the most selective SSRIs, meaning it specifically targets serotonin reuptake with minimal effects on other neurotransmitter systems. This selectivity may contribute to its tolerability profile for many people.
Note: Medication details of Lexapro, including dosage and usage, are provided for general understanding and are not a prescription recommendation. Always consult a licensed healthcare provider before starting, changing, or discontinuing any medication.
Most Common Side Effects of Lexapro in Women
According to the FDA, the most common side effects reported in clinical trials affect both men and women, though individual experiences vary. Understanding what's typical can help you recognize which effects are normal and which warrant medical attention.
Gastrointestinal Effects
Nausea: One of the most frequently reported side effects, particularly during the first week or two of treatment. Taking Lexapro with food may help reduce nausea. For most people, this side effect diminishes significantly after the initial adjustment period.
Diarrhea or constipation: Changes in bowel habits are common but usually mild. Staying hydrated and maintaining dietary fiber can help manage these effects.
Dry mouth: While generally not severe, dry mouth can be bothersome. Sipping water throughout the day, chewing sugar-free gum, or using moisturizing mouth sprays can provide relief.
Sleep-Related Effects
Insomnia or sleep disturbances: Some women experience difficulty falling or staying asleep, especially when taking Lexapro in the evening. Taking the medication in the morning may help, though some people find Lexapro makes them drowsy and prefer evening dosing.
Drowsiness or fatigue: Particularly during the first few weeks, some women feel more tired than usual. This side effect often improves with time but may persist in some individuals.
Physical Symptoms
Headaches: Mild to moderate headaches are common initially but typically resolve within the first few weeks.
Increased sweating: Some women notice increased perspiration, particularly at night. This side effect may persist throughout treatment.
Dizziness: Feelings of lightheadedness may occur, especially when standing up quickly. This is usually temporary.
According to the National Alliance on Mental Illness, these side effects are generally mild and often improve or resolve completely within one or two weeks as your body adjusts to the medication. However, abruptly stopping the medication can result in withdrawal symptoms, such as irritability, nausea, vomiting, headaches, etc.
Sexual Side Effects
Sexual side effects are among the most significant concerns for women (and men) taking Lexapro and other SSRIs, as they can appear within 1-3 weeks of initiating treatment and often tend to last for the duration of the treament.
Research on this topic reveals important gender differences. Medications that impact serotonin levels, including Lexapro, are associated with higher rates of adverse sexual effects.
Types of Sexual Dysfunction
According to a study on antidepressant-induced sexual dysfunction, women taking SSRIs may experience:
Decreased sexual desire or libido: Reduced interest in sexual activity is one of the most commonly reported effects.
Difficulty with arousal: Some women report probems with sexual arousal when taking SSRIs. This may be related to how serotonergic medications affect the autonomic nervous system balance necessary for vaginal arousal.
Delayed or difficulty achieving orgasm: About 42% of women on SSRIs report problems with orgasm.
Vaginal dryness: Some women may experience decreased lubrication, which can make sexual activity uncomfortable or even painful.
Genital numbness or reduced sensation: A less common but distressing effect involving decreased genital sensitivity.
Managing Sexual Side Effects
If you experience sexual side effects from Lexapro, several options may help:
Wait and monitor: Some sexual side effects diminish after the first few months of treatment as your body adjusts
Dose adjustment: Sometimes lowering the dose can reduce sexual side effects while maintaining therapeutic benefit
Timing changes: Scheduling sexual activity for when medication levels are lower (before the next dose) may help some people
Medication switch: Some antidepressants, like bupropion, have lower rates of sexual side effects and may be options if Lexapro's sexual effects are problematic
Augmentation strategies: In some cases, clinicians may consider carefully selected adjunctive treatments to address sexual side effects, but these strategies should only be pursued under medical supervision.
It's essential to discuss sexual side effects openly with your healthcare provider. Since depression may also harm sexual well-being, having an open discussion with your provider before starting treatment can help ascertain if your symptoms are related to depression or antidepressant-induced. This can help your provider guide you on further course of treatment.
Weight Changes
Weight changes are a common concern for women taking antidepressants, though the picture with Lexapro is complex.
Weight gain: Some women experience modest weight gain while taking Lexapro, though this is generally less pronounced than with some other antidepressants. The mechanisms aren't fully understood but may involve changes in metabolism, increased appetite, or reduced activity levels.
Weight loss: Particularly in the initial weeks of treatment, some women experience decreased appetite and weight loss. This effect usually levels off over time.
According to available research, significant weight changes don't affect the majority of Lexapro users, but individual responses vary. Maintaining regular exercise, eating balanced meals, and monitoring weight can help manage this potential side effect.
When to Contact Your Healthcare Provider
Contact your doctor if you experience:
Side effects that don't improve after a few weeks
Severe or worsening side effects
New symptoms not present before starting Lexapro
Thoughts of self-harm or suicide
Symptoms of serotonin syndrome
Severe allergic reactions
Unusual bleeding or bruising
Signs of low sodium (confusion, severe weakness, headache)
Your healthcare provider can adjust your dose, switch medications, or provide strategies to manage problematic side effects.
Making Lexapro Work for You
If you're experiencing side effects from Lexapro, open communication with your healthcare provider is essential. Many side effects can be managed through:
Dose adjustments
Timing changes (morning versus evening dosing)
Adding supportive strategies for specific side effects
Switching to a different medication if necessary
Combining medication with therapy for optimal outcomes
Blossom Health offers virtual psychiatric care with board-certified providers who can evaluate your symptoms, prescribe appropriate medications, and work with you to manage side effects effectively. Our psychiatrists provide comprehensive care for depression and anxiety, including careful monitoring and adjustment of medications like Lexapro to maximize benefits while minimizing side effects.
Medical Disclaimer
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. If you are experiencing a mental health crisis, contact the 988 Suicide and Crisis Lifeline by calling or texting 988.
Sources
Elgaddal, N., Weeks, J. D., & Mykyta, L. (2025, April). Characteristics of adults age 18 and older who took prescription medication for depression: United States, 2023 (NCHS Data Brief No. 528). National Center for Health Statistics. https://www.cdc.gov/nchs/products/databriefs/db528.htm#ref1
Brody, D. J., Pratt, L. A., & Hughes, J. P. (2018). Prevalence of depression among adults aged 20 and over: United States, 2013–2016 (NCHS Data Brief No. 303). National Center for Health Statistics. https://www.cdc.gov/nchs/products/databriefs/db303.htm
Palmsten, K., Hernández-Díaz, S., Huybrechts, K. F., et al. (2013). Use of antidepressants near delivery and risk of postpartum hemorrhage: cohort study of low income women in the United States. BMJ (Clinical research ed.), 347, f4877. https://pmc.ncbi.nlm.nih.gov/articles/PMC3748906/
Mayo Clinic. (2025, December 1). Escitalopram (oral route). https://www.mayoclinic.org/drugs-supplements/escitalopram-oral-route/description/drg-20063707
U.S. Food and Drug Administration. (2023). Lexapro (escitalopram oxalate) tablet, film coated; Lexapro (escitalopram oxalate) solution [Package insert]. Allergan USA, Inc. https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/021323s055,021365s039lbl.pdf
National Alliance on Mental Illness. (2024, December). Escitalopram (Lexapro). https://www.nami.org/about-mental-illness/treatments/mental-health-medications/types-of-medication/escitalopram-lexapro/
American Society of Health-System Pharmacists. (2025, October 15). Escitalopram [Drug information]. MedlinePlus. U.S. National Library of Medicine. https://medlineplus.gov/druginfo/meds/a603005.html
Pope, C. (2024, July 1). Lexapro (escitalopram): Uses, dosage, side effects & warnings. Drugs.com. https://www.drugs.com/lexapro.html
Hensley, P. L., & Nurnberg, H. G. (2002). SSRI sexual dysfunction: a female perspective. Journal of sex & marital therapy, 28 Suppl 1, 143–153. https://pubmed.ncbi.nlm.nih.gov/11898696
Lorenz, T., Rullo, J., & Faubion, S. (2016). Antidepressant-Induced Female Sexual Dysfunction. Mayo Clinic proceedings, 91(9), 1280–1286. https://pmc.ncbi.nlm.nih.gov/articles/PMC6711470/
Serretti, A., & Chiesa, A. (2009). Treatment-emergent sexual dysfunction related to antidepressants: a meta-analysis. Journal of clinical psychopharmacology, 29(3), 259–266. https://pubmed.ncbi.nlm.nih.gov/19440080/
Reichenpfader, U., Gartlehner, G., Morgan, L. C., Greenblatt, A., et al. (2014). Sexual dysfunction associated with second-generation antidepressants in patients with major depressive disorder: results from a systematic review with network meta-analysis. Drug safety, 37(1), 19–31.https://pubmed.ncbi.nlm.nih.gov/24338044/
Safak, Y., Azizoglu, S. I., Alptekin, F. B., et al. (2025). Antidepressant-associated sexual dysfunction in outpatients. BMC Psychiatry, 25, Article 317. https://link.springer.com/article/10.1186/s12888-025-06751-1
Mayo Clinic Staff. (2025, February 20). Serotonin syndrome: Symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/serotonin-syndrome/symptoms-causes/syc-20354758
