There is a common view that men with depression go off sex. There are good grounds for this but the situation isn’t quite as clear-cut. Human sexuality can be complex at the best of times and while periods of low mood may cause a loss of libido, in some men their sexual activity seems to increase as they look for distractions. Equally, while sexual function may decrease, desire may or may not remain.
For most men however the most marked feature of depression is that it hits them right below the belt. It may manifest itself as a lack of desire, or an inability to gain or sustain an erection, or both. Depression may be the cause of impotence as much as impotence can result in depression.
Erectile dysfunction is perhaps more common than many men realize. Very often it is a short-term problem that improves as a result of resolving some problem (a particular worry, sleep disruption, fatigue). It is also the case that erectile dysfunction affects men of all ages although as men age the risk increases. Age may also, quite naturally, affect sexual desire or sexual activity, although some men remain fully sexually active for most of their adult lives.
Where depression and sexual desire or activity combine it tends to be the case that sexual difficulties increase as depression worsens. This isn’t cast in stone. Some men go off sex completely at an early stage, others don’t. Some estimates suggest that around three quarters of men with depression report some kind of negative effect on their sex life. Many will have difficulties coming to terms with this and may find themselves in something of a downward spiral as depression feeds off their sexual difficulties and perhaps the fear that the situation will be permanent.
With all this going on it may seem a particularly low blow for men to discover that many antidepressants have a side effect of decreasing sex drive and can cause difficulties with erection and/or ejaculation. So far as antidepressant medication is concerned the rule of thumb tends to be that newer antidepressants come with fewer or less potent side effects. However, some trial and error may be required before an effective antidepressant is found.
Where loss of libido is caused by depression it usually follows that effective treatment of depression will resolve such problems. So far as medication is concerned it’s really a case of the long-term benefits to be gained from short-term losses. The side effects of medication nearly always subside after a few days or weeks. Not everyone experiences them, or they may experience some but not all and to varying levels of intensity.
Men may find it hard to accept the fact they are depressed, despite the fact that depression in men is far more common that previously realized. They may realize their mood is low but go to their doctor primarily because of erectile dysfunction issues and only then be made more fully aware of the problem. But the fact that depression is a treatable condition should encourage all men to seek help. The sooner the issue is identified and treatment begins, the faster the problems will resolve.