Sex and Psychotropic Side Effects   Leave a comment

I’ll never forget my Dad and I taking a long walk when I was twelve years old.  It was longest walk of my life.  Not because of the distance, it was the subject matter discussed that made it seem like it would never end.  It was his big “sex talk,” where my father proceeded to tell me most of the things I already knew only in more clinical terminology.  And every time I tried to make a joke to lighten things up, he’d smack me in the head.  And when he told me things about my Mom I didn’t want to know, I wanted him to smack me in the head again to knock the disgusting image out of my mind.

Well now it’s time to have my sex talk with you.  However, it’s going to have a little twist; I’ll be talking about the side effects antidepressants and mood stabilizers have on many people’s sexual performance and enjoyment, or lack thereof.   It’s the one side effect from psychotropic medications used to treat Bipolar Disorder that everybody wants to talk about but nobody wants to talk about simultaneously.  So I’ll spare everyone the embarrassment and put myself out there, because whenever I mention it in a blog, I get the most responses and inquiries.  Obviously it’s a major concern.

Many antidepressants and mood stabilizers diminish sexual sensation, gratification, performance and sometimes the ability to even participate at all.   It’s a consequence for men and women, obviously manifesting itself differently between the sexes because men have penises and women have vaginas.  I’ll speak from my experiences and try to offer some solutions that don’t involve leaches or blood letting.

The sexual side effects of psychotropics on men can be devastating.  A lot of them depend on the drug(s) you are taking.  I have taken many.  Personally I have been through not being able to get an erection, no matter how much my partner or I feverishly worked, occasionally producing a soft orgasm at the very end,  just to mock me.  Through it all the lack of sensation in the penis is greatly muted.  Your mind is sexually charged but your penis doesn’t want to party.  It feels like it’s wrapped in a thick wool blanket killing all sensitivity.

If a man can achieve an erection, the sensation can be so muffled that it takes forever to have an ejaculation.  Finally when you do, you barely feel a modicum of pleasure.  Enough to wonder “why bother?”  It is literally as pleasurable as going pee.   Again, your mind wants to have sex, but you have the libido of a dead Mexican rumba dancer. Plus, you have to force penile stimulation, which is counterintuitive.  If you achieve an erection, it is like trying to walk into a hurricane.

Unbelievably, some drugs will let you fight the good fight until you can get and maintain an erection.  Then you “anti-climax” with a dry ejaculation.  Absolutely no semen emerges, nor does it feel very good.  This is the ultimate emasculating effect of Bipolar medication.   It’s only good for people with hand-washing obsessive compulsive behavior because there is nothing to clean up.

The best overall description of how psychotropics can effect sex drive, and maybe only guys can get this, is that physical charge you get starting in the pit of your stomach when you are really excited.  When you are super attracted to your partner and know you are going to have a big orgasm almost just by looking at them.  With antidepressants and mood stabilizers it’s very difficult to get that electrical current to radiate throughout your body.

When discussing what psychotropics do to women, I have to go with what Bipolar sexual partners and friends have told me.  Virtually all experience a diminished sex drive with desensitized genitalia.   But what I hear most is that it’s almost impossible for them to achieve an orgasm.  I have tried over and over to patiently orally stimulate a Bipolar girlfriend and she just couldn’t get “over the mountain.”  It’s even more difficult through traditional intercourse.  Women experiencing psychotropic sexual side effects need intense clitoral stimulation for a long period of time if they are interested in sex at all.  And, many can only reach orgasm with the help of sexual aids that vibrate alone or in conjunction with their partner.  Many times the man feels very inadequate when the woman is forced to introduce  appliances in boudoir.

So what’s a penis and vagina to do?  Can you imagine if a “normal” man or woman started facing these sexual dysfunction issues?  They’d be beside themselves calling their urologist or gynecologist on the golf course in an utter state of panic.  “Doctor, I think my penis is dying.  Is this what happens before it shrivels up and falls off?”  Or, “Doctor, my vagina has a severe loss of sensitivity.  Is this a sign I’m turning into a bitter old spinster with no interest in men?”

If you are experiencing these sexual side effects, “what can you do about them?” is your next question.  Right now there is not a lot medically you can accomplish.  But before you scream in anguish, there are things that do work, you just may not hear about them from your doctor.  As far as pills go, you can ask your doctor to switch your medication(s) to something that may have less or no sexual side effects.  And this does work for some people.  It helped me to a noticeable degree.  However I was also once prescribed Yohimbine, which is some kind of plant extract.  The only thing that gave me was false hope.

Another medical option is just for men; Viagra, Cialis or other erectile aids.  I have not heard from any Bipolar men that they are the solution to getting and maintaining an erection.  I was prescribed Viagra and it did very little.  I also tried taking three times the recommended dose with wanton abandon for having an erection lasting more than four hours and having to go to the hospital, as they warn in the commercial.  I actually would have loved having that problem.  I’d be proud to be wheeled in on a stretcher with the sheets at my midriff noticeably aloft. But nothing. However everyone is different.

Women, I have heard that taking anti-histamines can help produce heightened sensation and lead to orgasm.  This is an off-label use of these over the counter drugs and in no way am I recommending it.  But I’ve heard it works for some.  Since I don’t have female organs, I have no idea why.  I haven’t seen any Bipolar women trying to catch colds or delighted to have allergies either.

A non-medication related solution requires you to change your sexual habits.  For a man or woman with this problem, you need to set the mood.  Just don’t jump into bed.  Have a romantic dinner.  Wear provocative lingerie if you’re a woman.  If you’re a guy, take a goddamn bath.  Have a candle-light dinner.  Talk dirty.  Watch some porn.  Tease one another.  Engage in each others fetishes.  Just do things to raise the level of excitement before you move forward with actual sex.  There is something to be said for mind over matter.

Also, do not drink alcohol before sex.  Medical evidence shows that it decreases the man’s ability to get and maintain an erection and for a woman to fully lubricate and reach orgasm.  Most people know this by having learned the hard way.  If you haven’t, any college student can validate my advice.  Just coupling alcohol with psychotropics could produce negative results unrelated to sex.

The big controversial possible solution is smoking marijuana before sex.  For me it heightens my arousal, increases my sensitivity and enjoyment of  an orgasm.  Some women report increased sensitivity and stimulation as well.  However, pot isn’t like buying a prescription, even when getting it legally from a California Dispensary.  Every “grow” has a different potency no matter how accurate the growers try to be with their various strains.  Plus, different people have different tolerances.  So you have to do a lot of experimentation.  And you don’t want to get so stoned you forget you’re having sex and drift off to slumber.

Exercise is one thing I am positive helps on the sex front.  A vigorous workout gets the blood pumping through all your organs.  When I am done running I almost always have an increased libido.  Better yet, I have less trouble achieving an erection, which is actually a function of getting blood flow to my penis,  a direct result of aerobic exercise.  Furthermore, it makes my orgasm much more forceful and enjoyable.  I have heard of similar sexual benefits regarding exercise from women.  But it has to be activity that really increases and sustains your heart rate for at least a half hour.

Finally, be conscious of when you take your medication.  I found if I take mine too close to having sexual activity, I can not perform well.  But if I wait several hours I can do better.  I realize it can ruin spontaneity, but so can a soft penis or dry ejaculation.

The reason I wrote this blog is so people with bipolar Disorder experiencing these embarrassing sexual side effects from antidepressants and mood-stabilizers know they are not alone.  There are a lot of us out there who have spent years making excuses to sex partners why we can not be adequately stimulated, fully enjoy sex or even perform in the first place.  Do not give up on a solution.  This can be overcome.  It requires patience and willingness to experiment.  And the great thing about our bodies is that we can even experiment on ourselves!

If anyone ever tells you there is more to life than sex, they are right.  However sex is one of the few benefits about having a  human body.  Our bodies are constantly causing us sickness, inconveniences, ailments, embarrassing situations and in this case mental illness.  Everybody, especially people with Bipolar Disorder, deserves sexual pleasure.  It’s free, it feels great and it’s good for you.  Don’t deny yourself.  Apply yourself.

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