Trazodone is a prescription medication used to treat major depressive disorder and is also prescribed off-label for insomnia due to its sedative properties. Like many antidepressants, trazodone can cause a range of side effects, some of which may affect sexual health and function.
Common Sexual Side Effects
Trazodone’s impact on sexual function can vary among individuals. Unlike many antidepressants known for decreasing libido, trazodone can have mixed effects on sex drive, with some people experiencing a decrease in sexual desire while others report an increase.
For men, trazodone can lead to problems with ejaculation, which may manifest as either delayed or premature. For women, the medication can sometimes lead to increased vaginal lubrication. Difficulties in achieving orgasm, or anorgasmia, can also occur in both men and women taking the drug.
Trazodone is sometimes considered a treatment for sexual problems caused by other antidepressants, like selective serotonin reuptake inhibitors (SSRIs). The mechanism behind its varied effects on libido is not fully understood but is related to its interaction with serotonin receptors. The intensity of these side effects can differ from person to person.
Priapism as a Rare Complication
A serious, though uncommon, sexual side effect of trazodone is priapism. Priapism is a persistent, often painful erection that lasts for more than four hours and occurs without sexual stimulation. This condition is a medical emergency because the prolonged erection can restrict blood flow, potentially leading to tissue damage and permanent erectile dysfunction.
Priapism is a rare adverse effect, but due to the seriousness of the condition, anyone who experiences an unusually long-lasting or painful erection must seek immediate medical help. In a similar, though even rarer, instance, women may experience clitorism, a persistent and painful enlargement of the clitoris, which also warrants prompt medical evaluation.
The risk of priapism underscores the importance of being aware of all potential side effects when starting a new medication. While the statistical probability is low, the potential consequences are serious.
Managing Sexual Side Effects
Experiencing sexual side effects from any medication can be distressing, but it is important to address them with a healthcare provider. A person should never abruptly stop taking trazodone or alter the dose on their own, as this can lead to withdrawal or the return of depressive symptoms. Open communication with a doctor is the most productive step.
A healthcare provider has several strategies to consider. In some cases, the side effects may diminish over time as the body adjusts to the medication. If the issues persist, the doctor might suggest lowering the dosage to see if that alleviates the problem while maintaining the drug’s therapeutic benefits.
If dose adjustments are not effective, other options are available. The timing of the daily dose could be changed to reduce the impact on sexual function. In other instances, a doctor may recommend switching to a different antidepressant or suggest lifestyle changes, such as limiting alcohol consumption.