Can fluoxetine affect your ability to climax? (3+guide)?

In this article, we will discuss if Fluoxetine affects the ability to climax, how it affects sexual function, research evidence, how to manage it, and when to seek medical advice.

Can Fluoxetine affect your ability to climax?

Yes, Fluoxetine (Prozac) can affect the ability to climax in some individuals. It is known to be associated with sexual side effects, including delayed orgasm or anorgasmia (inability to achieve orgasm) (1).

Fluoxetine, a selective serotonin reuptake inhibitor (SSRI), is commonly used to treat conditions such as depression, obsessive-compulsive disorder, and panic disorder. However, it has been associated with sexual dysfunction, a side effect that can significantly impact a person’s quality of life (2).

Sexual dysfunction is a common side effect of antidepressants, affecting between 58% to 70% of patients treated with these medications. Fluoxetine, like other SSRIs including citalopram, can cause various types of sexual dysfunction, including decreased libido, delayed orgasm, anorgasmia or no ejaculation, and erectile dysfunction (3).

How does Fluoxetine affect sexual function?

Fluoxetine impacts sexual function by altering the levels of serotonin in the body. This alteration can lead to a feeling of calm and less anxiety but can also lower our libido. It prevents the hormones that cause our bodies to respond to sex from transmitting their message to our brains.

Fluoxetine, which is a type of antidepressant known as a selective serotonin reuptake inhibitor (SSRI), can have an impact on sexual function (4). The effects on sexual function can include:

  • A change in your desire for sex


  • Erectile problems


  • Orgasm problems


  • Problems with arousal, comfort, and satisfaction

Apart from lowering one’s desire for sexual activity,  Fluoxetine can make it tough to get in the mood, stay excited, and reach climax. For some people taking SSRIs, having an orgasm might be extremely challenging. These issues become more common as you get older. If you’re experiencing any sexual problems while taking Fluoxetine or any other SSRI medication, it’s important to talk with your doctor.

What does research say?

Fluoxetine, like other SSRIs, works by inhibiting the reuptake of serotonin, a neurotransmitter, in the brain. This increases the amount of serotonin available in the synaptic cleft (5). This increase in serotonin can also interfere with sexual function. Serotonin is involved in the regulation of sexual desire and arousal. Elevated serotonin levels can suppress sexual desire and cause challenges with arousal and achieving orgasm.

In addition to its effect on serotonin, fluoxetine is also a weak norepinephrine reuptake inhibitor. Norepinephrine is another neurotransmitter that plays a role in sexual function. It is involved in sexual arousal and orgasm. Therefore, the inhibition of norepinephrine reuptake by fluoxetine could potentially contribute to its effects on sexual function (6).

Furthermore, fluoxetine is an antagonist at 5HT2C receptors. This has been proposed as a potential mechanism for its activating properties. The 5HT2C receptor is a type of serotonin receptor that is involved in the regulation of various functions, including sexual behavior. Antagonism at these receptors by fluoxetine could potentially contribute to its effects on sexual function (7).

It’s important to note that these are proposed mechanisms based on our current understanding of how fluoxetine works. The exact mechanisms by which fluoxetine affects sexual function are still not fully understood and are likely to be complex and multifactorial.

How to manage difficulty in achieving climax while on Fluoxetine?

Managing difficulty in achieving climax while on fluoxetine involves various strategies. These include: Adjusting the dosage: Sometimes, sexual side effects may decrease with a lower dose of the medication.

Timing intercourse:

Some people find that their medication causes more pronounced side effects at certain times of the day, such as a few hours after taking it.

Taking a “drug holiday”:

This involves skipping a dose of the medication before planned sexual activity. However, this strategy should only be used under the guidance of a healthcare provider.

Introducing an additional medication:

Certain medications, like bupropion, may help stimulate arousal and libido.

Lifestyle adjustments:

Lifestyle adjustments can also support sexual function while on fluoxetine. These may include regular exercise, maintaining a healthy diet, reducing alcohol intake, quitting smoking, and managing stress levels through relaxation techniques such as mindfulness and yoga.

Consulting with a healthcare provider:

It’s important to discuss these issues with your healthcare provider, who can investigate potential underlying causes and suggest appropriate treatments. For some men, taking sildenafil (Viagra) or tadalafil (Cialis) can alleviate SSRI-induced erectile dysfunction.

Remember, it’s important to discuss these strategies with your healthcare provider before making any changes to your medication regimen. They can provide guidance based on your specific situation and health status. It’s also worth noting that sexual difficulties during antidepressant treatment often resolve as depression lifts but may persist over long periods.

When to seek professional help for sexual dysfunction while on Fluoxetine?

If the sexual side effects persist or cause significant distress, it is important to seek professional help. A healthcare provider can guide the management of these side effects and discuss potential changes in medication or other treatment strategies.

Communication and support play a crucial role in dealing with the sexual side effects of fluoxetine. If you experience any sexual problems while taking an SSRI medication, talk with your doctor or therapist. Sexual side effects sometimes subside with time, so it’s worth waiting a while to see if problems diminish.


In conclusion, while fluoxetine can cause sexual dysfunction including difficulty achieving climax, there are several strategies available to manage these side effects. It’s important to have open discussions with healthcare providers about any concerns related to sexual function while taking this medication.

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Atmaca M. Selective Serotonin Reuptake Inhibitor-Induced Sexual Dysfunction: Current Management Perspectives. Neuropsychiatr Dis Treat. 2020 Apr 20;16:1043-1050. doi: 10.2147/NDT.S185757. PMID: 32368066; PMCID: PMC7182464.


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