Antidepressants are the most common treatment for depression in the United States. Most women taking antidepressants (96%) report sexual side effects. In addition to diminishing patients’ quality of life, sexual side effects significantly impede medication compliance. Despite this, there are few empirically validated interventions for sexual side effects proven better than placebo. Often, adjunctive treatments interfere with the antidepressant function or increase risk of additional side effects. A promising behavioral intervention for sexual side effects is exercise. In a series of studies, we have shown that moderately intense exercise prior to presentation of sexual stimuli increases sexual arousal in healthy women (Meston & Gorzalka 1996a; 1996b), and there is a curvilinear relationship between SNS activity and genital sexual arousal in women, with moderate SNS activation associated with higher sexual arousal than either high or low SNS activity (Lorenz, Harte, Hamilton, & Meston, 2012).
Antidepressants have been shown to depress SNS activity. It is feasible that exercise may provide a means for counteracting this suppression. In a laboratory study, we (Lorenz and Meston, 2012) tested the effects of exercise in 47 women taking antidepressants. Participants ran on a treadmill for 20 min at a moderate to high intensity (70% of VO2 max) and then watched a sexually explicit film while their genital arousal was recorded. On average, exercise prior to sexual stimuli increased genital arousal more than a no-exercise control, and these effects were strongest in women reporting greater sexual dysfunction.
In a follow-up at home study we (Lorenz & Meston, 2014) evaluated whether exercise improves sexual desire, orgasm, and global sexual functioning in women experiencing antidepressant-induced sexual side effects. Fifty-two women who were reporting antidepressant sexual side effects were followed for 3 weeks of sexual activity only. They were randomized to complete either three weeks of exercise immediately before sexual activity (3×/week) or 3 weeks of exercise separate from sexual activity (3×/week). At the end of the first exercise arm, participants crossed to the other. We measured sexual functioning, sexual satisfaction, depression, and physical health. Exercise immediately prior to sexual activity significantly improved sexual desire and, for women with sexual dysfunction at baseline, global sexual function. Our finding suggest that exercise may be an effective tool for the behavioral management of sexual side effects of antidepressants.
Recommended papers:
Lorenz, TK, & Meston, CM (2014). Exercise improves sexual function in women taking antidepressants: results from a randomized crossover trial. Depression and Anxiety, 31(3), 188-195. PDF (284 KB)
Lorenz, TA, Meston, CM (2012). Acute exercise improves physical sexual arousal in women taking antidepressants. Annals of Behavioral Medicine, 43, 352-361. PDF (311 KB)
