ADs and sexual function

[DadIsSad]

Sorry - this is going to be a long post I think, as it needs a lot of context. I'm not even sure it should be in this section, but it was the most obvious to me and where I've posted before. If you want to search you can find my previous posts which give a bit more history, but in summary me and DW have only had sex twice in the last 6 years - the first time we managed to conceive our second child (who is almost 3), the second in November last year, I didn't manage to ejaculate. Just in case anybody read my previous thread, the outcome of that is that it made our relationship a lot worse rather than better, and significantly decreased the chances of us having sex again any time soon.

The lack of sex isn't down to my choice or lack of capability (we've not even got as far as determining that - though I don't have a problem with erections), but because DW isn't interested. Various reasons for that - I think I know what the main one is, but we've just started going to relate and I'm hoping we'll discuss that there, so not going to bring it up - this is about my problems!

I've been depressed by this for a while - probably at least a bit for 6 years, but more significantly for about 8 months. At the prompting of the Relate counsellor and DW I finally went to see my GP yesterday and got prescribed Citalopram.

Now the one significant side effect the doctor mentioned was delayed ejaculation - I also made the mistake of googling, and am seeing the same information (though strangely the leaflet with the pills doesn't mention it at all). I did eventually take the first pill last night, after putting it off for ages, but this morning I'm no longer sure they're going to help at all. My thought process is that whilst this doesn't really matter at all at the moment as we're not having sex anyway, I'm not going to be happy to be celibate for the rest of my life no matter how many pills I take. Assuming we do get somewhere with relate, being on this drug is going to make successful sex very difficult - it doesn't really matter whether there is a physical effect, the fact I know it might is probably going to result in the same problem anyway (last November wasn't the first time ever I'd had an issue, and from what I read I do naturally take rather longer than most men). So before we have sex I'm going to need to come off this - but if the point of it is to lift my mood, and I'm depressed because we're not having sex, oh and of course I'm also less attractive when I'm depressed so less likely to get the chance, how is that going to work? In any case just taking the pills feels like an admission that we're not ever having sex again, which really doesn't help my mood at all (I know the chances are slim anyway, but there's a difference knowing it's definitely not on the menu).

Now I'm sure some of what I've written sounds really stupid, and that the correct answer is to go back to my GP (and discuss this with DW - however she's at work, and I feel the need to get this out now), but I'd appreciate any comments. Are there other ADs which don't have this side effect (a quick google suggests it's a problem with most)? Are there any drugs I can take to counteract it, or even make things better than if I wasn't on it? I also appreciate that sex isn't just about reaching a climax, but neither do I want to spend the rest of my life without having that experience again - it's now been 3 1/2 years :( Please go a little easy on me - I tried to be honest in the last post I made in November, and it got all misinterpreted and didn't go well.

What is it that you are asking us?

There's a few question marks in there - mainly whether it's a good idea to be on this drug or not in my circumstances, and what the alternatives are. Whether I'm worrying about nothing. What experiences other people have had.

not all antidepressants have that effect, and if it does, then you could always try a different one. I think not being able to orgasm is quite a significant side effect.

I was really worried that libido and orgasm would go when i started antidepressants, but if anything my libido has increased, and its only a little bit harder to orgasm. (im on venlafaxine)

I think you've got two separate problems. The first one is a medical one and yes, you should talk to your GP about the side-effects of the medication. That's the first thing.

The second problem is what sounds like a lack of physical affection between you and DW. Sex is obviously only part of that - admittedly an important part. But is it a loving, demonstrative relationship otherwise? Do you get on well together? Do you find time to laugh? Cuddle on the sofa? Hold hands in the street? Is there any romance in the relationship? Do you do nice things for each other? Spend time together as a couple without your children? Sex follows on from intimacy and intimacy follows on from compatibility and feeling happy in each other's company. If DW not only rejects sex but isn't intimate or relaxed with you either, I'm not sure Relate is going to help.

is it a loving, demonstrative relationship otherwise?
no
Do you get on well together?
yes
Do you find time to laugh?
not much
Cuddle on the sofa?
never
Hold hands in the street?
never
Is there any romance in the relationship?
no
Do you do nice things for each other?
not really
Spend time together as a couple without your children?
once in 5 years - my birthday last year (just over 12 months ago) - we didn't even cuddle or kiss afterwards though.

I'm aware of all these things, and upset by them - possibly more than by the lack of sex - it's just quicker and easier to mention the lack of sex. The thing is, having a good sexual relationship is surely still the end goal? The question though is chicken or egg - I'm not convinced that some of this doesn't stem from her not wanting to have sex with me, and thinking that any affection we do have is going to lead to that. I wish I could be more romantic, but the continual rejection has got me down to the point I don't want to try any more (and doesn't romance involve at least some sort of physical connection?)

If relate isn't going to help (it's what everybody always seems to suggest), what is?

To be fair, things have actually already improved slightly since our first relate session. I moved into the spare bedroom when DW was snoring due to being bunged up, and then stayed there when I realised that actually I wasn't missing out on anything by not sharing a bed (and I could now read in bed when DW was asleep). Yesterday DW asked me to come back because she was lonely, which was quite a shock. Still didn't have any physical contact, but it's a start. The thing is, you see that "yes" up there - it's like she's a good friend who I share a house and co-parent with - surely there's some hope?

Oh, and on the drugs thing - my doctor was busy saying that he always prescribed ADs in my circumstances because they didn't really have much in the way of bad side effects, but almost always worked well at lifting your mood. Only then as an aside when he'd written it did he mention the delayed ejaculation thing - it was the only specific thing he'd mentioned. At which point I mentioned the issue I'd had in November (it hadn't come up until then - I mean it's not the easiest thing to discuss with a complete stranger).

Should I have made more of a point of it? At the time it just seemed unimportant and irrelevant, it was only later that the implications sank in. My head's just spinning round between thinking it is irrelevant as we're not having sex anyway, or that it's the biggest thing ever as it's wiped out any chances we do have.

There's always hope but it takes two to make a relationship. Relate can make everyone think about how to make improvements but, if nothing ever changes, it's all a little pointless. Sharing a house with a friend and co-parenting... well it's OK I suppose but that just makes you flatmates. I would take the fact that she still wants you to share her bed as a good sign and then take the initiative.

Do remove sex from your mind as the end goal. Tell her up front that you don't want sex - if she's nervous about intimacy this removes any hint of expectation or pressure - but you want to be more than flatmates. It's going to take some effort and it still might not work but, if it doesn't, then you can make a decision whether to put up with things as they are or call it a day.

I'd suggest things like setting up 'dates', nights out together, weekends away, romantic evenings in. Random compliments, silly gifts, thoughtful gestures, helping without being asked, holding her hand in the street, laughing at her jokes. Clicheed wooing behaviour basically but it's all important stuff. Take a hard look at yourself in the mirror and see if you could smarten yourself up. Set up conversations where you remind each other what first attracted you to each other. Tell each other what you appreciate them for. Always say 'thank you' and 'please'.

Never forget an elderly couple I used to know. Adored each other. He'd bought her some new boots for her birthday and said quite loudly so she could hear...."Don't they make her legs look fantastic? She's always had a terrific pair of pins has my Jean". Lovely.

"Should I have made more of a point of it?"

Yes. If anything's bothering you about medical treatment, talk to the doctor. They may be a stranger but they are medically qualified and, I can assure you, pretty unshockable.

Thanks for that. Going out is difficult - we don't have childcare readily available, and DW isn't happy about leaving 2yo with somebody who doesn't know him really well, given he always gets upset if she doesn't put him to bed (even though I point out to her that he goes to bed with me quite happily when she goes out for the evening). I know I need to try harder at the other stuff - it's difficult when I've got so used to the idea she doesn't want me to hold her hand etc., all a bit of a vicious circle. I'm not sure I've ever been much good at that - always shy around girls, and it feels just so like being a teenager again trying to woo somebody who's not that interested. I am trying though, and just hoping relate will help a bit with some of this.

I suppose in a way the drugs is actually quite an easy way to raise what might otherwise be the awkward topic of me not wanting sex (to be honest I don't think I do right now - the idea of failing again scares me rotten!) I do need to discuss this with her tonight - and probably go back to my GP. I feel like I need an extended discussion about taking my ADs - not something which really fits into a GP's schedule.

The worst thing is that I felt so up yesterday when she asked me to share a bed again, we were getting on very well and I'd even got some exercise as my cough is finally relenting after several weeks. Today after spending all my time thinking about this I feel worse than ever, and have no motivation to exercise :(

Few people have motivation to exercise :) Sometimes you can't wait for everything to be right before you get on with something. You have roll your sleeves up and make things happen regardless of how you're feeling. Same goes for relationships. 'Faint heart never won fair lady'.

How about taking through the ADs issue with your GP and leaving DW out of it this time? As you say, you're getting on well and I can't help thinking that a big heavy discussion about your problems and your meds would be a serious romantic downer. We all love someone that thinks we're the most interesting person on the planet. So instead, talk about her... what would she like to do at the weekend, for example?

One thing about the ad's and counselling is that they can help make the counselling more effective as they stop you repressing/depressing your emotions. This makes it easier for the counselling to 'unearth' things that might be buried too deeply without.

"Few people have motivation to exercise"
I used to - it's something I know will usually give me a lift. I wish I could say what it is I did yesterday, as it's something you'd probably also think of as fun, but it's unusual enough to make me far too easy to identify.

I shall think about whether to bring up the meds issue - I feel like I've spent far too long avoiding issues which might be "serious romantic downers" without it really achieving anything in the way of romantic upness, but I suppose this is one I don't need to discuss with DW. The irony is that usually you lot ask if I've discussed things with my wife, and now when I want to you tell me not to!

Sharing and discussing problems is usually healthy but if it gets to the stage where a partner is feeling more like a carer than a lover then it can really throw a wet blanket over the physical/romantic side of a relationship.

there is an a-d drug out there called bupropion that actually tends to boost libido. some doctors prescribe it with Prozac/similar or on its own, when sexual dysfunction is an issue.

not sure if that will help but perhaps bring it up with the Dr.

Thanks oikopolis - that is helpful, at least in terms of something to discuss with GP. Actually almost all input is probably helpful. Not that I think I need my libido boosting - if anything decreasing that might be a good thing - but a bit of googling suggests bupropion does also help with delayed ejaculation.