Can Zoloft cause permanent erectile dysfunction? (5 factors at play)

In this article, we will discuss whether Zoloft can cause permanent erectile dysfunction. We will discuss some research studies, additional factors that could be at play here, and management tips for people experiencing ED on Zoloft.

Can Zoloft cause permanent erectile dysfunction?

Zoloft may or may not cause permanent erectile dysfunction (ED). Sexual side effects are quite common with Zoloft (sertraline), a selective serotonin reuptake inhibitor (1,2). However, these side effects are expected to be temporary and may resolve as your body adjusts to the medication. 

Zoloft can temporarily delay release or even cause erectile dysfunction, but it shouldn’t linger, especially if the treatment with Zoloft is discontinued. However, people are different and may respond differently to medications like Zoloft. 

In some cases, antidepressants can severely affect sexual functions, leading to discontinuation of treatment, and it may take a long time to return to normal. If you are experiencing ED while taking Zoloft, please reach out to your healthcare provider.

What does research suggest?

There is limited research on the permanent sexual disturbances or ED caused by Zoloft. Research does indicate that more than 70% of individuals taking sertraline or other SSRIs like fluoxetine experience sexual side effects (3). 

Men commonly experience loss of libido, delayed release, orgasmic difficulties, and erectile dysfunction. However, these symptoms are believed to improve with time (4). 

Some research studies have indicated that sertraline, the active ingredient in Zoloft, might be able to help people with premature release (5). This indicates that sertraline has different effects on people and can affect some individuals more severely than others.

What factors can contribute to erectile dysfunction while taking Zoloft?

Several factors can contribute to erectile dysfunction while taking Zoloft, including:


Age can be a contributing factor, as older individuals may be more susceptible to experiencing erectile dysfunction while using Zoloft. The impact of the medication on sexual function may vary based on age-related factors.


The dosage of Zoloft can play a role in the intensity of sexual side effects. Higher doses may increase the probability of experiencing erectile dysfunction or other sexual issues. It’s essential to discuss any concerns about dosage and side effects with a healthcare provider.

Underlying health conditions

Individuals with pre-existing health conditions, such as diabetes, Parkinson’s disease, cardiac issues, or other medical conditions, may be more susceptible to developing erectile dysfunction when taking Zoloft. 

Lifestyle factors

Unhealthy lifestyle habits, including smoking and excessive alcohol consumption, can contribute to erectile dysfunction. When combined with the effects of Zoloft, these factors may have a more pronounced impact on sexual function.

Use of other medications

Concomitant use of medications, especially those known to cause erectile dysfunction on their own, can exacerbate the issue when taken with Zoloft. It’s important to inform your provider about all medications that you are currently taking to prevent potential drug interactions.

What to do if Zoloft is causing erectile dysfunction?

If Zoloft is causing erectile dysfunction, it is important to talk to your healthcare provider. If you’re new to Zoloft, your doctor might opt for a dose reduction to see if it makes any difference. Low doses are easier to tolerate, and dose reduction has proven effective for many people in such cases. 

However, if that doesn’t work, your doctor might recommend some add-on treatments to help manage your symptoms while giving Zoloft some time to take effect. If Zoloft continues to cause ED or affect your sexual functions, your doctor may consider alternative treatment options.

What antidepressants are safe to take with erectile dysfunction?

The following antidepressants can be used as alternatives if Zoloft causes ED: 

  • Wellbutrin (Bupropion) (6)
  • Remeron (Mirtazapine)
  • Viibryd (Vilazodone)
  • Trintellix (Vortioxetine)

These antidepressants are least likely to cause ED and do not worsen pre-existing ED. However, it is important to note that Zoloft should not be stopped abruptly, and one should switch to a different antidepressant only under their doctor’s supervision. 

If your doctor believes that Zoloft is not the right choice for you or is worsening your ED, they will recommend a safe and suitable alternative and adjust your dose if needed.

How is erectile dysfunction managed in clinical settings?

Doctors often prescribe pills like Viagra, Cialis, Levitra, or Stendra to manage ED. However, the management and treatment of ED can depend on various individual-specific factors. The common pharmacological treatments are: (7)

TreatmentDose Range
Sildenafil (Viagra)25 mg to 100 mg as needed
Tadalafil (Cialis)2.5 mg to 20 mg as needed
Vardenafil (Levitra)5 mg to 20 mg as needed
Avanafil (Stendra)50 mg to 200 mg as needed
Alprostadil (Caverject, Edex)Dose varies; available in injection or suppository forms

Most healthcare providers also recommend making good and healthy lifestyle changes. This includes things like regular exercise, maintaining a healthy weight, and avoiding excessive alcohol or tobacco use. Healthy habits contribute to better blood circulation, which is important for good erectile function.

In some cases, low testosterone levels might be a factor. Testosterone replacement therapy, which could be in the form of injections, gels, or patches, may be recommended to address this issue.

As a pharmacist, I always advise patients to stick to their doctor’s prescriptions. Each individual is unique and what works for one may not work for another. It is important to discuss all your concerns with your provider, as these details are crucial to determining the best treatment plan for you.


  1. Singh HK, Saadabadi A. Sertraline. 2023 Feb 13. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 31613469. Available from:
  1. The Food and Drug Administration (FDA). HIGHLIGHTS OF PRESCRIBING INFORMATION. ZOLOFT (sertraline hydrochloride) tablets, for oral use. Available from:
  1. Kennedy SH, Eisfeld BS, Dickens SE, Bacchiochi JR, Bagby RM. Antidepressant-induced sexual dysfunction during treatment with moclobemide, paroxetine, sertraline, and venlafaxine. J Clin Psychiatry. 2000 Apr;61(4):276-81. doi: 10.4088/jcp.v61n0406. PMID: 10830148. 
  1. antidepressants: a descriptive clinical study of 32 patients. Int J Psychiatry Med. 1995;25(2):191-201. doi: 10.2190/1DHU-Y7L7-9GKG-V7WV. PMID: 7591493. 
  1. Mendels J, Camera A, Sikes C. Sertraline treatment for premature release. J Clin Psychopharmacol. 1995 Oct;15(5):341-6. doi: 10.1097/00004714-199510000-00006. PMID: 8830065. 
  1. Pereira VM, Arias-Carrión O, Machado S, Nardi AE, Silva AC. Bupropion in the depression-related sexual dysfunction: a systematic review. CNS Neurol Disord Drug Targets. 2014;13(6):1079-88. doi: 10.2174/1871527313666140612112630. PMID: 24923342.
  2. Huang SA, Lie JD. Phosphodiesterase-5 (PDE5) Inhibitors In the Management of Erectile Dysfunction. P T. 2013 Jul;38(7):407-19. PMID: 24049429; PMCID: PMC3776492. 

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