Psychological and sexual functioning of persons suffering from post-SSRI sexual dysfunction – cases study
Kacper Gargul; Beata Pastwa-Wojciechowska
Current Issues in Personality Psychology2025
In plain terms
Researchers in Poland asked four young women, aged 22 to 27, who had finished a course of SSRI antidepressants (a common type of antidepressant) to answer 15 open questions in writing about their sex lives before, during and after treatment. Two said some problems that began on the medicine, such as weaker orgasms or lower desire, were still there about six months after stopping. The other two described some improvements in their sex lives during or after treatment, although one of them also described much lower desire after stopping.
What it doesn’t show: It can't show how common these problems are or that the medicine caused them: it describes only four people, who recalled the past at a single sitting, with no comparison group.
Summary (paraphrased)
While most PSSD research has catalogued somatic symptoms, this case study focuses on the psychological side: the authors described the sexual functioning, and feelings about it, of four young women aged 22-27 before, during and after SSRI treatment, using a written interview of 15 open questions. Two were presented as PSSD cases and two as contrasting cases in which SSRIs seemed to have had a positive effect; the authors noted that personality aspects were not explored sufficiently. They document how these sexual changes interact with identity, mood, and interpersonal functioning, arguing that the psychological dimension is under-studied relative to the physical symptoms. The paper frames PSSD as a biopsychosocial condition requiring psychological as well as medical attention.
Evidence
Extracted from the full text; page numbers refer to the paper. The library’s own notes are labelled as such.
- Design
- Qualitative studyQualitative study of four cases, using a written interview with 15 open questions, analysed case by case with an approach drawn from thematic analysis
- Setting
- University of Gdansk, Poland; participants from the Pomeranian region (mainly the Tricity area), autumn 2021
- Population
- Four young adults aged 22–27, all described as women, studying for or holding a higher-education degree, who had finished SSRI treatment and noticed changes in their sexuality. Recruited from University of Gdansk students and through psychotherapists. Excluded: people taking other medicines, still on treatment, or with no sexual changes.
- Size
- 4 · 4 participants, described as two PSSD cases and two contrasting cases; numbers approached or excluded not reported
- Exposure
- SSRIs, sertraline (Zoloft) in cases 1 and 2 (50 mg in case 1), not named in cases 3 and 4; about 6 months to about 2 years of treatment
- Compared with
- None; each participant's recalled sexual functioning before treatment
- Outcome
- Self-described sexual functioning (desire, arousal, orgasm, pain, satisfaction) and feelings about it, before, during and after treatment, across six question areas.
- Follow-up
- One retrospective interview, about 6 months after stopping (cases 1 and 2) or 7 months (case 3); case 4 started about 5 years earlier and took the drug for about 6 months
Key results
- Case 1 (aged 23, sertraline for about a year): difficulty reaching orgasm and lower desire from 2–3 weeks into treatment; half a year after stopping, sex life "almost the same as before", but orgasm "weaker than before" · p. 38
- Case 2 (aged 27, sertraline for two years): lower desire a few months into treatment; six months after stopping, sexual functioning had not returned to its pre-treatment state, though at interview the problems did not bother her · pp. 38–39
- Case 3 (aged 23, an SSRI for almost two years, stopped seven months earlier): intercourse less painful and libido higher during treatment; satisfaction rose further after stopping, with no pain on penetration · p. 39
- Case 4 (aged 22, an SSRI for about six months): libido rose during treatment; after stopping, a "significant" fall in libido and stress about sex focused on her; she suggested her gender identity as a possible other cause · p. 39
- Authors' summary: symptoms persisted after stopping in cases 1 and 2; in the other two, "treatment alleviated sexual dysfunctions during or after pharmacotherapy" · p. 40
Limitations the authors note
- Small sample limits generalisability, and its size may have increased bias
- Retrospective design; memory is unreliable and tends to be positive, and respondents may have concealed facts
- Results are mainly descriptive case reports, lacking deeper analysis in some areas
- Personality aspects (gender incongruence, mood swings, religious beliefs, guilt) were not explored sufficiently
- The analysis drew on Braun and Clarke's thematic analysis but was not conducted according to that method
Also worth weighing (library’s note)
- Only two of the four cases are described as PSSD; the paper cites diagnostic criteria (p. 36) but does not say whether any case met them
- Case 4 is counted among the two contrasting, positive cases (pp. 35, 40) but is described as having a marked fall in desire after stopping (pp. 39–40)
- The summary that all four had good sexual functioning before treatment (p. 40) differs from the descriptions of earlier difficulty reaching orgasm or painful intercourse in cases 2 and 3 (pp. 38–39)
- Data collection is described both as written answers to a paper interview and as a semi-structured interview that was transcribed (p. 37)
- Data were collected in autumn 2021 (p. 37); the ethics approval cited is numbered 1/01/2024, with no date given (p. 41)
- Participants named other possible influences, such as workload, religious guilt and gender identity (p. 39)
Funding: No external funding Interests: None declared
What it can support (library’s note): Descriptions of how four young women experienced sexual changes during and after SSRI treatment, two of whom reported some problems persisting about six months after stopping. It cannot show how common persistent problems are, that the medicine caused them, or what PSSD is like in general.
Why it’s in the corpus
One of few papers centering the psychological/identity impact of PSSD rather than physiology. Rounds out the corpus's human-impact coverage.
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