Professor Leon Pitermana, Ms Lisa McKay-Browna, Dr Catherine Kirbya, Dr Helen Conaglenb, Dr John Conaglenc
a Department of General Practice, Monash University
b Psychology Department, The University of Waikato
c The Faculty of Medical and Health Sciences, University of Auckland
Beyond Blue Victorian Centre of Excellence
Project completion year
The impact of depression in men on relationships includes issues relating to emotional and physical well-being. Side effects can include sexual dysfunction and reduced libido. While antidepressants are treatment options for depression, there is little research on the impact of antidepressant use on a couple’s sexual relationship.
Twelve couples were interviewed about the impact of men’s depression and antidepressant use on:
- each partner’s sexual desire, functioning and relationship
- the female partner’s level of depression
- sexual desire discrepancy between partners (including how this related to changes in depression and sexual function that results from antidepressant use)
- couples’ experiences of antidepressant use.
In Phase 1, participants were couples where the male partner had been diagnosed with depression and was about to commence antidepressant medication. Phase 1 included assessment at diagnosis and three months after treatment. Participants in Phase 2 were couples who had participated in Phase 1 in the previous 12 months.
Male sexual dysfunction was reported by approximately 72 per cent of men in the study. Male depression negatively affected sexual desire in both men and their female partners. When taking antidepressant medication, many men experienced medication-induced anorgasmia or erectile dysfunction; however this group and their partners also had an increase in sexual desire.
Women retrospectively reported that they had decreased sexual desire when their partner was depressed, prior to treatment. While their own sexual desire increased after their partner started treatment, other issues – such as rebuilding the relationship and changing from being a caregiver to being a sexual partner – had a greater impact on the sexual relationship than level of sexual desire or functioning. Their own sexual desire and functioning was not affected by medication-induced sexual dysfunction in male partners.
The qualitative data suggested a causal link between men’s level of depression, erectile function and desire. Correlation studies were not conducted because of the small number of participants.
The couples’ experiences of men’s antidepressant use was generally positive, with both men and women reporting positive changes in the man’s level of depression and behaviour. For most couples, using antidepressants enhanced their emotional well-being, sense of intimacy and sexual relationship.
Implications for policy, practice and further research
Consumer-based education should highlight the impact of depression on both individuals and their partners. Education should address not only the potential benefits of antidepressant therapy, but also the potential effects on relationships, sexual intimacy and sexual function. Healthcare practitioners should promote shared decision making by couples. Follow-up appointments are essential to address any difficulties encountered by the couple. The qualitative link between men’s level of depression, erectile function and desire identified in this research needs exploration in a larger study.