Embarrassed to tell your GP? 3 things to say

If a medicine has changed your sex drive, erections or orgasm, you don’t need perfect words for your GP. Start with three things: the medicine and when you took it, what changed, and whether it carried on after you stopped.

With some medicines, sexual problems can continue after you stop. After an SSRI antidepressant such as sertraline, patients call it post-SSRI sexual dysfunction (PSSD). After the hair loss tablet finasteride, it’s post-finasteride syndrome (PFS). After the acne medicine isotretinoin (Accutane), it’s post-Accutane syndrome (PAS).

All three can go beyond sex. A checklist doctors and researchers agreed in 2022 includes problems with concentration and memory. After an antidepressant, people can also feel emotionally numb. After finasteride or isotretinoin, depression can come too, even without any sexual problems.

About three weeks after coming off an SSRI antidepressant, Emily found that all sexual sensation had gone. In this clip she says what people got wrong about it.

Play video: Emily on why people stay silent (PSSD Canada, extract)

People often took it as just a lower sex drive, she says, when she’d lost far more. Then she says why she thinks people stay quiet:

“I strongly suspect there’s a lot of people suffering in silence because it’s such an embarrassing thing to bring up to your doctor or even to your family.”

What should I say to my GP?

Three short lines will do. Say them near the start, so they don’t get squeezed in at the door.

You won’t be the first. In a large survey in Britain, people who looked for help with a sexual problem went to their GP more than anywhere else.

1

The medicine and dates

“I took sertraline 50 mg from January 2023 to March 2024.”

2

What changed, in exact words

“My genitals feel numb, and orgasm has no pleasure.”

3

Whether it lasted

“It hasn't gone since I stopped. The leaflet says this can happen.”

For finasteride, your first line might be “Finasteride 1 mg from May 2022, last tablet February 2024.”

Be exact about what changed. Men with PSSD sometimes describe it as erection problems, and women often as a low sex drive, the researchers David Healy and Dee Mangin wrote in a 2024 paper. Numbness, and orgasms that feel weaker, aren’t always mentioned unless a doctor asks. “Numb” tells your GP far more than “things aren’t right”.

Connor shows how plain it can be. In this BBC film, he names his first side effect in three words.

Play video: Connor on genital numbness after sertraline (BBC News, extract)

What if it carried on after I stopped?

Say so plainly, and show your GP the line in your leaflet. Don’t wait to be asked. Doctors don’t routinely check whether sexual side effects went away once someone stops an antidepressant, Healy and Mangin write.

The UK leaflets give you the words:

• Sertraline: “In some cases, these symptoms have continued after stopping treatment.”
• Finasteride (Propecia): “persistent decrease in sex drive after discontinuation of treatment”. That means a lower sex drive that lasts after stopping.
• Isotretinoin (Roaccutane): “long-lasting sexual problems where the symptoms have continued despite stopping treatment”.

The finasteride and isotretinoin leaflets also tell you to talk to your doctor about sexual problems. You don’t need to be sure the medicine caused it. Our guide Did a medicine cause this? shows how doctors work that out.

What if I can’t say it out loud?

Write it down and hand it over. Before any appointment, the NHS suggests jotting down your symptoms and when they started, and taking that with you. A note can be one line: “I’d like to talk about a sexual side effect. I’ve written it down.”

Our free letter for your doctor does the writing for you. It makes a one-page letter about PSSD, PFS or PAS to hand over, and nothing you type is saved.

Worried about the receptionist? Your surgery may ask what you need help with when you book, so it can find the right person. You can keep it short: “a side effect from a medicine”. Or use your surgery’s online form, which the NHS calls secure and confidential. Appointments may also be by phone or online, the NHS says.

What if my GP doesn’t take it seriously?

Go back, or put it in writing. Doctors can find talking about sex awkward too. If a doctor seems uncomfortable, Healy and Mangin write, a patient may decide not to raise it again. One bad conversation doesn’t have to be the last.

Katie took the antidepressant fluoxetine (Prozac) for about three years. When the sexual problems stayed after she stopped, she went back to her GP. Her doctors, she says, put them down to low self-esteem, trauma and depression.

Play video: Katie on going back to her GP (Moral Medicine, extract)

Nobody had told her it could be a side effect, so she came to believe something was wrong with her personally, she says.

If you go back, bring the leaflet line and your dates. You can also report it yourself, even if a doctor doesn’t agree. For the next step, see who to see for PSSD, who to see for PFS or how PAS is diagnosed.

These medicines help many people. If side effects make you think about changing a medicine, that’s a decision for you and your prescriber. Don’t stop an antidepressant suddenly. Our pages on PSSD, PFS and PAS explain each condition.

Report it: it helps everyone

A doctor’s note helps you. A report to the medicines regulator helps everyone else: it is how patterns get noticed.

• No proof needed. A suspicion is enough, even years after stopping.
• Where: the Yellow Card scheme in the UK, MedWatch in the US.
• Use the right words. If symptoms continued after stopping, write Post-SSRI sexual dysfunction (MedDRA 10086208) for an antidepressant, or Post 5-alpha-reductase inhibitor syndrome (MedDRA 10082430) for finasteride. PAS has no term yet, so say the symptoms continued after stopping isotretinoin.

Our reporting guide walks you through it

What else do people ask?

Can I go to a sexual health clinic instead? For erection problems that keep happening, the NHS says you can see a GP or go to a sexual health clinic, and many clinics take walk-ins. For a low sex drive, it says to see a GP if you think a medicine is the cause.

Can I bring someone with me? Yes. The NHS says you can ask a friend or family member to come with you, and to take notes. If saying it in front of them feels harder, hand over your note instead.

Does this apply to women? Yes. The isotretinoin leaflet lists vaginal dryness, orgasm difficulties and reduced sensation in the genitals. Our page on PSSD in women covers what women describe.

You don’t have to say it out loud: put your three lines in your phone and show them to your GP.

Sources

1. Montejo-González AL, Llorca G, Izquierdo JA and colleagues. SSRI-induced sexual dysfunction: fluoxetine, paroxetine, sertraline, and fluvoxamine in a prospective, multicenter, and descriptive clinical study of 344 patients. J Sex Marital Ther 1997;23(3):176-94. Abstract: sexual dysfunction reported spontaneously by 14% and found in 58% when physicians asked direct questions. Outpatients on SSRIs in Spain with normal sexual function before treatment.
2. Prozac (fluoxetine), US prescribing information, revised August 2023. DailyMed, US National Library of Medicine. Section 6: reliable estimates are difficult to obtain, “in part because patients and healthcare providers may be reluctant to discuss them”, so label figures “are likely to underestimate their actual incidence”.
3. Lustral (sertraline) 50 mg and 100 mg film-coated tablets, patient information leaflet, Electronic Medicines Compendium, last revised December 2025. Section 2, “Sexual problems”.
4. Propecia 1 mg film-coated tablets, patient information leaflet, Electronic Medicines Compendium, last revised May 2026. Section 2: “If you experience symptoms of impaired sexual function, contact your doctor for further medical advice.” Section 4, frequency not known: “persistent decrease in sex drive after discontinuation of treatment”.
5. Roaccutane 10 mg soft capsules, patient leaflet, Electronic Medicines Compendium, last revised April 2026. Section 2: sexual problems including vaginal dryness, orgasm difficulties and reduced sensation in the genitals; long-lasting problems after stopping; “Talk to your doctor if you experience any sexual problems during treatment.”
6. Healy D, Bahrick A, Bak M and colleagues. Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoin. Int J Risk Saf Med 2022;33(1):65-76. Proposed criteria. Section 3: emotional numbing and cognitive impairment among the possible non-sexual symptoms of PSSD. Sections 5 and 6: after finasteride or isotretinoin, cognitive impairment and depression can occur with or without sexual difficulties.
7. Healy D, Mangin D. Post-SSRI sexual dysfunction: barriers to quantifying incidence and prevalence. Epidemiol Psychiatr Sci 2024;33:e40. Editorial. On embarrassment, and a doctor who “appears uncomfortable”. On men describing erectile dysfunction and women loss of libido, while changes in genital sensation and orgasm are “not always volunteered unless asked about directly”. On doctors not routinely asking whether sexual side effects resolved after stopping an antidepressant.
8. Hobbs LJ, Mitchell KR, Graham CA and colleagues. Help-seeking for sexual difficulties and the potential role of interactive digital interventions: findings from the third British National Survey of Sexual Attitudes and Lifestyles. J Sex Res 2019;56(7):937-46. Abstract: help or advice was sought by less than half of those with distressing sexual difficulties; family doctor the most popular source (47.5% to 54.8%); people under 35 preferred the internet or family and friends. Natsal-3, 11,637 sexually active people aged 16 to 74, interviewed 2010 to 2012.
9. NHS, What to ask your doctor or other healthcare professional, page last reviewed 12 January 2023.
10. NHS, Appointments and bookings at your GP surgery, page last reviewed 10 March 2023.
11. NHS, Using an online form to contact your GP surgery, page last reviewed 15 June 2023.
12. NHS, Erection problems (erectile dysfunction), page last reviewed 28 July 2023.
13. NHS, Low sex drive (loss of libido), page last reviewed 26 May 2026.
14. PSSD Canada, Emily’s experience with PSSD, 27 February 2022 (the title is the channel’s). From the YouTube captions. All sexual sensation gone about three weeks after coming off an SSRI (0:20 to 0:32). People hearing it as “just oh lower libido” (2:28 to 2:35). “Such an embarrassing thing to bring up to your doctor or even to your family” (3:40 to 3:50).
15. Moral Medicine, I Lost My Sexual Identity After Prozac, interview with Katie, May 2026. Took the drugs “for around 3 years” (0:48). Back to her GP after stopping (4:40); “believed there was something wrong with me personally” (5:16 to 5:24).
16. BBC News, Antidepressants: Should we talk about side-effects?, 11 August 2023. Connor, 5:54 to 6:27.
17. SIDEfxHUB, A letter for your doctor.

Sources checked on 27 October 2026. AI-assisted writing and review, not clinical review.