Lexapro (escitalopram) sexual side effects

Lexapro sexual side effects include lower sex drive, delayed or absent orgasm, delayed ejaculation and erection problems. In the UK, escitalopram’s brand name is Cipralex, and its leaflet calls these side effects common: up to 1 in 10 people. It also says side effects “usually disappear after a few weeks of treatment”. Yet the same leaflet warns that in some cases, sexual symptoms “have continued after stopping treatment”.

That warning sits among the precautions, not in the list of side effects, and neither the NHS page on escitalopram nor the US label mentions it. We could find no study that has measured how often it happens with escitalopram. We think the warning is easy to miss, and that anyone starting escitalopram should hear both sentences.

Common, and expected to ease

The official picture is reassuring, and much of it is fair. The NHS page, reviewed in June 2026, lists “sexual problems, such as low sex drive” among the common side effects. Most side effects, it says, “should ease after a couple of weeks as your body gets used to the medicine, but some can last longer”.

The US Lexapro label, revised in October 2023, treats sex as something to manage during treatment. It tells prescribers to ask about sexual function before the first dose and during treatment, and to “discuss potential management strategies”. Its guide for patients adds that “there may be treatments your healthcare provider can suggest”.

Not every change comes from the tablets. The US label notes that changes in desire and sexual performance “often occur as manifestations of a psychiatric disorder”. And antidepressants help many people, which is why this matters: they deserve the whole picture. What none of these texts mentions is the sentence in section 2 of the UK leaflet.

How common depends on who asks

The leaflet’s “up to 1 in 10” comes from clinical trials, and how a trial asks decides what it finds. The UK prescribing information says its frequencies “are taken from clinical studies”. The US label says its trials collected side effects “primarily by general inquiry”, written down by each investigator in their own words.

Counted that way, 12% of men on escitalopram reported ejaculation problems, against 1% on a placebo, a dummy tablet. Among women, 3% reported being unable to reach orgasm, against under 1%. The label itself warns that such figures are “likely to underestimate” the real rate, partly because “patients and physicians may be reluctant to discuss them”.

Asking everyone directly gives a different answer. In two trials published by Clayton and colleagues in 2006, adults with depression and a normal sex life at the start filled in a questionnaire about sexual function. By week 8, when the trials ended and people were still taking the tablets, 30% of the 281 people on escitalopram had problems with orgasm, against 9% of the 273 on placebo. Sexual function had got worse overall for 36% on escitalopram and 15% on placebo.

The placebo figures are a fair reminder that depression affects sex too. But like every figure on the labels, these cannot tell you what happens after stopping.

Can Lexapro sexual side effects be permanent?

Nobody can tell you in advance. What is documented is that for some people, they did not stop when the tablets did.

In May 2019 the safety committee of the European Medicines Agency, which oversees medicines in the EU, reviewed reports of sexual problems that continued after two groups of antidepressants were stopped: SSRIs, the group escitalopram belongs to, and the related SNRIs. It weighed evidence from the EU’s database of side effect reports, published research, social media and the companies’ own reviews. Escitalopram was named, and every company licensed to sell it was asked to add a warning.

The sentence in the UK leaflet is the committee’s wording, with the brand name filled in, and the UK prescribing information tells doctors of reports of “long-lasting sexual dysfunction”. The warning is on every SSRI and SNRI, so it does not single out escitalopram. The full list has its own page, and so do comparisons between antidepressants.

UK leaflet, 2025

Sexual symptoms have sometimes continued after stopping

UK prescribing information, 2025

Reports of long-lasting sexual dysfunction after stopping

NHS escitalopram page, 2026

Sexual problems listed, nothing on after stopping

US Lexapro label, 2023

Sexual problems during treatment, nothing on after stopping

How often, on escitalopram

No published figure

It is the same medicine. Whether you see the warning depends on which page you read.

When sexual problems continue after an SSRI or SNRI is stopped, patients and researchers call it post-SSRI sexual dysfunction, or PSSD. Rosie’s account shows what it can mean for one person. She is president of the PSSD Network and was prescribed Lexapro. In a 33-minute interview with Moral Medicine, published in July 2024, she describes side effects that had lasted more than four years, and how hard it was to have them medically acknowledged. Her story has its own page.

How often PSSD follows escitalopram is unknown, and the reason is built into the evidence. Reports show that something happened, never how often. In 2018, Healy and colleagues described 300 cases of lasting sexual problems that people in 37 countries chose to send to RxISK, a drug safety website the authors helped to set up. The site’s articles on the subject had “likely encouraged reporting”, so the study’s figures are not rates. Escitalopram was named in 42 cases. Many people described something neither label mentions, genital numbness: 49% of the men and 60% of the women whose problems followed an antidepressant.

A 2023 study by Ben-Sheetrit and colleagues counted it in 19 years of Israeli health records, but only in men, and only as erection problems treated with prescription tablets. Of 866 otherwise healthy men aged 21 to 49 who had taken an antidepressant acting on serotonin, 4 were still taking those tablets months after stopping the antidepressant: 1 in 216. The authors say their method “may underestimate” the true figure. Escitalopram was among the drugs those four men had taken, so it is not a figure for escitalopram alone.

A figure for escitalopram would need what the 2006 trials had, direct questions, and what they lacked: years of follow-up after stopping. Until one exists, patients’ own records are among the few places this is written down, such as the SIDEfxHUB registry. Its members chose to join, so it cannot give a rate either, but it can follow how symptoms change over years.

What to ask, and what to do if it has not lifted

If you are about to start, you can raise the warning before the first tablet. The US label already expects prescribers to ask about your sex life, and the question can come from you:

• The leaflet says sexual symptoms have sometimes continued after stopping. What do you know about that?
• How will we notice early if my sex life changes?

If you have stopped and the changes have not lifted, the leaflet’s sentence is something to put in front of a doctor.

1. Tell your prescriber. They may not have come across it. Show them section 2 of the leaflet.
2. Report it to your country’s medicines regulator, using the term in the box below. You do not need a doctor to agree with you, or proof that the drug caused it.
3. Join the registry. A report records one reaction, once. The registry follows you over months and years.

The leaflet says side effects usually disappear. For sexual side effects it also says they have sometimes continued after stopping, and we think that sentence belongs in the conversation before the first tablet, not only after the last. Until someone measures how often it happens, the record is the one patients make, in a report and in the registry.

If you are struggling with your mental health, the Samaritans are on 116 123 in the UK, free, at any hour. In the US, call or text 988.