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Sexual functioning improved in women with regularly scheduled exercise and sexual activity.

Adverse sexual effects are common in women taking antidepressants. Exercise can increase sexual arousal in healthy women, improve sexual function in depressed women not taking medication, and increase genital arousal in women taking antidepressants in a laboratory setting.

Now, investigators have conducted a randomized, crossover trial to assess whether exercise could alleviate sexual side effects from selective serotonin or norepinephrine reuptake inhibitors in 52 affected women (mean age, 32; 73% meeting DSM-IV-TR criteria for sexual dysfunction). After a 3-week interval for measuring baseline sexual activity (alone or with a partner), participants exercised vigorously for 30 minutes 3 times per week for 3 weeks and were assigned to engage in sex within 30 minutes of exercising or 6 hours or more after exercising. Participants then switched groups for another 3 weeks. A total of 42% dropped out of the study, mostly because of time constraints.

Exercise before sex increased sexual desire overall, and, in women with sexual dysfunction, it increased global sexual function. Improvement of sexual function with exercise at least 6 hours before sex was not statistically significant. Orgasm improved with scheduling of regular sexual activity. Sexual satisfaction was not significantly affected.

COMMENT

The authors hypothesized that exercise-induced stimulation of the sympathetic nervous system would increase sexual desire and arousal, especially if exercise occurred shortly before sexual activity. Of note, simply scheduling regular sexual activity improved orgasm, whereas scheduling exercise, especially just before sexual activity, increased desire. The high dropout rate suggests that these interventions are not for everyone. However, clinicians should consider prescribing regularly scheduled exercise and sexual activity for women with sexual side effects from antidepressants.

Deborah Cowley, MD reviewing Lorenz TA and Meston CM. Depress Anxiety 2013 Nov 1.