Prozac and male libido

Dear Alice,

I know that you've briefly addressed the use of Prozac and its effects on the male libido, but I was wondering if you could comment in a bit more detail on its use by men to help them maintain a strong libido and increased control of release. I've heard recent stories about how a "very small" amount of Prozac can have a very dramatic result in increased control for the male — to the point of providing his partner with the best sex of their relationship... Could you comment? What are the dosages typically used for this purpose, and are there any major side effects?

—Looking for stimulation

Dear Looking for stimulation,

Prozac, generically known as fluoxetine, is the world's most widely prescribed anti-depressant; currently, more than 54 million people all over the globe use this medication to treat depression, panic disorder, obsessive-compulsive disorder, and bulimia nervosa. Fluoxetine works by normalizing the levels of the neurotransmitter serotonin in the brain. This provides freedom from constant negative thoughts, sadness, suicidal thoughts, low energy, negative self-image, pervasive thoughts of needing to perform a specific act, and overwhelming feelings of dread and fear. Contrary to what you've heard, fluoxetine does not increase libido. Actually, it usually reduces sexual desire or drive and inhibits orgasm, or the reflex of a sexual release; as a result, some men use fluoxetine recreationally to delay ejaculation.

However, if someone thinks there is a problem with premature ejaculation, they may want to see a health care provider, such as a urologist, who can suggest an appropriate treatment regimen. Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine and Paxil (generically known as paroxetine), are prescribed by some medical providers for premature ejaculation. These drugs, often used in conjunction with sex therapy, can address this. Some sex therapists also use Eastern disciplines, such as Tantra, for maintaining erections and lasting longer during sex.

From your question, it's not clear if you are asking about the use of fluoxetine as an anti-depressant, or just curious about having it as a tool in one's sexual shed. Based on the info offered here, recreational use of fluoxetine by someone who does not experience premature ejaculation will neither allow for greater ejaculatory control or stamina, nor provide their "partner with the best sex of their relationship." In addition, what one considers the best sex, another may not. Plus, this pressure over pleasure creates an undue expectation, excluding other essentials that enhance sexual experiences. What about the feelings involved in being wanted, desired, lusted after? What about tender touching and caressing? Lasting longer is not the only or primary factor in satisfying a partner sexually.

Last updated May 14, 2015
Originally published May 08, 1995

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