Skip to main content

Acute Exercise Improves Physical Sexual Arousal in Women Taking Antidepressants



Antidepressants can impair sexual arousal. Exercise increases genital arousal in healthy women, likely due to increasing sympathetic nervous system (SNS) activity.


Test if exercise increases genital arousal in women taking antidepressants, including selective serotonin reuptake inhibitors (SSRIs), which suppress SNS activity, and selective serotonin and norepinephrine reuptake inhibitors (SNRIs), which suppress the SNS less.


Women reporting antidepressant-related sexual arousal problems (N = 47) participated in three counterbalanced sessions where they watched an erotic film while we recorded genital and SNS arousal. In two sessions, women exercised for 20 min, either 5 or 15 min prior to the films.


During the no-exercise condition, women taking SSRIs showed significantly less genital response than women taking SNRIs. Exercise prior to sexual stimuli increased genital arousal in both groups. Women reporting greater sexual dysfunction had larger increases in genital arousal post-exercise. For women taking SSRIs, genital arousal was linked to SNS activity.


Exercise may improve antidepressant-related genital arousal problems.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3
Fig. 4


  1. 1.

    Stimulation of other NE receptors, particularly the α1 receptors, generally causes vasoconstriction; however, there is evidence that in sacral nerves such as those innervating the genital vasculature, the effect of β2-related blood vessel dilation is far stronger than that of α1-related constriction [52].


  1. 1.

    Olfson M, Marcus S, Druss B, et al.: National trends in the outpatient treatment of depression. JAMA. 2002, 287:203–209.

    PubMed  Article  Google Scholar 

  2. 2.

    Ashton A, Rosen R: Accommodation to serotonin reuptake inhibitor-induced sexual dysfunction. J Sex Marital Ther. 1998, 24:191–192.

    PubMed  Article  CAS  Google Scholar 

  3. 3.

    Thiels C, Linden M, Grieger F, Leonard J: Gender differences in routine treatment of depressed outpatients with the selective serotonin reuptake inhibitor sertraline. Int Clin Psychopharmacol. 2005, 20:1–23.

    PubMed  Article  Google Scholar 

  4. 4.

    Paulose-Ram R, Safran M, Jonas B, Gu Q, Orwig D: Trends in psychotropic medication use among US adults. Pharmacoepidem Dr S. 2007, 16:560–570.

    Article  Google Scholar 

  5. 5.

    Clayon A, Keller A, McGarvey EL: Burden of phase-specific sexual dysfunction with SSRIs. J Affect Disord. 2006, 91:27–32.

    Article  Google Scholar 

  6. 6.

    Rosen R, Lane R, Menza M: Effects of SSRIs on sexual function: A critical review. J Clin Psychopharmacol. 1999, 19:67–85.

    PubMed  Article  CAS  Google Scholar 

  7. 7.

    Werneke U, Northey S, Bhugra D: Antidepressants and sexual dysfunction. Acta Psychiatr Scand. 2006, 114:384–397.

    PubMed  Article  CAS  Google Scholar 

  8. 8.

    Taylor M, Rudkin L, Hawton K: Strategies for managing antidepressant-induced sexual dysfunction: Systematic review of randomised controlled trials. J Affect Disord. 2005, 88:241–254.

    PubMed  Article  CAS  Google Scholar 

  9. 9.

    Perlis R, Fava M, Nierenberg A, et al.: Strategies for treatment of SSRI-associated sexual dysfunction: A survey of an academic psychopharmacology practice. Harv Rev Psychiatry. 2002, 10:109–114.

    PubMed  Google Scholar 

  10. 10.

    Nurnberg H, Hensley P, Heiman J, et al.: Sildenafil treatment of women with antidepressant-associated sexual dysfunction: A randomized controlled trial. JAMA. 2008, 300:395–404.

    PubMed  Article  CAS  Google Scholar 

  11. 11.

    Safarinejad MR: Reversal of SSRI-induced female sexual dysfunction by adjunctive bupropion in menstruating women: A double-blind, placebo-controlled and randomized study. J Psychopharmacol (Oxf). 2011, 25:370–378.

    Article  CAS  Google Scholar 

  12. 12.

    Masand PS, Ashton AK, Gupta S, Frank B: Sustained-release bupropion for selective serotonin reuptake inhibitor-induced sexual dysfunction: A randomized, double-blind, placebo-controlled, parallel-group study. A J Psychiatry. 2001, 158:805–807.

    Article  CAS  Google Scholar 

  13. 13.

    Souery D, Amsterdam J, De Montigny C, et al.: Treatment resistant depression: Methodological overview and operational criteria. Eur Neuropsychopharmacol. 1999, 9:83–91.

    PubMed  Article  CAS  Google Scholar 

  14. 14.

    Montejo A: Are sexual disorders core symptoms of depression? Medicographia. 2008, 30:24–29.

    Google Scholar 

  15. 15.

    Serretti A, Chiesa A: Treatment-emergent sexual dysfunction related to antidepressants: A meta-analysis. J Clin Psychopharmacol. 2009, 29:259–266.

    PubMed  Article  CAS  Google Scholar 

  16. 16.

    Millan M, Lejeune F, Gobert A: Reciprocal autoreceptor and heteroreceptor control of serotonergic, dopaminergic and noradrenergic transmission in the frontal cortex: Relevance to the actions of antidepressant agents. J Psychopharmacol (Oxf). 2000, 14:114–138.

    Article  CAS  Google Scholar 

  17. 17.

    Gothert M, Fink K, Frolich D, et al.: Presynaptic 5-HT auto-and heteroreceptors in the human central and peripheral nervous system. Behav Brain Res. 1995, 73:89–92.

    Article  Google Scholar 

  18. 18.

    Enguix M, Sanchez L, Villazun M, et al.: Differential regulation of rat peripheral 5-HT 2A and 5-HT 2B receptor systems: Influence of drug treatment. N-S Arch Pharmacol. 2003, 368:79–90.

    Article  CAS  Google Scholar 

  19. 19.

    Hull E, Muschamp J, Sato S: Dopamine and serotonin: Influences on male sexual behavior. Physiol Behav. 2004, 83:291–307.

    PubMed  CAS  Google Scholar 

  20. 20.

    Shores M, Pascualy M, Lewis N, Flatness D, Veith R: Short-term sertraline treatment suppresses sympathetic nervous system activity in healthy human subjects. Psychoneuroendocrino. 2001, 26:433–439.

    Article  CAS  Google Scholar 

  21. 21.

    Barton D, Dawood T, Lambert E, et al.: Sympathetic activity in major depressive disorder: Identifying those at increased cardiac risk? J Hypertens. 2007, 25:2117–2124.

    PubMed  Article  CAS  Google Scholar 

  22. 22.

    Licht C, Penninx B, de Geus E: Response to depression and blood pressure control: All antidepressants are not the same. Hypertension. 2009, 54:e2.

    Article  CAS  Google Scholar 

  23. 23.

    Bradford A, Meston C: Autonomic nervous system influences: The role of the sympathetic nervous system in female sexual arousal. The Psychophysiology of Sex. Bloomington, Indiana: Indiana University Press, 2007, 66-82.

    Google Scholar 

  24. 24.

    Lorenz TK, Harte CB, Hamilton LD, Meston CM: Evidence for a curvilinear relationship between SNS activation and women’s sexual arousal. Psychophysiology. in press.

  25. 25.

    Meston CM: A randomized, placebo-controlled, crossover study of ephedrine for SSRI-induced female sexual dysfunction. J Sex Marital Ther. 2004, 30:57–68.

    PubMed  Article  Google Scholar 

  26. 26.

    Ahrold T, Meston C: Effects of SNS activation on SSRI-induced sexual side effects differ by SSRI. J Sex Marital Ther. 2009, 35:311–319.

    PubMed  Article  Google Scholar 

  27. 27.

    Bymaster FP, Zhang W, Carter PA, et al.: Fluoxetine, but not other selective serotonin uptake inhibitors, increases norepinephrine and dopamine extracellular levels in prefrontal cortex. Psychopharmacology (Berl). 2002, 160:353–361.

    Article  CAS  Google Scholar 

  28. 28.

    Perry K, Fuller R: Fluoxetine increases norepinephrine release in rat hypothalamus as measured by tissue levels of MHPG-SO 4 and microdialysis in conscious rats. J Neural Transm. 1997, 104:953–966.

    PubMed  Article  CAS  Google Scholar 

  29. 29.

    Sanchez C, Hyttel J: Comparison of the effects of antidepressants and their metabolites on reuptake of biogenic amines and on receptor binding. Cell Mol Neurobiol. 1999, 19:467–489.

    PubMed  Article  CAS  Google Scholar 

  30. 30.

    Meston CM, Gorzalka BB: The effects of immediate, delayed, and residual sympathetic activation on sexual arousal in women. Behav Res Ther. 1996, 34:143–148.

    PubMed  Article  CAS  Google Scholar 

  31. 31.

    Meston CM, Gorzalka BB: Differential effects of sympathetic activation on sexual arousal in sexually dysfunctional and functional women. J Abnorm Psychol. 1996, 105:582–591.

    PubMed  Article  CAS  Google Scholar 

  32. 32.

    Hoffman B, Babyak M, Sherwood A, et al.: Effects of aerobic exercise on sexual functioning in depressed adults. Mental Health and Physical Activity. 2009, 2:23–28.

    Article  Google Scholar 

  33. 33.

    Chivers ML, Seto MC, Lalumière ML, Laan E, Grimbos T: Agreement of sef-reported and genital measures of sexual arousal in men and women: A meta-analysis. Arch Sex Behav. 2010, 39:5–56.

    PubMed  Article  Google Scholar 

  34. 34.

    American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders (Revised 4th Ed.). Washington, DC: Author, 2000.

  35. 35.

    Pischon T, Boeing H, Hoffmann K, et al.: General and abdominal adiposity and risk of death in Europe. N Engl J Med. 2008, 359:2105–2120.

    PubMed  Article  CAS  Google Scholar 

  36. 36.

    Gellish RL, Goslin BR, Olson RE, et al.: Longitudinal modeling of the relationship between age and maximal heart rate. Med Sci Sports Exerc. 2007, 39:822–829.

    PubMed  Google Scholar 

  37. 37.

    Hamilton LD, Fogle EA, Meston CM: The roles of testosterone and alpha-amylase in exercise-induced sexual arousal in women. Journal of Sexual Medicine. 2008, 5:845–853.

    PubMed  Article  Google Scholar 

  38. 38.

    Laan E, Everaerd W, van Bellen G, Hanewald G: Women’s sexual and emotional responses to male- and female-produced erotica. Arch Sex Behav. 1994, 23:153–169.

    PubMed  Article  CAS  Google Scholar 

  39. 39.

    Laan E, Everaerd W, Evers A: Assessment of female sexual arousal: Response specificity and construct validity. Psychophysiology. 1995, 32:476–485.

    PubMed  Article  CAS  Google Scholar 

  40. 40.

    Laan E, van Driel E, van Lunsen R: Genital responsiveness in healthy women with and without sexual arousal disorder. Journal of Sexual Medicine. 2008, 5:1424–1435.

    PubMed  Article  Google Scholar 

  41. 41.

    Harte C, Meston C: Gender comparisons in the concordance between physiological and subjective sexual arousal. International Society for the Study of Women’s Sexual Health. Orlando, FL, 2007.

    Google Scholar 

  42. 42.

    Harte C, Meston C: The inhibitory effects of nicotine on physiological sexual arousal in nonsmoking women: Results from a randomized, double blind, placebo controlled, cross over trial. Journal of Sexual Medicine. 2008, 5:1184–1197.

    PubMed  Article  CAS  Google Scholar 

  43. 43.

    Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology: Heart rate variability: Standards of measurement, physiological interpretation and clinical use. Circulation. 1996, 93:1043–1065.

    Article  Google Scholar 

  44. 44.

    Heiman J, Rowland D: Affective and physiological sexual response patterns: The effects of instructions on sexually functional and dysfunctional men. J Psychosom Res. 1983, 27:105–116.

    PubMed  Article  CAS  Google Scholar 

  45. 45.

    Brotto L: The DSM diagnostic criteria for hypoactive sexual desire disorder in women. Arch Sex Behav. 2010, 39:221–239.

    PubMed  Article  Google Scholar 

  46. 46.

    Leiblum SR, Koochaki PE, Rodenberg CA, Barton IP, Rosen RC: Hypoactive sexual desire disorder in postmenopausal women: US results from the Women’s International Study of Health and Sexuality (WISHeS). Menopause. 2006, 13:46–56.

    PubMed  Article  Google Scholar 

  47. 47.

    Rosen RC, Brown C, Heiman JR, et al.: The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther. 2000, 26:191–208.

    PubMed  Article  CAS  Google Scholar 

  48. 48.

    Ottesen B, Pedersen B, Nielsen J, et al.: Vasoactive intestinal polypeptide (VIP) provokes vaginal lubrication in normal women. Peptides. 1987, 8:797–800.

    PubMed  Article  CAS  Google Scholar 

  49. 49.

    Wiegel M, Meston CM, Rosen R: The female sexual function index (FSFI): Cross-validation and development of clinical cutoff scores. J Sex Marital Ther. 2005, 31:1–20.

    PubMed  Article  Google Scholar 

  50. 50.

    Thomas MSC, Annaz D, Ansari D, et al.: Using developmental trajectories to understand developmental disorders. J Speech Lang Hear Res. 2009, 52:336–358.

    PubMed  Article  Google Scholar 

  51. 51.

    Carmeliet P, Tessier-Lavigne M: Common mechanisms of nerve and blood vessel wiring. Nature. 2005, 436:193–200.

    PubMed  Article  CAS  Google Scholar 

  52. 52.

    von Heyden B, Riemer R, Nunes L, et al.: Response of guinea pig smooth and striated urethral sphincter to cromakalim, prazosin, nifedipine, nitroprusside, and electrical stimulation. Neurourol Urodyn. 1995, 14:153–168.

    Article  CAS  Google Scholar 

  53. 53.

    Davison T, McCabe M: Relationships between men’s and women’s body image and their psychological, social, and sexual functioning. Sex Roles. 2005, 52:463–475.

    Article  Google Scholar 

  54. 54.

    Lawlor D, Hopker S: The effectiveness of exercise as an intervention in the management of depression: Systematic review and meta-regression analysis of randomised controlled trials. Br Med J. 2001, 322:1–8.

    Article  Google Scholar 

  55. 55.

    Dove NL, Wiederman MW: Cognitive distraction and women’s sexual functioning. J Sex Marital Ther. 2000, 26:67–78.

    PubMed  Article  CAS  Google Scholar 

  56. 56.

    Masters W, Johnson V: Human Sexual Inadequacy. Boston: Little Brown, 1970.

    Google Scholar 

  57. 57.

    Brotto L, Gorzalka B: Genital and subjective sexual arousal in postmenopausal women: Influence of laboratory-induced hyperventilation. J Sex Marital Ther. 2002, 28:39–53.

    PubMed  Google Scholar 

  58. 58.

    Schueller PO, Feuring M, Sharkova Y, Grimm W, Christ M: Effects of synthetic progestagens on autonomic tone, neurohormones and C-reactive protein levels in young healthy females in reproductive age. Int J Cardiol. 2006, 111:42–48.

    PubMed  Article  Google Scholar 

  59. 59.

    Sanders SA, Graham CA, Bass JL, Bancroft J: A prospective study of the effects of oral contraceptives on sexuality and well-being and their relationship to discontinuation. Contraception. 2001, 64:51–58.

    PubMed  Article  CAS  Google Scholar 

  60. 60.

    Blumenthal J, Babyak M, Moore K, et al.: Effects of exercise training on older patients with major depression. Arch Intern Med. 1999, 159:2349–2356.

    PubMed  Article  CAS  Google Scholar 

  61. 61.

    Tschakovsky M, Joyner M: Nitric oxide and muscle blood flow in exercise. Appl Physiol Nutr Me. 2008, 33:151–154.

    Article  CAS  Google Scholar 

Download references


This research was supported by Grant Number 1F31MH085416 from the National Institutes of Mental Health (NIMH) to Tierney Lorenz and, in part, by 1RO1 HD051676 from the National Institute of Child Health and Human Development (NICHD) to Cindy M. Meston. The contents of the manuscript are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.

Conflict of Interest Statement

The authors have no conflict of interest to disclose.

Author information



Corresponding author

Correspondence to Tierney A. Lorenz M.A..

About this article

Cite this article

Lorenz, T.A., Meston, C.M. Acute Exercise Improves Physical Sexual Arousal in Women Taking Antidepressants. ann. behav. med. 43, 352–361 (2012).

Download citation


  • Antidepressant side effects
  • Sexual arousal functioning
  • Exercise
  • Sympathetic nervous system activity