Q. I have been on Prozac for the past 3 months. Recently, I have had trouble when my husband and I have sex. I only reach a certain plateau — not climax or orgasm. I know this is a side effect of the medication, but what can I do about it?

A. You’re right that delayed orgasm is one of the possible side effects of Prozac and some other SSRIs (the class of antidepressants called Selective Serotonin Reuptake Inhibitors). These medications act by inhibiting the central nervous system’s use of the neurotransmitter serotonin, which leaves more of that chemical floating around in the brain.

You might want to talk with the physician who prescribed Prozac for you to see if the dose can be adjusted or if you can be switched to another medication without such side effects. You may also go a different route. Try experimenting with your husband on different or additional sexual activities or positions that might increase your pleasure.

You don’t mention whether you’re in psychotherapy, or if you’ve found Prozac to be helpful in alleviating your depression or any other condition for which the medication was prescribed. If not, your physician could refer you to a psychologist or other therapist who can help you address your depression (and sometimes medical conditions, as well) through psychological and behavioral changes. Such therapy can be an addition to or a replacement for antidepressant medication.

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