While many midlife women are interested in pursuing non-hormonal options for the treatment of menopausal symptoms, they are understandably concerned about taking antidepressant medications, such as SSRIs and SNRIs, that, while effective for treating hot flashes and night sweats, are commonly associated with sexual side effects. A recent study indicates that venlafaxine (Effexor, an SNRI antidepressant) does not differ significantly from estradiol in terms of its effects on sexual functioning.

In an 8-week randomized controlled trial among women aged 40–62 years, sexual function was compared in women receiving 0.5 mg oral estradiol per day, 75 mg venlafaxine per day, or placebo. Overall sexual functioning among non-depressed midlife women with hot flushes did not change over the 8 weeks of treatment with either low-dose oral estradiol or venlafaxine (compared with placebo). However, there may be a subtle increase in desire among women taking estradiol and a decreases in orgasm and pain among women taking venlafaxine.

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Ruta Nonacs, MD PhD

Reed SD, Mitchell CM, Joffe H, Cohen L, et al. Sexual function in women on estradiol or venlafaxine for hot flushes: a randomized controlled trial. Obstet Gynecol. 2014 Aug; 124:233-41.

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