70% Taking Common Antidepressants Suffer Sexual Side Effects

What’s the latest on treating depression with the spice saffron? Years ago, I covered a head-to-head comparison of saffron versus Prozac for the treatment of depression in my video Saffron vs. Prozac, and saffron seemed to work just as well as the drug. In the years since, five other studies have found that saffron beat out placebo or rivaled antidepressant medications.

It may be the spice’s red pigment, crocin, since that alone beat out placebo as an adjunct treatment, significantly decreasing symptoms of depression, symptoms of anxiety, and general psychological distress. Perhaps, its antioxidants played a role in “preventing free radical-induced damage in the brain.” The amount of crocin the researchers used was equivalent to about a half teaspoon of saffron a day.

If the spice works as well as the drugs, one could argue that the spice wins, since it doesn’t cause sexual dysfunction in the majority of men and women like most prescribed antidepressants do. SSRI drugs like Prozac, Paxil, and Zoloft cause “adverse sexual side effects” in around 70 percent of people taking them. What’s more, physicians not only significantly underestimate the occurrence of side effects, but they also tend to underrate how much they impact the lives of their patients.

Not only is this not a problem with saffron, the spice may even be able to treat it, as I explore in my video Best Food for Antidepressant-Induced Sexual Dysfunction. “In folk medicine, there is a widely held belief that saffron might have aphrodisiac effects.” To test this, men with Prozac-induced sexual impairment were randomized to saffron or placebo for a month. By week four, the saffron group “resulted in significantly greater improvement in erectile function…and intercourse satisfaction,” and more than half of the men in the saffron group regained “normal erectile function.” The researchers concluded that saffron is an “efficacious treatment” for Prozac-related erectile dysfunction. It has all been found to be effective for female sexual dysfunction, as well, as you can see at 2:35 in my video. Female sexual function increased by week four, improving some of the Prozac-induced sexual problems but not others. So, it may be better to try saffron in the first place for the depression and avoid developing these sexual dysfunction problems, since they sometimes can persist even after stopping the drugs, potentially worsening one’s long-term depression prognosis.

This includes unusual side effects, such as genital anesthesia, where you literally lose sensation. It can happen in men and women. More rarely, antidepressants can induce a condition called restless genital syndrome. You’ve heard of restless legs syndrome? Well, this is a restless between-the-legs syndrome. These PSSDs, or Post-SSRI Sexual Dysfunctions, meaning dysfunctions that appear or persist after stopping taking these antidepressants, can be so serious that “prescribing physicians should mention the potential danger of the occurrence of genital (e.g., penile or vaginal) anesthesia to every patient prior to any SSRI treatment.” If you’re on one of these drugs, did your doctor warn you about that?

All hope is not lost, though. Evidently, penile anesthesia responds to low-power laser irradiation. After 20 laser treatments to his penis, one man, who had lost his penile sensation thanks to the drug Paxil, partially regained his “penile touch and temperature sensation.” However, he still couldn’t perform to his girlfriend’s satisfaction, and she evidently ended up leaving him over it, which certainly didn’t help his mood. But, before you feel too badly for him, compare a little penile light therapy to clitoridectomy, clitoris removal surgery, or another Paxil-related case where a woman’s symptoms only improved after six courses of electroshock therapy.

Pass the paella!


For more on the spice, check out:

Those drug side effects sound devastating, but depression is no walk in the park. However, when one balances risk and benefit, one assumes that there are actually benefits to taking them. That’s why the shocking science I explored in Do Antidepressant Drugs Really Work? is so important.

What else may boost mood? A healthy diet and exercise:

For more on sexual health generally, see:

What else can spices do? Here’s just a taste:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

Is It Healthier to be Happier?

More than 60 years ago, the World Health Organization defined health as a “state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” Just because you’re not depressed doesn’t necessarily mean you’re happy. But, if you look in the medical literature, there are 20 times more studies published on health and depression than there are on health and happiness. In recent years, though, research on positive psychology has emerged, and we’re now asking what we can do to increase our success, functioning, and happiness. Although these are all inherently good in themselves, what about the question I address in my video Are Happier People Actually Healthier?

“There is growing evidence that positive psychological well-being is associated with reduced risk of physical illness,” but it’s not surprising that healthier people are happier than sick people. “The intriguing issue is whether psychological well-being protects against future illness or inhibits the progression of chronic disease.” To figure out which came first, you’d have to get more than just a snapshot in time. You would need prospective studies, meaning studies that go forward over time, to see if people who start out happier do, in fact, live longer. A review of such studies indeed “suggests that positive psychological well-being has a favorable effect on survival in both healthy and diseased populations.”

Not so fast.

Yes, positive states may be associated with less stress, less inflammation, and more resilience to infection. But, positive well-being may also be accompanied by a healthy lifestyle that itself reduces the risk of disease. Happy people tend to smoke less, exercise more, drink less alcohol, and sleep better. So, maybe happiness leads to health only indirectly. The apparent protective effect of positive psychological well-being, however, persists even after controlling for all these healthy behaviors. This means that even at the same level of smoking, drinking, exercising, and sleeping, happier people still seem to live longer.

Ideally, to establish cause-and-effect definitively, we’d do an interventional trial, in which participants would be assigned at random to different mood levels and tracked for health outcomes. It’s rarely feasible or ethical to randomly make some people’s lives miserable to see what happens, but if you pay people enough you can do experiments like the one whose objective stated: “It has been hypothesized that people who typically report experiencing negative emotions are at greater risk for disease and those who typically report positive emotions are at less risk.” Researchers tested this using the common cold virus. Three hundred and thirty-four healthy volunteers were assessed for how happy, pleased, and relaxed they were, or how anxious, hostile, and depressed. Subsequently, they were given nasal drops containing cold rhinoviruses to see who would be more likely to come down with the cold. Who would let someone drip viruses into their nose? Someone paid $800, that’s who!

Now, just because you get exposed to a virus doesn’t mean you automatically get sick. We have an immune system that can fight it off, even if the virus is dripped right into our nose. But, whose immune system fights better?

In one-third of the bummed out folks, their immune systems failed to fight off the virus and they came down with a cold. But only about one in five got a cold in the happy group. Could it be that those with positive emotions slept better, got more exercise, or had lower stress? No. It appears that even after controlling for the healthy practices and levels of stress hormones, happier people still appear to have healthier immune systems and a greater resistance to developing the common cold.

It also works with the flu. When researchers repeated the study with the flu virus, increased positive emotions were associated with decreased verified illness rates, just like in their earlier study on colds. These results indicate that feeling vigorous, calm, and happy may play a more important role in health than previously thought.


Okay, so if happiness improves health, how do we improve happiness? That’s the subject of my video Which Foods Increase Happiness?.

I’m as guilty as the rest of my colleagues for focusing on mental illness rather than mental health (though my Laughter as Medicine video is a rare exception). It’s a consequence of what’s out there in the medical literature, though I’ll make a special effort to highlight new studies in this area as they’re published. I do, however, have a number of videos on preventing and treating negative mood states, such as depression and anxiety:

What about psychiatric medications? See my videos Do Antidepressant Drugs Really Work?, Exercise vs. Drugs for Depression, and Saffron vs. Prozac.

Interested in other ways to improve our immune system? Check out Using the Produce Aisle to Boost Immunity.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Fennel Seeds vs. Ginger for Menstrual Cramps and PMS

Ninety percent of women report having painful menstrual cramps at least some of the time. Around the Mediterranean, fennel seeds have been traditionally used to relieve painful menstruation. We call them seeds, but they’re actually whole little fruits. I discuss their effectiveness in the treatment of menstrual cramps in my video Fennel Seeds for Menstrual Cramps and PMS. It’s hard to create placebo seeds, so researchers used fennel seed extract to put it to the test. The women started out rating their pain as six out of ten, which then went down to a four within an hour after the taking the fennel seed extract. Fifty-two percent of the women rated the fennel seed treatment as excellent, compared with only 8 percent of those in the placebo group who were just unknowingly given placebo capsules just containing flour.

But women don’t take flour for cramps; they take drugs such as ibuprofen. Mefenamic acid is in the same class of nonsteroidal anti-inflammatory (NSAID) drugs and may actually work better than ibuprofen, but it is not available over the counter. How did it do against an extract of fennel seeds? In a head-to-head study, most women started out in severe pain but ended up pain-free after treatment, and the fennel worked just as well as the drug class considered the treatment of choice––but without the drug’s side effects, which include diarrhea, rashes, autoimmune anemia, and kidney toxicity.

The drug also doesn’t help with the other symptoms of bad periods. During menstruation, women can feel nauseated, out of sorts, weak, achy, and diarrheic. But when put to the test, fennel seeds seemed to help; however, the control group wasn’t given a placebo, so we don’t know how much of that was a placebo effect.

One downside of taking fennel is that women bleed about 10 percent more. Menstrual cramps are caused by the uterus contracting so hard its blood supply is compromised, and we think fennel works through muscle relaxation. It also helps with infant colic, which is thought to be due to intestinal spasms. The advantage of fennel there, too, is the lack of side effects, unlike the drug commonly used for colic. Indeed, dicyclomine hydrochloride can work a little too well to get your baby to stop crying––by developing side effects like death.

Ginger is effective for cramps and reduces bleeding when an eighth of a teaspoon of ginger powder is taken three times a day during one’s period. This is important since up to 18 million young women in the United States experience iron deficiency anemia due to heavy menstrual bleeding. In a study, the amount of blood loss was estimated using a scoring system that gave points for level of saturation and clot size. On ginger, they went from half a cup per period down to a quarter cup. Ginger appears to be a highly effective treatment for the reduction of menstrual blood loss. It is cheap, at only about 6 cents a month, easy to use, and may have fewer side effects than medications and invasive approaches, even sometimes fewer than placebo! The researchers used lactose (milk sugar) for the sugar pills, which may have caused the reported flatulence.

Ginger may also work better for premenstrual syndrome (PMS). An eighth of a teaspoon twice a day of ginger powder for a week before one’s period yields a significant drop in PMS mood, physical, and behavioral symptoms, whereas fennel may help with PMS anxiety and depression but not with the emotional or physical symptoms.


Other dietary interventions that may help include a reduction in salt and animal fat consumption, which I address in my video Dietary Treatment for Painful Menstrual Periods.

We should use whatever works––because sometimes, evidently, PMS symptoms can lead to death. Case in point: Christine English who, at that time of the month, ran down her husband. Accepting PMS as a defense, the court released her with one year of probation.

For more on treating menstrual pain and PMS, see:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations: