That's an interesting update.

There are the "old" MAOInhibitors that I think do not have many sexual side effects... Nardil. But they are difficult because of risk from tyramines in food interacting. So doctors don't use them anymore for that reason. What I see on the web is some men have difficulty and others not.

Wellbutrin (bupropion) works on dopamine systems and usually has few if any sexual side effects. Using a low dose may be all you need. Some people get cardiac palpitations on this drug... and have to stop it, however. We've had a few PNers on here claim it also helped their PN pain.

Almost all the SSRIs and SNRIs affect sexual performance and enjoyment. Some less than others. Zoloft is less so than Prozac... but they all affect it somewhat.

What antibiotics are you on....? Long term some of those have nutrient depletion factors, that you need to attend to, as well.

SAMe is OTC and works for mild depression and low mood. You might look into that. Its price has come down quite a bit over the years. NatureMade is one of the better brands. It has a rebate program online... you get a $7 coupon, for 500 or so pts (which is about 3 packages). Costco has good prices on SAMe...that is where I used to get mine. Start at 200mg a day for a while to see it if agrees with you. Some younger people may get irritable on it. (like my son did). The arthritis dose goes up to 600mg-800mg a day...but most people feel better on just the 200mg. (take on an empty stomach early in the day--it may cause insomnia at first but not always).

edit 3-12-16--- The NatureMade rebate program has been discontinued.