Hi! I am a 20 year old AFAB person (pronouns she/they) that has anxiety and ADHD. I am on Fluoxetine (aka Prozac) for my anxiety and Adderal for my ADHD. I started Fluoxetine at the beginning of 2021 and began taking Adderal is August if 2021. I have been having a lot of issues sex wise. I think I may be on the asexual spectrum, because I’m constantly up and down with how I feel about sex. Sometimes I’m excited and ready to do something with my partner (also AFAB, pronouns they/she). But most of the time I am disinterested or even repulsed by sex. When I DO want sex though, two things happen: a) my drive does not last long and I’ll be in the mood for a bit, we’ll start doing something, and it will disappear (sometimes randomly, sometimes out of boredom) and b) it is really hard for me to come. Any penetration is painful so my partner and I stick to the clit and other parts of my body. My vulva does not create a ton of natural lubricant, so we always add some to our sessions. The thing is, it takes SO LONG. We can go for an hour and nothing. It will eb and flow with something feeling good and not really feeling anything at all, with no change of technique or position. My partner and I say that I have a very particular pussy. On top of that, I pee very often because I have a small bladder and I drink a lot of water. Once I feel the urge to pee it both stops me from orgasming and once I do pee I can never get back in the mood. My partner is so wonderful and understanding. We have tried so many things with no luck. And I have a similar issue while masturbating as well. I know that sex is not often on the table for me but I want it to be good when it is! I guess I just need help with everything overall: boosting my libido/sex drive, figuring out the pee situation, working with my brain that gets bored easily, and figuring out how the fuck to come! I know that isn’t the most important thing about sex, but it is such a downer for both my partner and I. HELP PLEASE 
oh yes and also on top of all this I grew up very religious and have a lot of shame around sex, especially queer sex that I’m struggling to overcome. I’m struggling over here!
Hi VolcanicLove, I’m sorry your having such a hard time! If I tried to tell you how much I can relate to what your going through, I’d write a novel! So let me say that I’m 59 and have been where you are regarding the meds for anxiety and ADHD. I’m happy to be able to say that I was able to come off of all medications in 1996. While on it, and other medications, it seriously destroyed my libido! I had severe chronic major depression, anxiety, and 3 other major diagnoses. They told me I was literally on enough medication for 3 people. So much so, that the hospital where my doctor worked out of asked me to sign a letter stating that if I had a severe adverse reaction or died from the medications that I was being prescribed that neither me, nor my family would seek restitution… in other words, I/we wouldn’t sue them. In an 8 yr period, from 1987-1995, I had 17 admissions for suicide attempts. So when I say I’ve been there, I’ve REALLY been there. All of it combined had a serious effect on my being interested in sex or not. It was usually not! But even then, after coming off of all the psych drugs I was still on medications for severe chronic pain. It had the same effect. By the time I got off the meds, my husband and I were divorced by late '97. Then in late '99 to early 2000 I started having breathing problems that put me on oxygen and less than a year later I developed adult onset asthma. By Sept 2016 I was told that I was dying, and by Oct I was in hospice. I almost died several times that year, but by January 2017 I had started improving to where I no longer needed hospice. Now? I’m much better than I was, but I’m still on O2, my lung disease is still undiagnosed, and since last Dec. I’ve been hospitalized twice for my asthma. So yup! I get it! I mention all of that because in late 2016 I was put on a BOATLOAD of pain medications for pain in my lungs. That too left me not caring if I had sex. I’m now off of that and I’m not having that problem anymore.
So here’s the thing. I’m not a doctor, but I know just enough about medicine to probably get myself in trouble, if I weren’t careful! So fluoxetine is what’s called an SSRI (Selective Serotonin Reuptake Inhibitor). To the best of my knowledge serotonin is a key hormone in the brain. fluoxetine helps stabilize it within your brain. Unfortunately, it can effect your ability to enjoy or even have sex. If you have a primary doctor, I would suggest that you ask to be referred to an Endocrinologist. Those are the docs that deal with hormones. I would also consider that you think about if this is something that you feel like you can be comfortable talking to a man about. IF NOT, whoever you end up being sent to, when you make that appt be sure to request a female doctor. I’m dealing with that now, but I’m having the opposite problem your having! LOL! It’s always something. The sad thing is, no one suggested that I see someone. Maybe because there was nothing to do. I don’t know. But you won’t know if you don’t try. I hope they can do something to help!
As for your anxiety, do you know what the origin of it is? What caused it? That’s partly how I got better. I finally remembered WHY I was depressed and anxious. When you know the why’s, you can begin to make conscious decisions about how it affects you. You CAN make the choice that what ever it was, I’m NOT going to allow it to have control over you. I’m not by any means saying that it will be easy, certainly not suggesting that you try to do it without medication, and if you’re seeing someone, a therapist, don’t try to do it without them! It would be to easy to fall in a whole that you’d likely have trouble getting out of by yourself. But, I will also tell you that I was prayed over. That part of the story is way to long to include here, but was the most important part of the story. I know this was stupid long. I can only hope that at least something here was helpful. Good luck to you!