6 Common Medications That Can Cause Erectile Dysfunction

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<h2 class="wp-block-heading">What is Erectile Dysfunction?</h2>
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<p>Erectile dysfunction. We’ve all heard of it. And Pfizer’s advertising campaign when it introduced its blockbuster erectile dysfunction drug Viagra (<a href="https://medlineplus.gov/druginfo/meds/a699015.html" target="_blank" rel="noreferrer noopener">sildenafil</a>) made it a household phrase. Up to <a href="https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/definition-facts" target="_blank" rel="noreferrer noopener">30 million men in the US</a> have trouble getting or maintaining an erection sufficient for sexual intercourse, according to recent estimates. It can affect men of all races and ages, though rates are moderately higher among men aged <a href="https://www.uwhealth.org/urology/erectile-dysfunction-ed/20537" target="_blank" rel="noreferrer noopener">70 and older</a>, compared to men in younger age groups.</p>
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<p>Contrary to popular belief, however, aging does not cause erectile dysfunction. A wide range of physical and psychological conditions can lead to erectile dysfunction, including high blood pressure, heart disease, diabetes, anxiety, depression and lifestyle factors such as alcohol and illicit drug use and smoking.</p>
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<p>Another common cause of erectile dysfunction is prescription medications, and six types of drugs in particular have the biggest effect on libido.</p>
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<h2 class="wp-block-heading">6 Common Medications That Can Cause Erectile Dysfunction</h2>
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<li><strong><a href="https://www.health.harvard.edu/mens-health/blood-pressure-drugs-and-ed-what-you-need-to-know" target="_blank" rel="noreferrer noopener">Blood Pressure Medications</a></strong></li>
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<p>“No question these impact erectile function,” says Landon Trost, MD, founder of the Male Infertility and Peyronie’s Clinic in Orem, Utah. It is not clear why blood pressure lowering medications can cause ED, but it reverses if a patient quits taking the drug. <a href="https://medshadow.org/should-you-worry-about-beta-blockers/" target="_blank" rel="noreferrer noopener">Beta blockers</a>, thiazide <a href="https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/diuretics/ART-20048129?p=1" target="_blank" rel="noreferrer noopener">diuretics</a> and loop diuretics are among the ones more likely to cause erectile dysfunction. ”If the medication can be switched for another blood pressure drug, angiotensin receptor blockers or ACE inhibitors are preferred,” adds Trost.</p>
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<li><strong><a href="https://www.cancer.gov/publications/dictionaries/cancer-terms/def/androgen-receptor-antagonist" target="_blank" rel="noreferrer noopener">Androgen Blockers</a></strong></li>
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<p>Often prescribed to treat prostate cancer, androgen blockers, also called androgen receptor antagonists, include Casodex (<a href="https://medlineplus.gov/druginfo/meds/a697047.html" target="_blank" rel="noreferrer noopener">bicalutamide</a>) and <a href="https://medlineplus.gov/druginfo/meds/a697045.html" target="_blank" rel="noreferrer noopener">flutamide</a> and can cause erectile dysfunction and decreased libido along with many other side effects. “It typically takes several months to years to see the full impact of these medicines, and often they cannot be discontinued,” says Trost, unless they were prescribed for recurrent long-lasting erections — a condition called <a href="https://www.mayoclinic.org/diseases-conditions/priapism/symptoms-causes/syc-20352005?p=1" target="_blank" rel="noreferrer noopener">priapism</a> — in the first place. In that case, your doctor may be able to prescribe an alternative medication.</p>
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<li><strong>Hair Loss Drugs</strong></li>
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<p>Hair loss medications include <a href="https://medshadow.org/propecia-hair-for-most-impotence-and-worse-for-some/" target="_blank" rel="noreferrer noopener">Propecia </a>(<a href="https://medlineplus.gov/druginfo/meds/a698016.html" target="_blank" rel="noreferrer noopener">finasteride</a>), which is also sold under the brand name Proscar for <a href="https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/prostate-enlargement-benign-prostatic-hyperplasia" target="_blank" rel="noreferrer noopener">benign prostatic hyperplasia</a> (BPH), and Avodart (<a href="https://medlineplus.gov/druginfo/meds/a603001.html" target="_blank" rel="noreferrer noopener">dutasteride</a>), a BPH drug used off label to treat male hair loss.  These drugs “diminish dihydrotestosterone levels and suppress libido in about 10% of men but these effects are much more profound in younger guys,” according to Jesse N. Mills, MD, an associate clinical professor of urology at the David Geffen School of Medicine at UCLA Health and director of the Men’s Clinic at UCLA. “Try stopping and using <a href="https://medlineplus.gov/druginfo/meds/a689003.html" target="_blank" rel="noreferrer noopener">minoxidil</a> instead for hair preservation,” if you have erectile dysfunction that is caused by one of these drugs, he advises.</p>
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<li><strong>Sedatives and Anxiolytics</strong></li>
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<p>“Anything that depresses nerves, such as Xanax (<a href="https://medlineplus.gov/druginfo/meds/a684001.html#side-effects" target="_blank" rel="noreferrer noopener">alprazolam</a>), Ativan (<a href="https://medlineplus.gov/druginfo/meds/a682053.html#side-effects" target="_blank" rel="noreferrer noopener">lorazepam</a>), Valium (<a href="https://medlineplus.gov/druginfo/meds/a682047.html#side-effects" target="_blank" rel="noreferrer noopener">diazepam</a>), alcohol, and any of the sleep aids often impact erectile function,” says Trost. The effect is reversible and is most likely caused by direct suppression of nerve signals or possibly by changes in hormonal signaling. Mills adds that “narcotic use causes suppression of testosterone which can alter blood flow to the penis.”</p>
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<li><strong><a href="https://medshadow.org/coping-with-antidepressants-side-effects/" target="_blank" rel="noreferrer noopener">Antidepressants</a></strong></li>
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<p>These commonly prescribed medications affect sexual function in different ways depending on the specific type of drug and how it works. “Central regulation of erections relies on dopamine and serotonin, so any impact on these processes can worsen erectile function,” says Trost. Antidepressants most likely to cause erectile dysfunction include <a href="https://www.mayoclinic.org/diseases-conditions/depression/in-depth/ssris/ART-20044825?p=1" target="_blank" rel="noreferrer noopener">selective serotonin reuptake inhibitors</a> (SSRIs, including Prozac  and Paxil), <a href="https://www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20044970" target="_blank" rel="noreferrer noopener">serotonin and norepinephrine reuptake inhibitors</a> (SNRIs, including Effexor XR and Cymbalta), <a href="https://www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/ART-20046983?p=1" target="_blank" rel="noreferrer noopener">tricyclic and tetracyclic antidepressants</a>, such as Pamelor and Anafranil, and <a href="https://www.mayoclinic.org/diseases-conditions/depression/in-depth/maois/ART-20043992?p=1" target="_blank" rel="noreferrer noopener">monoamine oxidase inhibitors</a> (MAOIs, such as Marplan). Trost notes that Wellbutrin (<a href="https://medlineplus.gov/druginfo/meds/a695033.html" target="_blank" rel="noreferrer noopener">bupropion</a>) and Remeron (<a href="https://medlineplus.gov/druginfo/meds/a697009.html" target="_blank" rel="noreferrer noopener">mirtazapine</a>) are among the antidepressants that<a href="https://www.mayoclinic.org/diseases-conditions/depression/expert-answers/antidepressants/FAQ-20058104?p=1" target="_blank" rel="noreferrer noopener"> have the least impact on erectile function</a>.</p>
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<li><strong>Antihistamines</strong></li>
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<p>Commonly used to treat allergy symptoms, heartburn or motion sickness, certain antihistamines may impact sexual function. Among its many roles in the body, histamine is thought to act as a neurotransmitter and appears to contribute to sexual arousal and erections. One antihistamine, Tagamet (<a href="https://my.clevelandclinic.org/health/drugs/18309-cimetidine-tablets" target="_blank" rel="noreferrer noopener">cimetidine</a>), appears to have <a href="https://urology.wisc.edu/wp-content/uploads/2018/10/Module_4_ED.pdf" target="_blank" rel="noreferrer noopener">antiandrogen properties</a>, leading to <a href="https://www.issm.info/sexual-health-qa/can-prescription-medications-affect-testosterone-levels/" target="_blank" rel="noreferrer noopener">reduced testosterone levels</a> and thus, sexual dysfunction. Other antihistamines that may contribute to erectile dysfunction include Benadryl (<a href="https://medlineplus.gov/druginfo/meds/a682539.html" target="_blank" rel="noreferrer noopener">diphenhydramine</a>), Claritin (<a href="https://medlineplus.gov/druginfo/meds/a697038.html" target="_blank" rel="noreferrer noopener">loratidine</a>), Dramamine (<a href="https://medlineplus.gov/druginfo/meds/a607046.html" target="_blank" rel="noreferrer noopener">dimenhydrinate</a>), Antivert (<a href="https://medlineplus.gov/druginfo/meds/a682548.html" target="_blank" rel="noreferrer noopener">meclizine</a>) and Zantac (<a href="https://medlineplus.gov/druginfo/meds/a601106.html" target="_blank" rel="noreferrer noopener">ranitidine</a>).</p>
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<p>While each of these medications alone can affect erectile function, “the greater the number of medications a patient is taking, the greater the impact on sexual function,” says Trost. “In addition to eliminating as many of these as possible, changing to an alternative where possible, and optimizing health through lifestyle choices, we can typically <a href="https://medshadow.org/alternatives-erectile-dysfunction-drugs/" target="_blank" rel="noreferrer noopener">treat the erectile dysfunction directly through other therapies</a>.”</p>
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<p>While you shouldn’t stop taking prescribed medications without consulting your healthcare provider, you can have a discussion about whether a particular drug is necessary in the first place, suggests Mills. “For blood pressure medications and antidepressants, there are alternatives that most physicians know to prescribe if a man is having erectile dysfunction,” he says.</p>
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