The most common medications that cause erectile dysfunction
  man taking a tablets with a glass of water    

Could your medication be causing erectile dysfunction?

Some recreational, prescription and everyday over-the-counter medications such as painkillers and antihistamines can potentially cause erectile dysfunction. Some medicines can affect sex drive and blood flow to the penis, all of which can hinder sexual function and performance.

While there are many causes of impotence, if you’ve exhausted all other possible causes it may be time to take a look at your medication.

Your doctor may be able to adjust your dose or change your medication if this is the cause. Erection problems as a side effect of medication usually subside after stopping the medication, however, you should not stop without consulting your doctor first.

Read on to find out some of the most common medications known to cause impotence.


What is erectile dysfunction?


Erectile dysfunction, also known as impotence or ED, is a common issue that affects men. It is the inability to achieve or maintain an erection. Erection problems can happen occasionally but if it happens frequently, you should see your GP. Erectile dysfunction can be treated with medication or lifestyle changes.


7 medicines that cause erectile dysfunction


1. Antidepressants


Taking antidepressants can cause erectile dysfunction in a number of ways. Firstly, ED is a side effect of this drug. Antidepressants are used to treat clinical depression and other psychological disorders.

They work by correcting chemical imbalances in the brain that may cause low mood. However, although it’s unclear why, taking antidepressants may lead to low sexual desire. If you're uninterested in sex, this makes it difficult to get an erection.

Antidepressants are also linked to delayed ejaculation. Sexual problems as a side effect of taking antidepressants may subside as you get used to your medication, and it’s important that you don't stop taking antidepressants without consulting your GP first.

Untreated depression can also lead to sexual problems such as low libido, so it’s about finding the right treatment plan that suits you. Your GP may be able to adjust your dose, try other types of antidepressants and use it in combination with talking therapies.

Some types of antidepressants are more likely to cause erectile dysfunction than others. Selective serotonin reuptake inhibitors (SSRIs) are the most widely prescribed antidepressants but are more likely to cause ED than other types. SSRIs are also known commonly under the brand name, Prozac.


2. Blood pressure medication


Medicines to control blood pressure are often prescribed, but they’re amongst the top culprits in causing erectile problems. Erectile dysfunction is directly linked to high blood pressure, but it’s also a side effect of some drugs that treat this condition.

An erection that lasts long enough for sex depends on adequate blood flow to the penis. Hypertension (high blood pressure) puts strain on your blood vessels and heart making it difficult to pump blood around the body because the arteries become narrow and hardened. A decrease in blood flow to the penis causes weaker erections.

Unfortunately, the medicines used to treat high blood pressure can also cause impotence. They reduce blood pressure by either relaxing or widening the blood vessels, flushing the body of excess water and salt (diuretics), or slowing down heartbeats and reducing their force (beta blockers).

If impotence has started soon after taking blood pressure medication, it’s likely that this is the cause. It’s important to remember though, that being diagnosed with a condition such as high blood pressure can cause a great deal of stress for some people. The psychological effects of a diagnosis can cause erectile dysfunction rather than the medication.


3. Antihistamines


You may be surprised to discover that regular over-the-counter medicines such as antihistamines can cause, or at least contribute, to impotence.

Histamine is a natural substance produced by the immune system in response to an allergy or injury. Surprisingly, it’s also known to play a role in healthy erections, not only in psychological arousal but also physically by promoting blood flow to the penis.

By blocking the actions of histamine through the overuse of antihistamine drugs, it’s thought that erectile problems can occur.

Should you be worried about taking antihistamines? Antihistamines are generally considered safe, but if you’re taking them regularly and are experiencing erectile dysfunction, you may find that reducing your use brings back erections.

Diphenhydramine and promethazine are noted as being the top antihistamines associated with ED. Speak to your GP about alternative treatments if you believe antihistamines are causing your impotence.


4. Painkillers

    Ibuprofen - medications that cause erectile dysfunction    

Long-term use of painkillers such as opioids and non-steroidal anti-inflammatory drugs are linked to erectile dysfunction and low sex drive, directly and indirectly.

Firstly, long-term use of painkillers can lower the male sex hormone, testosterone. This hormone plays an essential role in sex drive and a healthy libido is vital to achieve an erection.

Secondly, opioid use can go hand in hand with mental health issues such as depression, anxiety and addiction, all of which can lower mood and sex drive and contribute to ED.


5. Antiepileptics


Drugs used to treat epileptic seizures such as phenytoin include sexual dysfunction such as low libido and erectile problems as possible side effects.

Although not everyone who takes antiepileptics will experience these side effects, their ability to lower testosterone levels in men increases the chances of erectile dysfunction. Some antiepileptic drugs can leave people feeling unaroused despite attempts to arouse; this makes it difficult to achieve an erection.

Some antiepileptics are less likely to cause sexual dysfunction such as pregabalin. Speak to your GP about trying these alternatives instead.


6. Parkinson’s disease medication


Some drugs used to treat Parkinson’s disease can decrease sex drive and cause problems with arousal. It’s common to experience depression whilst living with Parkinson’s and some drugs used to treat depression can have a negative impact on sexual desire.

On the other hand, hypersexuality (impulsive sexual feelings and thoughts that may lead to compulsive and inappropriate behaviour) is also a side effect of some medicines used to treat the symptoms of Parkinson’s disease, particularly dopamine agonists.


7. Medicines for prostate cancer


Prostate cancer treatments can affect erections in two ways. Hormone therapy can lower levels of testosterone which is an important hormone that plays a role in erections and orgasms.

If a tumour is close to the nerves and radiotherapy is needed, this treatment can cause nerve damage and erection problems can occur as a result.


Recreational drugs


Prescription and over-the-counter medicines are not the only drugs that can cause impotence. Other drugs that are used recreationally whether obtained illegally or not also run the risk of causing sexual dysfunction.

Alcohol and nicotine are common recreational substances that are linked to erectile dysfunction. Alcohol not only lowers testosterone, but it also depresses the central nervous system and interferes with the signals between the brain and the penis, preventing blood flow to the penis and decreasing sensitivity in the genital area.

Whilst some substances may increase sex drive such as alcohol and cannabis, abuse of these substances can cause physical side effects that prevent penetrative sex from happening because an erection cannot be achieved or maintained.

Other recreational drugs known to cause impotence include:

  • Cocaine
  • Heroine
  • Amphetamines
  • Barbiturates

How to treat erectile dysfunction


The majority of the medicines listed above are taken to treat a serious illness or condition, and often, erectile dysfunction can be a symptom of the psychological distress of a diagnosis or a decrease in quality of life rather than medication.

That said, these medicines can also cause physiological side effects that cause or contribute to erectile dysfunction.

ED can be treated with tablets such as sildenafil and tadalafil, or you may recognise them by their brand names Viagra and Cialis. These work by enabling adequate blood flow to the penis in order to get an erection.

There are lots of erectile dysfunction medicines out there, as well as vacuum pumps and even surgical implants. If you want to try medicines that treat erectile dysfunction, make sure that these drugs won’t interact with any other medicines you’re currently taking.

Finally, leading a healthy lifestyle that involves eating a balanced diet, exercising, not smoking and reducing alcohol intake can help restore healthy erections. This alongside counselling and therapy may help improve your response to sex if adjustments to your medication are not possible.

Laura Shillcock - Medical Content Writer
James O'Loan - CEO & Superintendent Pharmacist
James O'Loan , CEO & Superintendent Pharmacist on 03 July 2023
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