Have you recently — and somewhat abruptly — begun to have problems getting and keeping an erection suitable for intercourse? Before you descend into full-blown panic, you might want to check your medicine chest first. If your doctor has recently prescribed a new medication, no matter how innocuous that drug might seem at first glance, it’s possible that it could be causing symptoms of erectile dysfunction.
The good news, of course, is that you’ll likely regain normal erectile function once you stop taking the drug. However, if your doctor has prescribed this new drug to treat a serious health problem, such as high blood pressure or depression, your future health may well depend on the beneficial effects of this new medication.
Some Alternatives Cause Fewer Problems
Fortunately, many prescription and over-the-counter drugs that affect erectile function adversely have acceptable alternatives with more erection-friendly effects. If your doctor can switch you to such a substitute, you’ll probably be fine. However, if there is no reasonable alternative to the medication producing your erection problems, you may have to learn to live with its side effects.
The effects of certain medications on erectile function are not widely understood by the general public, according to the experts at Consumers Reports’ Best Buy Drugs. All too often, drug-related effects on sexual function are mistakenly attributed to age-related sexual decline, a spokesman told The Washington Post.
Mechanisms of Action Differ
J. Dennis Fortenberry, M.D., former chair of the board of the American Sexual Health Association and the Donald Orr Professor of Adolescent Medicine at Indiana University School of Medicine, concurred with Consumer Reports. “Many medications can affect things like erectile dysfunction, desire, and ejaculation in different ways and through different mechanisms of action,” he said.
Here, courtesy of EverydayHealth.com, is a list of medications and drug therapies that have been associated with erection problems. The list is fairly broad and may include categories in which certain drugs are known to interfere with erectile function while others may not. If you are taking one of these types of drugs and experiencing erection problems, check with your doctor to see if he can prescribe an equally effective alternative that is less likely to cause such problems. If not, the doctor can probably suggest a course of action that will allow you to continue taking the offending drug and still function sexually as you were previously.
- Diuretics. These medications increase the amount of fluid and sodium that is excreted from the body. They are prescribed most often to treat high blood pressure but can be taken for other purposes as well.
- High blood pressure medications. If your blood pressure has been trending higher than normal, your doctor may prescribe a drug to lower it. Some antihypertensives tend to interfere more with erectile function than others.
- Antihistamines. Taken to combat the discomfort of allergic reactions caused by a wide variety of triggers, including pollen, dust, mold spores, and insect stings.
- Antidepressants. Drugs to combat depression, which is itself a cause of ED, can cause erection problems. Some drugs in this overall category have less adverse effects on erectile function than others.
- Parkinson’s disease drugs.
- Antiarrhythmics. These drugs are taken to stabilize your heart beat and combat the effects of irregular heart beat, whether too fast, too slow, or otherwise abnormal.
- Tranquilizers and sedatives. Prescribed to treat anxiety and stress, these medications can sometimes cause unintended anxiety by interfering with normal erectile function.
- Muscle relaxants. Taken to ease the discomfort of temporary back pain caused by strain or sudden movement, as well as the pain associated with fibromyalgia.
- Nonsteroidal anti-inflammatory drugs, popularly known by their acronym NSAIDs. These medications include aspirin, celecoxib (Celebrex), ibuprofen (Advil and Motrin), and naproxen sodium (Aleve and Anaprox DS) and are taken to treat mild to moderate pain. Acetaminophen (Tylenol) might be an acceptable substitute for some forms of pain.
- Histamine H2-receptor antagonists, also known as H2 blockers. Prescribed to treat both duodenal and gastric ulcers, these drugs also treat Zollinger-Ellison disease, a condition in which the stomach produces too much acid.
- Hormone replacement therapies.
- Chemotherapy drugs.
- Prostate cancer medications.
- Antiseizure medications.
Seven Types of Problematic Drugs
In his overview of medications most likely to interfere with sexual function, pasted at AARP.org, geriatric pharmacist Armon B. Neel Jr. singled out the seven types of drugs that most often cause sexual dysfunction. He also explained how they cause the problems that they do.
First on Neel’s list are statins and fibrates, both of which are prescribed to lower blood levels of cholesterol. However, because cholesterol is a building block of hormones, these drugs interfere with the production of testosterone, estrogen, and other sex hormones. He also notes that statins can cause rhabdomyolysis, a breakdown of muscle tissue that could lead to joint pain.
Some Antihypertensives Worse Than Others
Second, says Neel, are blood pressure medications. He acknowledges, of course, that high blood pressure itself can cause sexual dysfunction, but says that some antihypertensives can reduce sexual desire in men and interfere with erectile function and ejaculation. Of the various drugs used to treat hypertension, said Neel, the three types most likely to cause sexual dysfunction are diuretics, alpha-blockers, and beta-blockers.
Antidepressants, third on the list, can cause problems in all areas of sexual function, says Neel. He says that they probably do so by blocking the natural action of three neurotransmitters — acetylcholine, serotonin, and norepinephrine — that carry signals between nerve cells. Clomipramine, sold under the brand name Anafranil, is most often prescribed to treat obsessive-compulsive disorder and is associated with a high level of sexual dysfunction.
Antipsychotic Drugs Also Offend
Fourth on the list are antipsychotic drugs. These are prescribed to treat schizophrenia and other psychiatric disorders. Many of the drugs in this category block dopamine, a neurotransmitter that helps to control the brain’s reward and pleasure centers. The drugs also increase levels of prolactin, a hormone that can lead to reduced sexual desire, ED, and difficulty in achieving orgasm.
Benzodiazepines are fifth on Neel’s list. Better known as tranquilizers or sedatives, these drugs are prescribed to treat anxiety, as well as agitation, insomnia, muscle spasms, and to prevent seizures. The drugs’ sedative and muscle-relaxant properties can lead to a loss of sexual desire and sensation. They can also interfere with the production of testosterone, which plays a key role in sexual desire among both men and women.
H2 Blockers Can Cause Problems
Sixth on Neel’s list are the H2 blockers, also known as H2-receptor antagonists, prescribed to treat gastric and peptic ulcers, erosive esophagitis, and gastroesophageal reflux disease or GERD. Of the drugs in this class, cimetidine, sold under the brand name Tagamet, has been associated with more sex-related side effects than other H2 blockers.
Last on Neel’s list are anticonvulsant medications, prescribed to control seizures in people suffering from epilepsy. Older drugs in this category, carbamazepine (Tegretol) and phenytoin (Dilantin) seem to cause more sexual dysfunction than new drugs such as gabapentin (Neurontin) and topiramate (Topamax).
As previously noted, many of these drugs have acceptable alternatives that tend to cause fewer, if any, sexual side effects. However, never stop taking a medication prescribed by your doctor or substitute another without first consulting the doctor.
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