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As men get older, they are more likely to experience sexual dysfunction.[1] The major types of male sexual dysfunction include erectile dysfunction, decreased libido and ejaculatory disorders.
Importantly, medications are a leading cause of sexual dysfunction in men. Knowing which drugs prescribed or recommended by your doctor cause sexual dysfunction will allow you to take steps to prevent or minimize this common, often troubling adverse drug effect. (We will discuss drug-induced sexual...
As men get older, they are more likely to experience sexual dysfunction.[1] The major types of male sexual dysfunction include erectile dysfunction, decreased libido and ejaculatory disorders.
Importantly, medications are a leading cause of sexual dysfunction in men. Knowing which drugs prescribed or recommended by your doctor cause sexual dysfunction will allow you to take steps to prevent or minimize this common, often troubling adverse drug effect. (We will discuss drug-induced sexual dysfunction in women in a future issue.)
Erectile dysfunction
Erectile dysfunction — sometimes called impotence — is defined as the inability to have and sustain an erection that is firm enough for sexual intercourse.[2] It is the most common type of sexual dysfunction in men, affecting nearly one-fifth of men aged 50-59 and more than one-third of men aged 70-75.[3] Risk factors for erectile dysfunction include cardiovascular disease, hypertension, obesity, high blood cholesterol and fats, smoking, depression and use of certain medications.[4]
It is estimated that one-quarter of erectile dysfunction cases are due to medications.[5] The list of oral drugs that have been linked to erectile dysfunction is lengthy (see the Table, below, for examples) and includes the following:
- antiandrogens (drugs that block or decrease testosterone)
- antidepressants, particularly serotonin reuptake inhibitors (SSRIs)
- antipsychotics
- numerous drugs for hypertension and cardiovascular disease, including certain abnormal heart rhythm drugs, beta blockers, calcium channel blockers and diuretics (water pills)
- histamine-2 receptor blockers, which are used to treat heartburn and other stomach-acid–related disorders (one of these drugs, cimetidine [TAGAMET HB], has weak antiandrogen effects).[6]
Examples of Oral Drugs That Can Cause Erectile Dysfunction
| Drug Category | Generic Drug Name (Brand Name[s]†) |
|---|---|
| Antiandrogens | Drugs for prostate cancer
|
| Antidepressants | Selective serotonin reuptake inhibitors
|
| Antipsychotics |
|
| Drugs for hypertension/heart disease | Abnormal heart rhythm drugs
|
| Histamine-2 receptor blockers |
|
| Other oral drugs |
|
†Combination brand-name drug products excluded
*Designated as Do Not Use by Worst Pills, Best Pills News
**Designated as Limited Use by Worst Pills, Best Pills News
Decreased libido
Approximately 5% to 15% of men have diminished libido (sexual drive or desire).[7] Low libido becomes more common as men get older and may occur in men who have erectile dysfunction. Decreased libido can be caused by testosterone deficiency, stress, relationship issues, depression and systemic illness.[8]
Many drugs also can cause decreased libido, including antiandrogens, SSRI antidepressants and opioid pain relievers, such as hydrocodone (HYSINGLA), hydromorphone (DILAUDID) and oxycodone (OXAYDO, OXYCONTIN, ROXICODONE, XTAMPZA ER).[9]
Ejaculatory disorders
Ejaculatory disorders include premature (early or rapid) ejaculation, delayed ejaculation, retrograde ejaculation (semen enters bladder during orgasm) and anorgasmia (difficulty reaching orgasm).[10] These disorders may be associated with other types of sexual dysfunction, particularly erectile dysfunction.
As with the other types of sexual dysfunction, ejaculatory disorders can be caused by medications, including certain alpha blockers used to treat benign prostatic hypertrophy (enlargement) — such as silodosin (RAPAFLO) and tamsulosin (FLOMAX) — and SSRI antidepressants.[11]
What You Can Do
If you experience symptoms of sexual dysfunction, review all of your medications with your doctor to determine whether any of them may be contributing to your problem. Do not stop taking any prescription medication without first talking to your doctor. Be aware that other drugs not listed in this article can cause sexual dysfunction.
References
[1] Rosen RC. Khera M. Epidemiology and etiologies of male sexual dysfunction. UpToDate. May 27, 2021.
[2] Ibid.
[3] Ibid.
[4] Ibid.
[5] Ibid.
[6] Ibid.
[7] Ibid.
[8] Ibid.
[9] Ibid.
[10] Ibid.
[11] Ibid.
