Erectile Dysfunction: Could My Xarelto Medication Be the Cause?

Erectile dysfunction


  1. Rivaroxaban (Xarelto) is a prescription blood thinner.
  2. It works by blocking clotting proteins in your blood.
  3. The most common and potentially serious side effect of Xarelto is bleeding.

Most men will have trouble getting or holding an erection from time to time. Usually, there’s no reason to be concerned. If it becomes an ongoing problem, it’s called erectile dysfunction (ED). Another word for it is impotence.

ED is just one type of sexual dysfunction. Others include:

  • decreased desire for sex
  • inability to have an orgasm
  • delayed ejaculation or inability to ejaculate

Prolonged sexual dysfunction can lead to increased anxiety and stress, which can make the problem worse.

Risk factors for erectile dysfunction

ED is usually the result of restricted blood flow to the penis. Blood vessels in the penis are small to begin with and if they narrow for any reason, it can lead to problems.

Some causes of erectile dysfunction include:

  • diabetes
  • heart conditions
  • high blood pressure
  • Peyronie’s disease
  • Parkinson’s disease
  • multiple sclerosis
  • spinal cord injury
  • injuries that damage nerves or arteries that affect erections
  • depression, anxiety, or stress
  • tobacco use
  • drug or alcohol use or abuse
  • obesity
  • prostate surgery or radiation treatment for cancer
  • aging

Certain medications can also affect your ability to achieve erection. These may include:

  • drugs that treat high blood pressure
  • some antidepressants
  • antihistamines
  • medications to treat prostate conditions
  • some pain medications

Anything that affects blood flow to the penis can contribute to ED. Even something as simple as prolonged bicycle riding can cause a problem.


Rivaroxaban (Xarelto) is a prescription blood thinner. It works by blocking clotting proteins in your your blood. That helps to prevent clots from forming. It’s used to treat a variety of conditions, including deep vein thrombosis and pulmonary embolism. It also reduces the risk of stroke and embolism in patients with nonvalvular atrial fibrillation.

Many people who take Xarelto may have had a blood clot or are at risk of a blood clot. Blood clots often occur in deep blood vessels. Risk factors include:

  • high blood pressure
  • heart disease
  • diabetes
  • smoking
  • cancer
  • other chronic illness

Most of these conditions can also cause ED. If your doctor prescribes Xarelto for you, you probably also have risk factors for ED.

Side effects of Xarelto

The most common and potentially serious side effect of Xarelto is bleeding. Because Xarelto is a blood thinner, it makes it harder for your blood to clot. That means it can take longer for bleeding to stop. This is especially true if you also take other medications that thin the blood. These include aspirin and nonsteroidal anti-inflammatory drugs.

Some additional side effects include:

  • back pain
  • tingling
  • numbness
  • muscle weakness
  • dizziness or feeling light-headed
  • bruising more easily

Side effects to any medication vary from person to person. Always check with your pharmacist for a complete list of side effects.

Tell your healthcare team you’re taking Xarelto before undergoing any medical procedure. And be sure to tell your doctor if you experience any of these symptoms or have abnormal bleeding for any reason.

When to see your doctor

You might feel a little embarrassed to bring it up, but you should talk to your doctor about your ED symptoms because they can help find the underlying cause of your ED.

Even if you’ve only recently begun taking Xarelto and experiencing ED, you shouldn’t assume Xarelto is causing your ED. There is no scientific evidence that Xarelto causes ED. Xarelto is designed to improve blood flow, which generally helps you achieve erection. It’s possible that your ED is a symptom of something else.

If you’re taking other medications, they may increase your risk for ED. Tell your doctor about all the medications and supplements you take. That includes over-the-counter drugs as well as prescription drugs. Sometimes, a medication adjustment is all that’s needed to set things right again. It often takes trial and error to find the correct drugs and doses for you. But don’t stop taking any of your medications. Doing so could put you at serious risk for complications.

ED can be a warning sign of an underlying medical condition you didn’t know you had. Health conditions like previous blood clots, heart disease, high blood pressure, or diabetes could cause ED. That’s why it’s important to work with your doctor to find out why you’re having problems. Once the cause is treated, your ED may go away.

What to do about ED

While working with your doctor, there are a few lifestyle changes that may prove beneficial. If you smoke, stop. Also, cut down on alcohol consumption and seek help if you have a substance abuse problem.

don't drinkdon't smokeseek help

Make exercise part of your daily routine. Regular exercise improves blood flow, eases stress, and is good for your overall health. Try to maintain a healthy diet and get a full night’s sleep.

eat healthysleepsleep

If underlying conditions are ruled out and nothing else is helping, your doctor may be able to prescribe medication specifically designed to treat ED.

Read More: Erectile Dysfunction Treatments

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