Erectile dysfunction (ED) is a common problem for people with a penis. Many factors can increase your chances of experiencing ED, including drug use.
Prescription, over-the-counter, and recreational drugs can all affect your body in many ways. Some of their effects can contribute to ED.
Here’s what to know about how certain drugs can lead to ED and what you can do about it.
If you’re taking a prescription medication and begin experiencing ED, speak with a doctor. They can help you weigh the benefits and risks of your current medication. A doctor may also be able to recommend different medications.
Below are some common medications that can contribute to ED.
Some types of antidepressants can cause ED, including:
- tricyclic antidepressants, such as amitriptyline, imipramine, and doxepin
- monoamine oxidase inhibitors (MAOIs), such as isocarboxazid and phenelzine
- selective serotonin reuptake inhibitors (SSRIs), such as citalopram, fluoxetine, and sertraline
- serotonin-norepinephrine reuptake inhibitors (SNRIs), such as duloxetine and venlafaxine
These drugs alter levels of different chemicals in your brain, such as dopamine, prolactin, and serotonin. However, it’s not fully known how these chemicals regulate sexual function.
Some chemotherapy drugs, such as cisplatin, vincristine, and bortezomib, can cause peripheral neuropathy. This is damage to parts of the nervous system. Peripheral neuropathy can sometimes affect nerves in the penis that control erections.
Blood pressure drugs
Some types of drugs used to treat high blood pressure may prevent smooth muscle in your penis from relaxing. This effect prevents enough blood from reaching the penis. Without proper blood flow, you can’t maintain an erection.
These drugs include:
- beta-blockers, such as atenolol and metoprolol
- diuretics, such as hydrochlorothiazide and chlorthalidone
Drugs that decrease or block testosterone
Some drugs may decrease the level of testosterone in your body or block testosterone from working. This effect can decrease your interest in sex.
These drugs include:
- older antihistamines, such as diphenhydramine and dimenhydrinate
- certain heart drugs, such as digoxin and spironolactone
- corticosteroids, such as prednisone and methylprednisolone
- anti-androgens, such as cyproterone (not available in the United States), flutamide, and bicalutamide
- opioids, such as oxycodone and morphine
- older antipsychotics, such as chlorpromazine, fluphenazine, and haloperidol
Some heartburn medications may cause ED in rare cases. These drugs are called H2 receptor blockers and include cimetidine (Tagamet).
In certain people or at high doses, these drugs may block testosterone from working. As a result, you may feel decreased interest in sex.
Recreational drugs can include illegal drugs like cocaine but also prescription drugs that are misused. Using drugs recreationally can alter the way your body functions and can sometimes cause serious damage.
Examples of recreational drugs that can contribute to ED include:
- amphetamines, which can cause blood vessels to narrow, preventing enough blood from reaching the penis
- barbiturates, which may decrease interest in sex
- nicotine, which can decrease sexual desire
- cocaine, which can cause blood vessels to narrow, preventing enough blood from reaching the penis
- cannabis, which may increase sexual desire but prevent smooth muscle in your penis from relaxing to let enough blood flow in
- heroin, which can decrease levels of testosterone and decrease your interest in sex
Occasionally, drinking alcohol can cause symptoms of ED. That’s because alcohol greatly affects all the body parts responsible for creating an erection.
Alcohol lowers hormone levels, including testosterone. It also damages cells in your testes. Even mild damage may prevent you from getting or maintaining an erection.
If lifestyle factors, such as alcohol or substance use, are causing your ED, changing your habits can be an effective treatment.
If you think drug use may be contributing to your ED, talk with a doctor. It’s important to speak openly with them. Explain what drugs you’ve been taking (including OTC ones), what symptoms you have, and how ED is affecting your life.
Together, you and your doctor can work through the situation. They can help find the help you need to manage and improve your ED.