In most cases of erectile dysfunction, different causes coexist in the same person.
It can be triggered by blood circulation problems and worsened by anxiety and stress.
Medications can also take a toll on the male reproductive system.
Most medicines won’t cause severe erectile dysfunction but reduce the quality and length of erections.
Combined with psychogenic triggers and biological causes, they may cause significant problems and compromise sexual health.
Thus, check your pill organizer and prescription list if you already have erectile issues.
If you use one of the medications listed in this article, be sure to talk to your doctor about your erection problems before making any changes to your current treatment.
What is erectile dysfunction?
Erectile dysfunction is a sexual dysfunction that reduces the erectile function that interferes with sexual activity. These patients can’t achieve a complete erection suitable for sexual intercourse. Erections do not respond to sexual stimulation or last enough to please the partner.
In some cases, there is no underlying condition, and patients experience occasional erectile dysfunction. There’s a biological cause in others, and sexual desire may or may not be affected, depending on each case (1).
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Prescription medications to avoid
Either if you have a health condition that triggers erectile problems or they are mainly psychological factors, consider this list of prescription medicines that may worsen your situation (2):
High blood pressure negatively affects erectile function. But some medicines to treat hypertension may also have a harmful effect.
For example, beta-blockers cause vasoconstriction in the corpora cavernosa, restricting the blood flow to the penis.
This type of diuretic is the most commonly prescribed as a part of antihypertensive therapy. It causes erectile dysfunction in some patients.
The exact mechanism is unknown, but it is postulated that diuretics increase adrenergic activity, an almost instantaneous boner killer.
This type of drug changes the way receptors and neurotransmitters work in the body. There’s a connection between erections and the nervous system, which is why spinal lesions affect erectile function.
Antidepressants dealing with serotonin receptors may contribute to erectile dysfunction sometimes. Other antidepressants that modulate adrenergic, dopaminergic, and melanocortin receptors may also influence erectile function.
This is a complex topic because each antidepressant has different effects on each receptor type. Thus, the solution to this problem is sometimes as simple as changing the antidepressant. In other cases, erectile dysfunction treatment may relieve this side effect.
Like antidepressants, this group of medications deals with dopamine receptors. Additionally, some of them may trigger the production of a hormone called prolactin.
According to studies, such an increase in prolactin levels is more common in first-generation and second-generation antipsychotics—for example, risperidone or paliperidone.
Additionally, antipsychotics inhibit cholinergic nerve signals, reducing vasodilatation. In other words, the blood vessels are tense and contracted, the blood does not flow as it should, and the penis does not fill with blood.
Testosterone production is stimulated by brain centers located in the hypothalamus and the pituitary gland. They create a feedback mechanism that regulates testosterone levels in the blood.
Antiepileptics may sometimes disrupt this mechanism, causing alterations in testosterone production. Epilepsy itself is an independent cause of sexual dysfunction and causes more pressing problems.
Thus, it is unclear to what extent antiepileptics are involved with erectile dysfunction because these patients may have penis erection problems with or without treatment.
It is worth noting that not all prescription drugs affect erections. Some of them have the exact opposite effect.
At the end of the day, each patient may react differently to the same drug. If you experience erectile dysfunction with one of the prescription treatments listed above, visit your doctor and find the best solution according to you.
Over the counter medications to avoid
Over-the-counter medications may also interfere with erectile function. These medications are safe to use in most cases.
However, if you’re experiencing sexual health problems, it might be a good idea to talk to your doctor about it. Be aware of these drugs and try to avoid them or talk to your doctor about your alternatives.
The over-the-counter medications associated with erectile dysfunction include (2):
Non-steroidal anti-inflammatory drugs (NSAIDs)
Many substances and body processes contribute to erections. One of them is known as prostaglandin, but this substance is also required to trigger inflammation.
NSAIDs inhibit an enzyme responsible for producing prostaglandin and other inflammatory mediators. As such, it would potentially contribute to erectile dysfunction.
However, this effect is only found in some patients, and studies in humans report mixed conclusions. Trying a different anti-inflammatory may sometimes help in some patients.
Gastroesophageal reflux drugs
Similar to prostaglandin, histamine is another substance that contributes to erectile function. It controls the blood vessel tissue and is involved in vasodilatation during penile erections.
But histamines are also mediators of gastric secretion. Thus, H2 receptor antagonists such as cimetidine and ranitidine are used to treat peptic ulcers and gastroesophageal reflux.
In doing so, they may sometimes inhibit relaxation in the corpus cavernosum and reduce the erection potential.
Erectile dysfunction causes are abundant and varied. Certain drugs may contribute to the problem, especially in patients with many risk factors or a baseline health condition such as diabetes.
Thus, it is recommended to check your oral medications if you’re taking prescription drugs such as anti-depressive, antipsychotics, and antihypertensives.
If you’re taking drugs listed in this article and currently have erectile problems, talk to your doctor to evaluate your options.
You may need erectile dysfunction treatment, but sometimes a new medication combined with lifestyle changes may help you recover your regular sexual activity.