Drug-induced Erectile Dysfunction
- drugs that may cause impotence
- medications that may cause erectile dysfunction
Erectile dysfunction (formerly called impotence), is a condition in which a man is unable to get or maintain an erection. One of several causes for this condition may be the medications or other drugs the man is taking.
What is the information for this topic?
It is estimated that about 5% of men younger than age 40 experience erectile dysfunction. It becomes more common as men get older and affects up to 75% of men over age 75.
The many medical causes of erectile dysfunction include depression, diabetes, and atherosclerosis, in addition to those episodes brought on by difficulties in the relationship with the man's sexual partner.
Any of a number of drugs may cause erectile dysfunction in some men. Some of the more common include the following:
smoking and smokeless tobacco
heroin, cocaine, and other mind-altering drugs
cimetidine (i.e., Tagamet), a drug sometimes used to treat peptic ulcers or gastroesophageal reflux
some diuretics, or "fluid pills." These are commonly used to treat high blood pressure, leg swelling, and congestive heart failure.
some high blood pressure medications. These include a commonly prescribed class of drugs called beta-blockers.
medications used to treat depression. These include amitriptyline (i.e., Elavil), fluoxetine (i.e., Prozac, Sarafem), sertraline (i.e., Zoloft), paroxetine (i.e., Paxil), and others.
medications used to treat psychosis, such as risperidone (i.e., Risperdal) or haloperidol (i.e., Haldol)
sedatives such as diazepam (i.e., Valium)
finasteride (i.e., Propecia, Proscar). This drug is used to treat benign prostatic hyperplasia (BPH), to prevent baldness, or to treat prostate cancer.
Other medications may also cause erectile dysfunction in some men, though most men take them without any trace of this symptom. A man may be completely unable to have an erection while using the drug.
If erectile dysfunction starts shortly after a man begins taking a new drug, the drug is the most likely cause of the problem.
In other cases, erectile dysfunction may not occur until a man has been taking a drug for months. It is not a good idea to stop taking the medication without consulting the healthcare professional. This could cause the condition being treated to return or get worse, resulting in serious health problems.
Often, a different drug that does not cause erectile dysfunction can be substituted. If this is not possible, other treatment options are available to correct erectile dysfunction. For example, the drug sildenafil, commonly known by its brand name Viagra, is a safe and effective treatment for erectile dysfunction for many men. Newer oral ED drugs include vardenafil (i.e., Levitra) and tadalafil (i.e., cialis) Many other treatments are also available.
The Natural Medicines Comprehensive Database lists DHEA, Panax ginseng, L-arginine, melanotan-II, propionyl-L-carnitine (taken with Viagra), yohimbine, as "Possibly Effective" for some forms of erectile dysfunction. They judge pycnogenol as having "insufficient evidence" to use with ED.
Though it may be embarrassing to discuss sexual issues with a healthcare professional, open communication is a necessary first step if the connection between the drug and the impotence is to be uncovered. Often the problem can be easily treated once it is brought out into the open.
When the drug that has been causing the erectile dysfunction is discontinued, normal erections should return within a few weeks. Men need to tell the healthcare professional if the problem goes away. If the erectile dysfunction continues, it is probably due to another cause. Further testing can be done to identify the source of the problem.
For men who smoke or use smokeless tobacco, drink alcohol, or use illegal drugs, the first step is to eliminate these substances. This will often resolve the erectile dysfunction, though it may take some time. Men who have used these substances for a long period may suffer erectile dysfunction for life.
Conn's Current Therapy, 2000, Rakel et al.
Harrison's Principles of Internal Medicine, 1998, Fauci et al.