Some treatments and medicines can cause erectile dysfunction. This will depend largely on the medication, and what pre-existing condition that medication is linked with. 

Part of the reason why ED becomes more likely with age is because the older a person is, the more likely they are to be taking some kind of medicine. “An estimated 25% of all ED is a side effect of drugs.”

The main types of treatments that can cause ED:

Hypertension treatments

Without the inclusion of medication related to the condition, high blood pressure can cause erectile dysfunction. In fact, erectile dysfunction can at times be an indicative symptom of high blood pressure, and can help lead to a diagnosis. 

However, some hypertension treatments can also cause erection problems. Certain treatments can do this for different reasons. 

Beta-blockers are a form of hypertension treatment known to induce erection problems in some. Broadly speaking, beta-blockers are treatments which can regulate abnormal or fast heart rhythm by reducing the quantities in which the body produces adrenaline. 

Essentially, this helps to ease the pace at which the heart pumps out blood, which reduces blood pressure overall. But this can detract from the force at which blood flows into the penis during moments of arousal, which can make it harder to achieve an erection. 

Diuretics are another type of high blood pressure medication which can also cause erectile dysfunction. Diuretics encourage the body to expel more fluids in the form of urine. They’re sometimes referred to simply as ‘water-pills’. 

Diuretics are good for high blood pressure because they reduce the quantity of fluid in the blood vessels, which reduces the strain on the heart when it pumps blood. But this can have similar effects as beta-blockers - meaning blood does not flow into the penis forcefully enough to get or maintain an erection. 

If you’re taking any treatment for high blood pressure and begin to develop erectile dysfunction, it’s worth discussing this with your doctor. There may be alternatives which can be recommended in these instances. 

Antidepressants

Antidepressants can cause a broad spectrum of side effects. Some can be moderate and others severe. However, they can also cause loss of sex drive (in women, as well as men). 

Many antidepressants take the form of selective serotonin reuptake inhibitors (SSRI). This sounds complicated, but all it means is that it helps the body to produce more serotonin (a neurotransmitter partially responsible for pleasure). 

When people take SSRIs, they can experience feelings of calmness and reduced anxiety because their bodies are producing more serotonin. 

However, it’s thought that SSRIs also decrease certain people’s sense of sexual desire. In men, this can mean difficulty in getting or maintaining an erection. This problem is thought to stem mainly from chemical messages in the brain and from psychological factors - it has little to do with the circulatory system or blood. 

However, reduced sex drive in antidepressant medication is not limited to SSRIs. Antidepressants that have been reported to reduce sex drive, and cause ED, include the following from the (non-exhaustive) list:

  • Celexa (Citalopram)
  • Remeron (Mirtazapine)
  • Prozac, Sarafem (Fluoxetine)
  • Wellbutrin, Zyban (Bupropion)
  • Cipralex, Lexapro (Escitalopram)
  • Cymbalta (Duloxetine)
  • Paxil, Seroxat (Paroxetine)
  • Amitriptyline (Elavil)
  • Amoxapine (Asendin)
  • Buspirone (Buspar)
  • Chlordiazepoxide (Librium)
  • Chlorpromazine (Thorazine)
  • Clomipramine (Anafranil)
  • Clorazepate (Tranxene)
  • Desipramine (Norpramin)
  • Diazepam (Valium)
  • Doxepin (Sinequan)
  • Fluoxetine (Prozac)
  • Fluphenazine (Prolixin)
  • Imipramine (Tofranil)
  • Isocarboxazid (Marplan)
  • Lorazepam (Ativan)
  • Meprobamate (Equanil)
  • Mesoridazine (Serentil)
  • Nortriptyline (Pamelor)
  • Oxazepam (Serax)
  • Phenelzine (Nardil)
  • Phenytoin (Dilantin)
  • Sertraline (Zoloft)
  • Thioridazine (Mellaril)
  • Thiothixene (Navane)
  • Tranylcypromine (Parnate)
  • Trifluoperazine (Stelazine)”

Antihistamines

Antihistamines treat the symptoms of allergic reactions - this can include conditions like hay fever, conjunctivitis, insect bites or stings and hives. They can also be used to treat motion sickness and insomnia. 

While the role antihistamines could play in erectile dysfunction is still an area yet to be explored fully, one study concluded that “histamine may play a role in human penile erection. The erection-promoting action of histamine is probably due to H2 receptor activation, although another histamine receptor, possibly H3, also seems to be involved. 

This study suggests that histamine could be a valuable tool in the diagnosis of erectile dysfunction.”

ED Medication: can they actually cause ED as well as treating it? 

“Because sildenafil citrate is a treatment, not a cure, for erectile dysfunction (ED), many men may choose to use it for an extended period.” This raises questions as to whether sildenafil citrate, and other drugs within its classification, retain their effectiveness over time. 

Research into this area is limited, though it is broadly thought that for the majority of men, treatments like sildenafil citrate (Viagra) remain effective treatment options over time. It could be argued that some men who are used to taking these treatments may encounter anxiety should they run out, which could influence the psychological process of ‘arousal’. 

In relation to injectable erectile dysfunction treatments, such as Caverject (which are not technically within the same classification as PDE5I treatments like Viagra), there may be some evidence to support these drugs becoming less effective over time. Though the reasons for this do not concern the active ingredients themselves, rather the method through which they are administered. 

“Repeated use of these treatments could cause corporal fibrosis which may distort an erection or cause it be become painful, the risk of this could be reduced by less frequent use and avoiding injecting at the same site.”

What to do if you’re unsure about medication and ED

Several other drugs not mentioned on this page may also contribute toward erectile dysfunction, or an otherwise reduced sex drive.

Whenever you’re prescribed medication, whatever the condition, it’s advisable to familiarise yourself with the patient information leaflet included with each treatment pack. This information will tell you a number of important things such side effects and how to take your treatment. 

It’s important to check whether reduced sex drive, or anything related to the cirulatory system, blood vessels or blood pressure, are mentioned or not. 

Check with your prescriber if you’re unsure. They’ll be able to give you the most appropriate advice and guidance surrounding medication and erectile dysfunction.

Page last reviewed:  29/07/2020