What Medications Cause Erectile Dysfunction? – Introduction
Erectile dysfunction is a problem that plagues millions of men across the globe. ED is defined as a lack of a capacity to produce or maintain an erection suitable for sexual intercourse. Many things can trigger ED, but drugs have not been recognized as the cause. In this paper, I will present some of the drugs that may induce or exacerbate ED.
1. Antidepressants
Antidepressants are one of the classes of drugs often used to treat depression, anxiety and other forms of mental illness. Although beneficial for mood and psychological health, some have been found to produce sexual side effects such as erectile dysfunction, most notably selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs).
They boost serotonin in the brain-a neurotransmitter responsible for mood regulation-but often inadvertently impact sex function. As many as 70 per cent of men on SSRIs have reported sexual side effects, including trouble erection-seeking. Luckily, the doctor may be able to cut your dose or modify your medication to minimize such an effect in some cases, so talk to your doctor about any issues.
2. Antihypertensives
Antihypertensives are medications used to treat high blood pressure and other cardiovascular diseases. Though it can boost blood flow and blood pressure, these medications have also paradoxically been found to cause erectile dysfunction.
The most often prescribed antihypertensives for ED include diuretics, beta-blockers, and calcium channel blockers. These decrease the blood supply to the penis, making it difficult for men to maintain or have erections. Beta-blockers, for instance, are effective for lowering blood pressure, but they interfere with physiological responses that drive erection. Again, this requires communication with a physician about alternative therapies with less sexual side effects.
3. Hormonal Medications
The pharmacological impact of hormones on sex health is staggering, especially when such medication throws the body out of sync with the normal levels of sex hormones. One particularly compelling example is androgen deprivation therapy, commonly used to treat prostate cancer. It can also lead to lowered levels of testosterone, a crucial hormone for maintaining libido and erections.
Other medications used to treat BPH include finasteride and dutasteride, which also have an erectile dysfunction side effect because they suppress dihydrotestosterone. DHT is one of the strongest androgens in life, and is central to masculine sexuality. These drugs could be helpful in managing urinary discomforts caused by overactive prostates but also may prevent good sexual performance.
4. Antihistamines:
For allergies and colds, the most common medications are antihistamines. Yet some antihistamines, including diphenhydramine (Benadryl) and hydroxyzine (Vistaril), have been linked to ED. Such drugs act by restraining histamine, a chemical involved in the body’s inflammatory response. Although the precise mechanism remains unclear, it’s thought that antihistamines induce ED by preventing the release of nitric oxide, a chemical that helps to relax smooth muscle in the penis.
5. Chemotherapy drugs:
The medications used to combat various cancers save thousands of lives every year. But they also carry with them a raft of adverse reactions, some of which are life-long. One of these side effects is erectile dysfunction (ED), as seen in many male cancer patients.
This connection between ED and chemotherapy might have several causes. Alkylating chemicals, vinca alkaloids and taxanes can directly damage the vascular and neural structures that make up erectile function. Indirectly, these drugs can disrupt hormonal levels and lead to psychiatric conditions that can exacerbate ED. The stress and emotional costs of having cancer diagnosis and treatment also contribute to ED.
6. Proton pump inhibitors (PPIs):
Proton pump inhibitors (PPIs) are a group of medications for the treatment of gastroesophageal reflux disease (GERD) and other acid-related conditions. While PPIs are generally safe, some research has indicated ED may be linked to the use of PPIs.
How exactly this correlation works remains elusive, but perhaps it’s due to PPIs acting on nitric oxide (NO) production. Just like we saw above, NO is essential to erectile function. PPIs inhibit the enzyme dimethylarginine dimethylaminohydrolase (DDAH) that breaks down asymmetric dimethylarginine (ADMA), an endogenous NO synthase inhibitor. Increased ADMA resulting from PPI use might result in reduced NO production and hence ED.
Additionally, PPIs have been associated with lowered testosterone levels in some trials. Perhaps this effect is because PPI exposure alters gut microbiota, and testosterone levels are influenced by the bacteria found in the gastrointestinal tract. Decreased testosterone has also been found to be related to ED — another potential reason why PPI use was connected to ED.
7. Opioids:
Opioids are powerful painkillers used to treat moderate-to-severe pain. The most commonly prescribed opioids are morphine, oxycodone, hydrocodone, and fentanyl. Opioids are known to have a host of side effects, including dependence, respiratory depression, and digestive disorders. Additionally, recent research suggests that ED is also linked to opioids.
No one understands how opioids trigger ED, though several hypotheses have been suggested. The hormones that are depleted by opiates, such as testosterone, affect sexual function in negative ways. Additionally, opioids can act on the central nervous system, disrupting the neural circuits that govern erectile function. The interactions between opioids and dopamine, a neurotransmitter responsible for sexual desire, might also contribute to ED formation.
Conclusion: What Medications Cause Erectile Dysfunction?
Bottom line: You never want to be unable to be aware of the side effects of your medication. You’ll need to talk to your healthcare provider. When you’re having ED, talk about that with your doctor so you can determine whether one of your medications is causing ED. A doctor can potentially substitute a different drug or order a new one that is less likely to induce ED. Yet these should not be avoided until a physician is called. When medications cause ED, it is typically reversible or manageable with proper treatment and discussion with a physician.
