Many common medications, including some antidepressants, blood pressure medicines, hormonal treatments and opioids, can affect desire, arousal, erections or orgasm. Never stop a medication on your own; talk with your prescriber about options.
Many widely used medications can affect sexual desire, arousal, erections or orgasm, including some antidepressants, blood pressure medicines, hormonal treatments, opioid pain relievers and antihistamines. The effect varies a great deal from person to person, and the medication is often treating something important. If you notice a change, the right step is to talk with your prescriber, not to stop or change the medication on your own. There are often ways to address sexual side effects while keeping the underlying condition well treated.
Sexual response involves the brain, hormones, nerves and blood flow working together. A medication that changes any of these systems can, as a side effect, change desire, arousal, erections, lubrication or orgasm. MedlinePlus notes an important point: a medicine that causes erection problems in one person may not affect another. Side effects are possibilities, not certainties.
| Medication group | What the sources report |
|---|---|
| Antidepressants | Sexual side effects are common with many, but rates vary by drug (see below) |
| Blood pressure medicines and diuretics | MedlinePlus says thiazide diuretics are the most common cause of ED among blood pressure medicines, followed by beta blockers; alpha blockers tend to be less likely to cause it |
| Opioid pain medicines | FDA: long-term use may be associated with decreased sex hormone levels and reduced interest in sex |
| Hormonal medicines | ACOG: some birth control methods can reduce desire; NIDDK lists hormone medicines, and MedlinePlus lists finasteride and dutasteride, among drugs linked to ED |
| Antihistamines and heartburn medicines | Listed by NIDDK and MedlinePlus among drugs that can cause ED |
| Sedatives and some anti-anxiety medicines | Listed by NIDDK and MedlinePlus |
| Some pain relievers | NIDDK lists NSAIDs, codeine and oxycodone; ACOG notes many pain medications can reduce desire |
This is not a complete list, and appearing on it does not mean a medication will cause problems for you. MedlinePlus also lists recreational substances, including alcohol, nicotine and marijuana, as possible contributors.
A 2009 meta-analysis in the Journal of Clinical Psychopharmacology pooled studies in which sexual function was specifically asked about, rather than waiting for patients to bring it up. Several antidepressants, including sertraline, venlafaxine, citalopram, paroxetine, fluoxetine and duloxetine, were associated with significantly higher rates of sexual side effects than placebo, with rates ranging from 25.8% to 80.3% of patients across drugs. Others, including bupropion and mirtazapine, showed no significant difference from placebo. The authors noted that the large variation between drugs should be considered when choosing a medication.
This does not mean anyone should switch or stop an antidepressant on their own. Depression and anxiety can themselves affect desire and function, and stopping treatment abruptly carries its own risks. It does mean sexual side effects are a legitimate topic to raise with your prescriber, who can weigh the options with you.
A small randomized crossover trial published in Depression and Anxiety in 2014 enrolled 52 women with antidepressant-related sexual side effects. Exercising immediately before sexual activity improved sexual desire and, among women with sexual dysfunction at baseline, overall sexual function. Scheduling regular sexual activity improved orgasm function. The authors concluded that these behavioral approaches may help manage sexual side effects. Results were averages from a small study, and individual results vary.
Finasteride, used for male pattern hair loss, is a medication many people ask about. The FDA-approved Propecia label reports that in year 1 of three controlled trials, decreased libido occurred in 1.8% of men taking finasteride compared with 1.3% on placebo, erectile dysfunction in 1.3% compared with 0.7%, and ejaculation disorder in 1.2% compared with 0.7%. Overall, 3.8% of men on finasteride reported one or more of these effects, compared with 2.1% on placebo.
According to the label, these effects resolved in men who stopped the medication and in most of those who continued, and the rate of each fell to 0.3% or less by the fifth year. The label also lists postmarketing reports of sexual dysfunction that continued after stopping treatment, as well as reports of depression and suicidal ideation. A licensed provider should discuss these possibilities before you start, and you should report any change in mood or sexual function.
It can feel awkward to bring up sexual side effects, but they are a recognized part of medication care. The NIDDK explains that a health care professional may review your medicines to see whether one is contributing, and may suggest a different dose or a different medicine. It also advises: do not stop taking any medicines on your own.
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For opioid medicines specifically, the FDA advises patients to tell their health care professional about symptoms such as low libido, erectile dysfunction, lack of menstruation or infertility, and says clinicians should conduct a laboratory evaluation when those symptoms are present.
No. Talk to your prescriber first. MedlinePlus warns that some medicines can lead to life-threatening reactions if they are stopped or changed without care, and the NIDDK advises against stopping any medicine on your own.
Often they are not. For example, the Propecia label reports that sexual side effects resolved in men who stopped finasteride and in most who continued it, although it also notes postmarketing reports of effects that persisted after stopping. Your prescriber can explain what is known about your specific medication.
Sometimes a prescriber may consider an additional treatment, but that depends on your health, the medication involved and possible interactions. Compounded PT-141 is not FDA-approved, and its use in men or outside the approved indication is off-label. A full medication review comes first.
Yes. Several of the lists above come from erectile dysfunction resources, but ACOG notes that medications, including some birth control methods and pain medications, can reduce desire in women, and the 2014 exercise trial studied women with antidepressant-related side effects.
If a medication seems to be affecting your sex life, you deserve a straightforward conversation about it. Keep taking your medication as prescribed, and talk with the prescriber who manages it about what you are noticing. A licensed provider can also look for other causes and discuss options that fit your overall health. You can learn more on our sexual health page. This article is educational and does not determine eligibility for any treatment.
Written by the NewDay Wellness editorial team from the sources above and checked against them before publication, and medically reviewed by Dr. Sean Arora and Dr. Shannon Arora of Arora Health & Aesthetics; see our editorial standards. This article is educational and does not diagnose conditions, establish eligibility for any medication, or replace care from a licensed provider. Compounded medications are not FDA-approved.
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