Medications that can cause erectile dysfunction

Erectile Dysfunction is one of the most common sexual problems in men and there are many causes for Erectile Dysfunction like psychogenic, endocrine and it can be caused by the medications used to treat other health problems related to heart,hypertension and etc. Today let’s discuss the medications that can cause Erectile Dysfunction.

Here is the list of Medications that can cause Erectile Dysfunction

  1. Thiazide diuretics, β-blockers, and spironolactone used to treat hypertension.
  2. Digoxin used to treat atrial fibrillation.
  3. 5α-reductase inhibitors used to treat benign prostatic hyperplasia.
  4. Anti-androgens used to treat prostate cancer.
  5. Luteinizing hormone-releasing agonists and antagonists used to treat prostate cancer.
  6. Tricyclic antidepressants, selective serotonin reuptake inhibitors, benzodiazepines, antipsychotics and phenytoin used to treat depression and other psychiatric conditions.
  7. H2 blockers used to treat ulcers.
  8. Opiates used to treat pain.

Now let’s discuss each of these medications in detail and know, how they are responsible for causing Erectile Dysfunction.

Erectile Dysfunction caused by Thiazide diuretics, β-blockers, and spironolactone used to treat hypertension

In the case of β-blockers, several reports have shown serious side effects on sexual function; in particular erectile dysfunction (ED) and loss of desire have been reported.

The mechanisms by which β-blockers may induce sexual dysfunction is inhibition of the sympathetic nervous system, which is involved in the integration of erection, emission, and ejaculation, in the regulation of luteinizing hormone secretion and in the stimulation of testosterone release. Indeed, several studies showed a depression in testosterone levels in patients receiving β-blockers.

After reviewing 15 trials involving 35,000 subjects,  the frequency of sexual dysfunction with β-blockers was 21.6 % and 17.5 % in the placebo group. In addition, β-blockers were associated with an increased risk of reported impotence in men.

Coming to Diuretics, Diuretics are considered one of the most implicated classes regarding sexual dysfunction. Although the mechanism is not clear, a study conducted on the basis of 23,582 patients the prevalence of impotence was measured by questionnaires after 2 years of treatment with propranolol, bendroflumethiazide, or placebo. Impotence was mentioned in 10.1 % of the placebo group, in 13.2 % of the propranolol group, and in 22.6 % of the bendroflumethiazide group.

spironolactone block the androgen receptor. This reduces sexual desire in both sexes and affects arousal and orgasm.

Erectile Dysfunction caused by Digoxin used to treat atrial fibrillation

Digoxin is a known inhibitor of sodium/potassium adenosine triphosphatase (sodium pump), a plasma membrane enzyme that has a role in the regulation of smooth muscle tone. it’s long use has been recognized to affect adversely male sexual function.

Digoxin associated alteration of human erectile function may be explained, in part, by inhibition of corporeal smooth muscle sodium pump activity, which promotes contraction and impedes nitric oxide induced relaxation which can cause Erectile Dysfunction.

Erectile Dysfunction caused by 5α-reductase inhibitors used to treat benign prostatic hyperplasia

Benign prostatic hyperplasia (BPH) is one of the most common genitourinary complications in men over 50 years of age and typically presents with lower urinary tract symptoms (LUTS). Classes of medications used to treat BPH include α1-adrenoceptor blockers, 5α-reductase inhibitors, and phosphodiesterase 5 inhibitors.

The adverse sexual side effects of these medications include erectile dysfunction (ED), decreased libido, orgasmic disorders, and ejaculatory disorders. These medications lower available -dihydrotestosterone which causes Erectile Dysfunction.

Erectile Dysfunction caused by Anti-androgens used to treat prostate cancer

The goal of Anti-androgens is to reduce levels of male hormones, called androgens, in the body, to stop them from fueling prostate cancer cells. But, Androgens play an essential role in maintaining sexual structures and their function at both the central and peripheral levels. These medications cause Erectile Dysfunction by reducing the levels of Androgens.

Erectile Dysfunction caused by Luteinizing hormone-releasing agonists and antagonists used to treat prostate cancer

Hormone therapies cause prostate cancer cells to die or to grow more slowly and these therapies reduce the levels of male hormones and androgens. But, Androgens play an essential role in maintaining sexual structures and their function at both the central and peripheral levels. These medications cause Erectile Dysfunction by reducing the levels of Androgens.

Erectile Dysfunction caused by Tricyclic antidepressants, selective serotonin reuptake inhibitors, benzodiazepines, antipsychotics and phenytoin used to treat depression and other psychiatric conditions

While antidepressants are typically used to treat depression, they’re also frequently prescribed for anxiety disorders, eating disorders, obsessive-compulsive disorder, chronic pain, smoking cessation, and some hormone-mediated disorders, such as severe menstrual cramps.

There are many different kinds of antidepressants, including tricyclic antidepressants, monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), dopamine antagonists, and lithium, among others.

Antidepressants cause problems in all areas of sexual function, probably by blocking the action of three brain chemicals that relay signals between nerve cells: acetylcholine, serotonin, and norepinephrine.

The adverse effects of clomipramine (Anafranil), for instance, include ejaculation failure (reported by more than 40 percent of men taking the drug), impotence (reported by at least 15 percent of patients) and decreased libido (reported by at least 18 percent of patients). 

Coming to Antipsychotics, Antipsychotics is used to treat schizophrenia, bipolar disorder, and other serious psychiatric conditions. Antipsychotics also are often prescribed “off-label” treat agitation and depression, among other conditions.

All antipsychotic drugs block dopamine, a brain chemical that helps regulate emotional responses and control the brain’s reward and pleasure centers. They also increase levels of the hormone prolactin, which can lead to ED, reduced libido, and difficulties achieving orgasm. And, like antidepressants, they block the action of acetylcholine, which researchers believe can lead to problems in all areas of sexual function.

The sexual side effects of these drugs have been difficult to tease out because many of the psychiatric conditions the drugs are used to treat are themselves associated with sexual problems. Nonetheless, the incidence of sexual dysfunction associated with antipsychotic drugs ranges in different studies from 45 percent to as high as 90 percent.

H2 blockers used to treat ulcers

H2 blockers, also called H2-receptor antagonists, are used to treat gastrointestinal disorders, including gastroesophageal reflux disease (GERD), gastric ulcers, peptic ulcers, and erosive esophagitis.

H2 blockers can cause impotence (as well as breast enlargement in men) when taken at high doses for a long period of time.

Cimetidine (Tagamet) is associated with a wider range of sex-related side effects than other H2 blockers, including ranitidine (Zantac), famotidine (Pepcid) and nizatidine (Axid). Cimetidine’s side effects include decreased libido, reduced sperm count, and ED.

Erectile Dysfunction caused by Opiates used to treat pain

Men who chronically use opioids report an unexpectedly high prevalence of erectile dysfunction and at younger ages compared to the general population. Across several published reports, in males with a mean age of 28-49 years, prevalence rates of ED ranged from 21-52%. The highest rates of ED were reported in men maintained on methadone (Hallinan et al., Quaglio et al.), followed by those using heroin (Bang-Ping) and lastly by those maintained on buprenorphine.

Conclusion

Erectile Dysfunction caused by medications can easily be treated by oral medications like viagra(Sildenafil) and Cialis (Tadalafil) available. Men need to muster up the courage to seek professional help from a doctor or a qualified clinical sexologist. Just taking this step will get them on their way to recover not only their sex life but their relationship as well. They need not worry about their privacy as clinics like “The ED Clinic”  take full care to make sure all privacy details are just that- Private.

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