Reginald Kapteyn

Medications that can impair sexual function

Medications and Sex
More is not better

In our latest installment of clinically healthy sex, the topic is medications and their effect on sexual health, Specifically positive and negative effects. The truth is that just as disease states affect healthy, successful sex, so do medications utilized to treat those disease states. They can wreak havoc on properly functioning sexual pathways. So today we explore medication and function, as well as dysfunction caused by medication use. The risk of sexual side effects is increased when an individual is taking certain medications, or several medications.

In considering impact of function, it is helpful to understand the various components that can become dysfunctional.

• Desire disorders — The lack of sexual desire or interest in sex
• Arousal disorders — The inability to become physically aroused during sexual activity, including problems achieving and maintaining an erection (erectile dysfunction)
• Orgasm disorders — The delay or absence of orgasm (climax)
• Pain disorders — Pain during intercourse (This mostly affects women.)

The most common impairment to healthy sexual function is simply using multiple medications. Most medications have at least some potential to affect desire, arousal, and orgasm. Maintaining low blood pressures is a goal of any good primary care plan, and a commonly utilized medication is a diuretic. These medications block or promote the release of ions from the kidney, which then causes fluid loss. Lower blood volume will affect the appropriate shunting of blood to vital sexual organs. Moreoever the ensuing decreased magnesium, potassium, calcium, and other ions in the body can slow the function of smooth muscle required to maintain active sex organs.

Another common class of medications used to treat both heart disease and elevated blood pressure are beta blockers. Some examples of these medications are propranolol (Inderal), metoprolol, or carvedilol. These medications essentially block adrenaline, otherwise known as epinephrine, which is the bodies hormone that ramps up the sympathetic nervous system. Stimulation of the sympathetic nervous system occurs once sexual tissue is activated, and controls the resultant climax and emissions. If the adrenaline receptors are blocked by beta blocker medication, then the activation of this nerve membrane becomes more difficult, and the climax and emission are more difficult to achieve.

Another extremely common class of medications are NSAIDs, or non-steroidal anti-inflammatory medications. This includes the common over-the-counter painkiller ibuprofen, which if consumed on a regular basis and over a long period of time, may contribute to erectile dysfunction (ED). NSAIDs stands for non-steroidal anti-inflammatory drugs, and they are available both over-the-counter and by prescription. In one study of more than 80,000 men, those who regularly took NSAIDs were more than twice as likely to have ED compared to men who didn’t take these medications on a regular basis. This is thought to be cause by alterations of prostaglandin levels due to these medications. If you are taking NSAIDs for arthritis or a chronic pain condition, and are experiencing ED, talk to your doctor to see if there are medication alternatives.

Some prescription medications and even over-the-counter drugs can have an impact on sexual function by impacting libido (desire) or ability to become aroused or achieve orgasm. Most of these medications function by altering levels of neurotransmitters, such as serotonin, dopamine, and norepinephrine. Tricyclic antidepressants, including amitriptyline (Elavil), doxepin (Sinequan), imipramine (Tofranil) and nortriptyline (Aventyl, Pamelor) all affect the neurotransmitters in the central nervous system. Monoamine oxidase inhibitors (MAOIs), including phenelzine (Nardil) and tranylcypromine (Parnate) also affect neurotransmitters.
Perhaps the most commonly reported, Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac), sertraline (Zoloft) and paroxetine (Paxil). Commonly reported side effects are difficulty achieving erection, difficulty achieving climax, and difficulty with arousal, and delayed ejaculation. If you experience any of these side effects, please contact your physician.

There is certainly hope as medications can often be adjusted to minimize these effects. Do not simply ignore or put up with a side effect once it is noted. Further consideration of improving sexual function should be examining diet and exercise patterns. Many of these medications are associated with poor health, so the best plan may be to implement healthy lifestyle choices to avoid medications whenever possible.

Until next time.

Reginald W Kapteyn, DO

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1 reply
  1. Harper Shelby Thornton says:

    Thankfully, my husband and I never had to use any type of medications, & our sex life was always great, but I feel for those who do 🙁 is there anything they can do to improve the sexual experience while taking meds?

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