Updated: Mar 11
Dear Dr. K, Since I've been on this new medication, I can't get hard. What gives?
There are certain medications and classes of medications that may cause or aggravate ED.
The most common drugs associated with ED and decreased libido are the psychoactive medications used in treating depression, anxiety, and psychoses. Antidepressant medications that boost the levels of the "feel-good hormone" serotonin block the release of oxytocin, a hormone that triggers the penis to get hard and reach climax. Serotonin boosts the production of another hormone, prolactin, that can decrease testosterone and interfere with sexual climax. Tricyclic antidepressants (e.g. amitriptyline, clomipramine) and monoamine oxidase inhibitors can suppress desire as well as cause orgasmic delay and ejaculatory difficulties. Your physician may be able to offer alternative medications that have lesser effects or your erections and libido.
Antihypertensive medications that are beta-blocking agents can be some of the worst for causing ED problems. These medications usually end in -olol and can decrease bloodflow into the penis and interfere with the dilation of the blood vessels. Some may suppress testosterone levels. Diuretics or “water pills” also have been known to cause ED. ACE inhibitors (names usually end in -pril) or alpha blockers (e.g. doxazosin, terazosin) are le