Americans think nothing of going to the drugstore to buy over-the-counter medication for ailments ranging from colds to back pain. For more serious conditions, their doctors will write a prescription for a pill to ease their symptoms. Since all of these medications have been approved by the U.S. Food and Drug Administration, the patient feels secure that the medication not only will be effective but also will not cause harm. Most of the time, that’s true.
But some drugs have negative side effects – and as many as 400 are known to cause at least occasional problems with sexual desire and function. With approximately 1.5 billion prescriptions written in the United States each year, many millions could find themselves getting better while their sexual fun takes an unwanted holiday. Forewarned is forearmed, so here’s some information that may help. First, let’s consider Shelton, a 55-year-old man who received a prescription for Tenormin to lower his blood pressure.
“I was on the drug about two weeks when I started having trouble getting an erection,” Shelton said. “I didn’t know if it was because of my heart condition or what, so I mentioned it to my doctor.”
Shelton’s doctor explained that Tenormin is a member of a class of drugs known as beta-blockers. These drugs alter the flow of blood through arteries. While this is desirable for someone with a cardiac condition, the drug also inhibits the flow of blood to the penis, thus making it more difficult to gain an erection. Shelton’s doctor switched the medication to Capoten, an ACE inhibitor.
While this helped with his erections, it wasn’t as successful in lowering his blood pressure. So his cardiologist then prescribed Cardizem, a calcium channel blocker. That successfully lowered Shelton’s blood pressure while not impeding his sexual function.
“I’m glad I mentioned it to my doctor,” Shelton said of his problems getting erections. “I was afraid this was something I was just going to have to live with.”
Talk To Your Doctor
Physicians and sex therapists agree that communication between patient and doctor is critical because each person reacts differently to a medication. In some cases, the sexual side effects of a drug are discovered during clinical trials and are included on the package insert. With some newer drugs, though, sexual side effects may not reveal themselves until after the drug has been on the market a while. In these cases, it may take some time before this information makes it onto the printed warnings.
Sometimes, the problem isn’t with a single medication but rather may be a reaction to two or more medications taken in combination. Here, again, communications with the doctor become vital. When it comes to the sexual side effects of medication, “some detective work is needed to determine what is going on,” said Bernie Zilbergeld, Ph.D., author of The New Male Sexuality. “Such work should always be done in conjunction with a physician.” Sometimes, evidence may point to a drug side effect when that’s not necessarily the case. Zilbergeld writes, “Even if you have an erection problem and are taking a medication known to produce this result in some people, this does not (always) mean the drug is the cause of your erection problem.” For example, a man may be anxious about having sex because of the effect he fears such activity might have on an already troubled heart. In these cases, sex therapy with a qualified professional may be needed to overcome the anxieties. In many cases, though, relief can be achieved by adjusting doses and/or changing medications. Zilbergeld warns: “Under no circumstances should you fiddle with dosages or stop taking them without the consultation of a physician who is knowledgeable about drugs and your medical and sexual situation.”
Drugs That Cause Problems
- Blood pressure medications – along with their pharmacological cousins diuretics, such as Hygroton, which are prescribed to increase urine flow – are the most common class of drugs to have negative sexual side effects. Other prescription medications are known to inhibit sexual function include:
- Antidepressants, especially those known as selective serotonin reuptake inhibitors (SSRIs), including such brand names as Prozac, Zoloft, and Paxil. These work by enhancing the action of serotonin, a brain chemical responsible for regulating mood. While helpful in reducing negative feelings, they also can limit the brain’s ability to register pleasure. (Because of these side effects, these drugs are sometimes prescribed to help men prone to premature ejaculation. If used for a long period, however, they can also cause impotence in these men.) Alternative antidepressants that are less likely to impede sexual function include Wellbutrin, Serzone and Remeron.
- Anti-ulcer drugs, such as Tagamet, interfere with testosterone and cause libido and erection difficulties for approximately 2 percent of all men taking the drug. Pepcid and Zantac have similar anti-ulcer and heartburn benefits without the sexual side effects of Tagamet.
- Prostate shrinkers, such as Proscar, not only relax prostate tissue but actually shrink an enlarged gland. But the drugs also lower the level of testosterone, causing erection difficulties in a reported 4 percent of men taking them. Alternative medications include Hytrin, Cardura, and Flomax.
- Much has been written lately about the benefits of Viagra for erectile dysfunction. While it may be useful in treating some cases of drug-induced impotence, it should never be used in conjunction with nitrates. The FDA has received dozens of reports of men who have gotten seriously ill and even died after using Viagra while already taking nitrates. The combination of the two can lower blood pressure to a lethal level. If changes in prescription medications and/or doses don’t help, other agents sometimes can offset the negative effect of a needed drug. Supplements of the hormone testosterone can enhance libido as can the natural erection aid yohimbine.
Prescription drugs are not the only culprit when it comes to negative sexual side effects. Al, for example, started taking Drixoril, a common over-the-counter antihistamine, for sinus congestion. “I assumed anything I could buy over the counter was safe,” Al said. But after a few days on the medication, “I tried and tried and tried and I still couldn’t get an erection.” That’s because antihistamines can constrict arteries and block the flow to erections. Once Al stopped taking the medication, sexual function was quickly regained. Sleeping pills can interfere with deep sleep in which sexually rejuvenating nocturnal erections occur. Sometimes it might help to take a “drug holiday” for a day or two in anticipation of a big date or a romantic weekend getaway. But, again a warning: Do so only after receiving approval from your doctor. When it comes to drugs, it’s best to learn all you can about the medication you’re taking and to share any difficulties you might be having with your doctor.