Medicines and sexual problems

Some medicines including over-the-counter (OTC) medicines may have side effects that can cause sexual problems in men and women. This may vary depending on the individual and type of medication. If you are concerned about this issue, talk to your doctor.

How can medicines cause sexual problems?

Medicines can cause sexual problems in men and women in a number of ways. These include:

  • a lack of sexual desire or interest in sex (libido)
  • reduced ability to become physically aroused during sexual activity, including problems achieving and maintaining an erection (erectile dysfunction)
  • delayed or absence of orgasm (climax)
  • pain during intercourse (this mostly affects women)
  • sustained erection lasting longer than 4 hours (priapism).

Examples of medicines that cause sexual problems

The following is a list of medicines that are known to cause sexual problems in some people. It is important to note that not all people respond in the same way to these medicines. The risk of sexual side effects is increased if you are taking multiple medications.

If you are taking a medicine and are worried about its effects – do not stop taking your medicine suddenly. Rather, discuss this with your doctor or pharmacist. Sometimes there might be a different medicine that you can take that is less likely to cause sexual problems.

Examples of medicines that are known to cause sexual problems in some people
  • antidepressants
  • antipsychotics
  • cardiovascular medicines
  • anti-epileptic medicines
  • oral contraceptives
  • treatments for cancer
  • medicines for bladder and prostate problems
  • corticosteroids 

Alcohol and recreational drugs

Recreational drugs such as alcohol, narcotics, stimulants and hallucinogens also affect sexual function. Short-term use of alcohol affects sexual desire and diminishes performance and delays orgasm and ejaculation. Consuming alcohol or using recreational drugs while taking some medicines can make sexual side effects worse.

How are medication-related sexual problems diagnosed?

Since not all sexual problems are caused by medicines, it is not always easy to know whether medicines are the cause. Erectile dysfunction can be caused by physical and emotional factors, or a combination of both. Sometimes sexual problems may be due to relationship difficulties or other causes.

Sometimes the underlying medical condition can also impair erectile function. For example, high blood pressure (hypertension) is associated with sexual problems. Similarly, some mental health conditions, such as depression and psychosis, can cause sexual difficulties. Read more about erectile dysfunction.

What can you do?

If you are worried about your medicines causing sexual problems, do not stop taking your medicine suddenly. Instead, discuss this with your doctor or pharmacist. Sometimes a more suitable medicine can be found or your dose can be reduced. Some medicines need to be stopped gradually, as sudden withdrawal can make you feel very unwell.

  • For men, your doctor will consider if taking a phosphodiesterase type 5 inhibitor (such as sildenafil, tadalafil and vardenafil) is suitable for you. However, phosphodiesterase type 5 inhibitors are not suitable for men with some medical conditions or taking some other medicines.
  • In women, your doctor will consider if oestrogen cream is suitable for you. 

Read more about talking to your doctor about sexual problems.

References

  1. Sexual dysfunction associated with antidepressants and antipsychotics Medsafe, 2015
  2. Drug-induced sexual dysfunction in men and women Australian Prescriber 2013
  3. Managing erectile dysfunction in patients treated with beta-blockers BPAC, NZ, 2017
  4. Sexual dysfunction – talking it over Joslin Diabetes Center, US
  5. Talk with your doctor about erectile dysfunction Harvard Health Publishing, US, 2018
Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 30 Oct 2018