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Erectile Dysfunction – Can it be drug induced?

Erectile dysfunction (ED) is the inability to achieve and sustain an erection necessary for adequate vaginal penetration. The most important question that I ask my patients who present with this problem is “Are you taking any medications”? A variety of drugs can cause ED and it is important that drug manufacturers have this on their inserts when they package these drugs.
Lets look at the most important of these:

Antihypertensives

Can cause ED by reducing the contraction of the smooth muscles of the penis, increasing prolactin levels and by decreasing testosterone levels. The most notorious drugs that cause ED in this group are Beta Blockers which usually end with a suffix (lol). Thiazides are diuretics and are another group which caused ED.
Other drugs in this group do not affect Erection.

Cholesterol Lowering drugs

The role of these drugs is a point of semantics. Cholesterol lowering drugs i.e. statins, when used along with drugs like Viagra help in ED, however when used alone for a long time may have an adverse effect basically due to the fact that Cholesterol is the basic substrate in testosterone synthesis and this may lower testosterone levels and hence cause ED.

Drugs Lowering Testosterone levels

A number of drugs like antiseizure drugs, hypnotics, diuretics, sedatives, anti gastritis drugs can lower testosterone levels and interfere with erection.

Drugs increasing prolactin levels

Most of the antidepressant group of drugs, some anti vomiting drugs, some hormones like estrogens, and some antihypertensives may cause increase in prolactin levels and cause ED.

Smoking-Nicotine

Smokers were 1.5 times more likely to suffer from ED than non smokers. Acute cessation of smoking improved ED and increased hardness in studies.

Alcohol

In small amounts may appear to improve or promote erection by vasodilatation and reduction of performance anxiety. However, in quantities in excess of (40-5-mg/dl) causes ED.

Intoxicants

Metamphetamine, marijuana/cannabis, heroin, cocaine can all lower sexual desire and increase ejaculation latency times and cause ED.

Medicines once prescribed are taken in a continuous manner by some men without revisiting the doctor again. This may lead to numerous side effects not to mention ED. It is important to understand that drugs should never be taken without the right indication and should always be taken for the shortest possible time.

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