Erectile dysfunction, or impotence, is a common disorder in men that has several causes. Vascular disease, which is dysfunction of the blood vessels as in atherosclerosis, is one common cause. Another potential cause is the side effects of particular medications. Some of the common offenders include recreational drugs, certain blood pressure medicines, antidepressants, antipsychotics, histamne blockers and antiandrogens.
Drugs of Abuse
Several drugs of abuse are known to cause impotence in some men. Perhaps the most common is the excessive consumption of alcohol. Other recreational drugs that cause erectile dysfunction include cocaine, marijuana and heroin. Cocaine and heroin may initially facilitate sexual desire and erectile function, but longer term use is associated with erection problems.
Blood Pressure Medications
According to "Harrison's Principles of Internal Medicine" by Dr. Anthony Fauci, several classes of blood pressure medications have been associated with erectile dysfunction. Thiazide diuretics are one of the most common. Examples include hydrochlolorthiazide and chlorthalidone. ACE inhibitors such as enalapril and captopril also may cause impotence. Diltiazem and amlodipine are examples of the class of blood pressure drugs known as calcium channel blockers which have also been implicated, as have beta blockers. The alpha blockers such as prazosin are the least likely to cause erectile dysfunction.
As noted by the American Academy of Family Physicians, antidepressants are associated with erectile dysfunction. The most common offenders are SSRIs and tricyclic antidepressants. Examples of SSRIs include fluoxetine, paroxetine and escitalopram. Tricyclics include nortriptyline and amitriptyline. SRRIs are more likely to cause anorgasmia than impotence, however. Anorgasmia is the inability to have orgasms or a delay and decrease in intensity of orgasm.
Antipsychotic medications are used to treat schizophrenia and similar psychotic disorders. Many of these drugs interfere with sexual functioning, as noted by The American Society of Family Physicians. These drugs interfere with multiple phases of the sexual response.
According to an article published in 2001 in the medical journal "Endocrine Reviews," some drugs are used to lower levels of the male hormones or block their activities. One treatment of prostate cancer involves giving a medication called leuprolide to lower testosterone. The result is to inhibit tumor growth and decrease bone pain in these patients. However, the lowered male hormones also interferes with sexual functioning.
In addition, some drugs used to treat benign prostatic hypertrophy, which is abnormal growth of the prostate that interferes with urination, can also cause erectile dysfunction, as noted by "Harrison's Principles of Internal Medicine." These drugs are sometimes used to treat male pattern baldness as well. Finasteride is the most common of this class.
According to "Harrison's Principles of Internal Medicine," H2 blockers are drugs used to treat excess acidity in the stomach or gastroesophageal reflux, GERD, or heartburn. Cimetidine is the most likely to cause this side-effect, other H2 blockers such as ranitidine do not appear to cause this as prominently if at all.
- American Academy of Family Physicians: Diagnostic Evaluation of Erectile Dysfunction
- "Harrison's Principles of Internal Medicine"; Anthony S. Fauci; 17th Ed 2008
- "Endocrine Reviews"; Male Sexual Function and Its Disorders: Physiology, Pathophysiology, Clinical Investigation, and Treatment; Kandeel et al; 2001