En español | Many people don’t know it, but drugs are among the most common causes of sexual problems. Indeed, studies show that prescription medications are responsible for as many as one of every four cases of sexual dysfunction — and this figure may understate the extent of the problem.
If your sex life isn’t what you think it should be — or what it used to be — talk with your physician or health care provider, even if initiating the discussion feels a little awkward or embarrassing. (If all those television ads can bring such subjects into your living room, surely you can bring them up in your doctor’s office.) At the very least, it’s helpful to rule out drugs as a cause of sexual problems before you undergo diagnostic tests that could lead to additional prescriptions.
Here’s a rundown of the major classes of drugs that can interfere with your sex life. As always, it’s important to remember that you should not discontinue drugs without consulting your doctor.
1. Statins and fibrates
Why they’re prescribed: Statins and fibrates are used to treat high cholesterol.
How they can cause sexual dysfunction: Researchers say that by limiting the availability of cholesterol, a building block of hormones, these drugs likely interfere with the production of testosterone, estrogen and other sex hormones. Additionally, statins can cause rhabdomyolysis, a breakdown of muscle tissue, leading to joint pain and fatigue.
A review of studies of statins and fibrates, published in 2002, concluded that both classes of drugs may cause erectile dysfunction (ED). And a six-month, government-funded study published in 2009 found that men and women taking statins reported increased difficulty achieving orgasm. In the study, people’s levels of sexual pleasure dropped along with their levels of LDL cholesterol.
Options: If you’re among the many millions of older Americans without known coronary disease who are taking these drugs, ask your doctor or other health care provider about treating your slightly elevated cholesterol with a combination of sublingual (under-the-tongue) vitamin B12 (1000mcg daily), folic acid (800mcg daily) and vitamin B6 (200mg daily).
2. Blood pressure medications
Why they’re prescribed: All blood pressure medications — and there are eight different categories of them — are used to lower the pressure inside blood vessels, so the heart doesn’t have to work as hard to pump blood throughout the body.
How they can cause sexual dysfunction: While high blood pressure in itself can lead to sexual dysfunction, studies show that many of the drugs used to treat this condition also can cause sexual difficulties. In men, the decreased blood flow can reduce desire and interfere with erections and ejaculation. In women, it can lead to vaginal dryness, a decrease in desire, and difficulties achieving orgasm.
Three types of blood-pressure medications — diuretics (or “water pills”), beta-blockers and alpha-blockers — have been found to have the highest incidence of sexual side effects. Some diuretics, for example, not only interfere with blood flow to the sex organs but increase the body’s excretion of zinc, which is needed to produce testosterone. And beta-blockers can sabotage a satisfying sex life at least three ways — by making you feel sedated and depressed, by interfering with nerve impulses associated with arousal and by reducing testosterone levels.
Options: Talk with your doctor or other health care provider about switching to another type of blood pressure medication. For older patients, a benzothiazepine calcium channel blocker is often the best choice, and drugs in this class have been shown to cause fewer adverse sexual effects than other antihypertensives.