# Medicines that can affect erections, and why you should not stop them on your own > The NIH lists erectile dysfunction as a possible side effect of many common prescription and over-the-counter medicines, including antidepressants, blood pressure medicines and water pills, chemotherapy and hormone medicines, antihistamines, some pain relievers, sedatives, appetite suppressants and ulcer medicines. Being on the list does not mean a medicine is the cause for you. Do not stop any medicine on your own: a clinician can review what you take and may suggest a different dose or a different medicine. _Last updated: 2026-10-17_ --- **The short version:** a lot of ordinary medicines can play a part in erection problems, and the list is longer than most people expect. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK, part of the NIH) says ED "can be a side effect of many common prescription and over-the-counter medicines," and names antidepressants, appetite suppressants, antihistamines, blood pressure medicines and diuretics, chemotherapy and hormone medicines, some pain relievers, sedatives and ulcer medicines ([NIDDK, Symptoms & Causes of ED](https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/symptoms-causes)). Two things matter just as much as the list. A medicine being on it does not mean it is the cause for you, and the same NIH guidance is plain about what to do next: "Do not stop taking any medicines on your own. Talk with your health care professional first" ([NIDDK, Treatment for ED](https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/treatment)). This guide walks through each group, what the labels and public health sources actually say, and what a medication review looks like. ## Which medicines can affect erections? The NIH groups the medicines linked to ED into eight families, and the National Library of Medicine's MedlinePlus encyclopedia fills in named examples for most of them. MedlinePlus also notes that its list is not complete: "There may be additional drugs other than those on this list that can cause erection difficulties" ([MedlinePlus, Drugs that may cause erection problems](https://medlineplus.gov/ency/article/004024.htm)). The table pairs the NIDDK categories with examples MedlinePlus names. | NIDDK category | Examples MedlinePlus names | | ---------------------------------------------------- | --------------------------------------------------------------------------------------------------------- | | Antidepressants | Fluoxetine, sertraline, nortriptyline, phenelzine, and some other mental health medicines | | Blood pressure medicines and diuretics | Hydrochlorothiazide, chlorthalidone, atenolol, metoprolol, furosemide, spironolactone | | Chemotherapy and hormone medicines | Antiandrogens, LHRH agonists (Lupron, Zoladex), an LHRH antagonist (Firmagon), cyclophosphamide, busulfan | | Antihistamines, for allergies or heartburn | Diphenhydramine, hydroxyzine, meclizine, cimetidine, nizatidine | | Some pain relievers | NSAIDs such as ibuprofen and naproxen; codeine, oxycodone, morphine and other opioids | | Sedatives, or medicines that make you calm or sleepy | Named by NIDDK as a category; MedlinePlus does not group them separately | | Ulcer medicines | Named by NIDDK as a category; MedlinePlus does not group them separately | | Appetite suppressants | Named by NIDDK as a category; MedlinePlus does not group them separately | Sources: categories from [NIDDK, Symptoms & Causes of ED](https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/symptoms-causes); examples from [MedlinePlus](https://medlineplus.gov/ency/article/004024.htm). MedlinePlus also lists medicines for Parkinson disease, finasteride and dutasteride, digoxin, metoclopramide, pseudoephedrine, sumatriptan and lipid-lowering agents, plus alcohol, nicotine, marijuana, cocaine and other recreational drugs. Medicines are one group of causes among several; our guide to [what causes ED](/what-causes-ed) covers the rest. ## Which medicines are most likely to cause erectile dysfunction? No single source ranks every medicine against every other, so any "most likely" list is a summary of where the clearest signals are, not a scoreboard. Across the government sources and drug labels on this page, the strongest signals come from hormone therapy for prostate cancer, SSRI antidepressants, some blood pressure medicines (thiazide water pills, then beta blockers), long-term opioid painkillers and, in a minority of men, finasteride and dutasteride. | Medicine group | What the source says | Source | More on this site | | -------------------------------------- | ---------------------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------ | --------------------------------------------------------------------- | | Hormone therapy for prostate cancer | ED and loss of interest in sex are listed side effects of androgen deprivation therapy; risk rises the longer treatment goes on | [NCI](https://www.cancer.gov/types/prostate/prostate-hormone-therapy-fact-sheet) | [ED after prostate treatment](/ed-after-prostate-treatment) | | SSRI antidepressants | A labeled warning: SSRI use may result in erectile dysfunction, decreased libido and delayed or failed ejaculation | [Zoloft label](https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=fda754f6-d0f3-4dce-a17a-927d64f912f7) | [Depression and ED](/ed-and-depression) | | Thiazide water pills and beta blockers | Thiazides are the most common cause among blood pressure medicines, then beta blockers; alpha blockers tend to be less likely | [MedlinePlus](https://medlineplus.gov/ency/article/004024.htm) | [Blood pressure medicines and ED](/blood-pressure-medications-and-ed) | | Long-term opioid painkillers | Extended use may lead to androgen deficiency that may show up as low libido, impotence or ED; the causal role is not known | [OxyContin label, section 12.2](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=bfdfe235-d717-4855-a3c8-a13d26dadede) | This page, below | | Finasteride and dutasteride | In year 1 of a 4-year trial, 8.1% on finasteride vs 3.7% on placebo reported drug-related impotence; no difference in years 2 to 4 | [Proscar label](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6f988153-fc74-4ca4-b29a-111f750c4a4b) | [Finasteride and ED](/finasteride-and-ed) | | Benzodiazepines such as lorazepam | Change in libido and impotence appear in the label's list of other adverse reactions to benzodiazepines | [Ativan label](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=89057c93-8155-4040-acec-64e877bd2b4c) | This page, below | The table is a guide to what to ask about, not a reason to suspect a particular pill on your own. Many of these medicines treat conditions that are themselves linked to ED, and the one small study of men starting a beta blocker, described below, shows how much expectation can matter. ## Does a medicine on the list mean it is causing my ED? No. A listing means ED is a possible side effect, not that it will happen to you or that it explains what you are noticing. MedlinePlus puts it simply: "What causes erection problems (also called erectile dysfunction or ED) in one man may not affect another man" ([MedlinePlus](https://medlineplus.gov/ency/article/004024.htm)). There is a second reason to be careful about blaming a pill. Many of the conditions these medicines treat are on the NIH list of ED causes in their own right, including high blood pressure, heart and blood vessel disease, depression, anxiety and stress ([NIDDK, Symptoms & Causes of ED](https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/symptoms-causes)). The label for the antidepressant sertraline makes the same point from the prescriber's side: when sexual function changes, "obtaining a detailed history (including timing of symptom onset) is important because sexual symptoms may have other causes, including the underlying psychiatric disorder" ([ZOLOFT prescribing information, DailyMed](https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=fda754f6-d0f3-4dce-a17a-927d64f912f7)). Expectations can play a part too. In a small study of 96 men with newly diagnosed cardiovascular disease who were starting the beta blocker atenolol, none of whom had ED at the start, 32 men were placed in each of three groups. After 3 months the share reporting ED was 3.1% among men not told which drug they were taking, 15.6% among men told the drug's name only, and 31.2% among men told the drug's name and its possible effect on erections ([Silvestri et al., European Heart Journal, 2003](https://pubmed.ncbi.nlm.nih.gov/14585251/)). The authors concluded that knowledge of, and prejudice about, beta blocker side effects can produce anxiety that may affect erectile function. It was one small study of one drug, so it does not settle anything about other medicines, but it is a good reminder that how and when a change started is worth describing carefully. Our guide on [telling ED from performance anxiety](/ed-vs-performance-anxiety) covers that side in more detail. ## Should you stop a medicine if you think it is affecting your erections? No, not on your own. The NIH says to talk with your health care professional first, and explains what they can do instead: "They may suggest taking a different dose of medicine or switching to another medicine" ([NIDDK, Treatment for ED](https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/treatment)). MedlinePlus gives the reason this matters: "Some medicines may lead to life-threatening reactions if you do not take care when stopping or changing them" ([MedlinePlus](https://medlineplus.gov/ency/article/004024.htm)). Stopping abruptly also leaves the original problem untreated. A blood pressure medicine, an antidepressant or a cancer treatment was prescribed for a reason, and that condition does not pause while you test a theory about side effects. Keep taking your medicines as prescribed and raise the erection changes with the clinician who prescribes them, or with a pharmacist. Bring a full list, including over-the-counter products and supplements, and when the changes started. Only change or stop a medicine with their guidance. ## Can antidepressants affect erections? Yes. Antidepressants are the first item on the NIH list, and MedlinePlus names several, including fluoxetine (Prozac), sertraline (Zoloft), nortriptyline, imipramine, clomipramine, phenelzine and tranylcypromine ([MedlinePlus](https://medlineplus.gov/ency/article/004024.htm)). The FDA label for sertraline has a dedicated warning on sexual dysfunction: "In male patients, SSRI use may result in ejaculatory delay or failure, decreased libido, and erectile dysfunction" ([ZOLOFT prescribing information, DailyMed](https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=fda754f6-d0f3-4dce-a17a-927d64f912f7)). The same label asks prescribers to bring the subject up themselves, because "sexual function may not be spontaneously reported," and to "discuss potential management strategies to support patients in making informed decisions about treatment." Its patient guide adds, "There may be treatments your healthcare provider can suggest." This is also the group where stopping on your own carries the clearest documented risk. The sertraline label describes a discontinuation syndrome after stopping serotonergic antidepressants, "particularly after abrupt discontinuation," with symptoms such as dizziness, irritability, electric shock sensations, anxiety and confusion, and its patient guide says, "Do not stop ZOLOFT without first talking to your healthcare provider" ([ZOLOFT prescribing information, DailyMed](https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=fda754f6-d0f3-4dce-a17a-927d64f912f7)). Depression itself is on the NIH list of ED causes, so the condition and the medicine are often tangled together, which is one more reason the conversation belongs with your prescriber. Our guide to [depression and ED](/ed-and-depression) covers that two-way link. ## Can blood pressure medicines and water pills affect erections? Yes. "Blood pressure medicines and diuretics, or water pills" are on the NIH list ([NIDDK, Symptoms & Causes of ED](https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/symptoms-causes)), and MedlinePlus names many, including hydrochlorothiazide, chlorthalidone, atenolol, metoprolol, propranolol, clonidine, methyldopa, spironolactone and others. MedlinePlus also compares the classes: "Thiazides are the most common cause of erectile dysfunction among the high blood pressure medicines. The next most common cause is beta blockers. Alpha blockers tend to be less likely to cause this problem" ([MedlinePlus](https://medlineplus.gov/ency/article/004024.htm)). High blood pressure is itself on the NIH list of conditions that can lead to ED, so a change that shows up after starting a new pill is worth mentioning without assuming the pill is the whole story. Because there are several classes of blood pressure medicine, a prescriber who knows about the change has options to weigh, which is the NIH's point about a different dose or a different medicine. Our guide to [blood pressure medicines and ED](/blood-pressure-medications-and-ed) goes through what the lisinopril, amlodipine and losartan labels say, and our guide to [ED and your overall health](/ed-and-your-health) explains why blood pressure and blood vessels matter for erections in the first place. If an ED medicine is ever part of the plan, your blood pressure medicines matter in the other direction too. The sildenafil label advises caution when it is taken with alpha blockers or other blood pressure medicines, because using them together may lead to low blood pressure ([VIAGRA prescribing information, DailyMed](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=0b0be196-0c62-461c-94f4-9a35339b4501)), and our page on [sildenafil interactions](/sildenafil-drug-interactions) sets out what that label says. ## Can cancer treatment or hormone medicines affect erections? Yes, and for some hormone treatments it is a well-documented effect. The NIH lists "chemotherapy and hormone medicines" ([NIDDK, Symptoms & Causes of ED](https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/symptoms-causes)), and MedlinePlus names antiandrogens, LHRH agonists (Lupron, Zoladex), an LHRH antagonist (Firmagon), and chemotherapy drugs such as cyclophosphamide and busulfan ([MedlinePlus](https://medlineplus.gov/ency/article/004024.htm)). For prostate cancer, the National Cancer Institute lists loss of interest in sex and erectile dysfunction among the side effects of androgen deprivation therapy, and adds that antiandrogens "can cause diarrhea, breast tenderness, nausea, hot flashes, loss of libido, and erectile dysfunction." It also notes that the risk of side effects increases the longer a person is on hormone therapy, and that "most of the sexual and emotional side effects caused by low levels of androgens will eventually go away if a man stops taking hormone therapy" ([NCI, Hormone Therapy for Prostate Cancer](https://www.cancer.gov/types/prostate/prostate-hormone-therapy-fact-sheet)). That decision belongs to the cancer team, because the treatment is there to control the cancer. Our guide to [ED after prostate cancer treatment](/ed-after-prostate-treatment) covers surgery and radiation as well. Chemotherapy is more nuanced than the list suggests. The NCI says chemotherapy "may lower your testosterone levels and libido during the treatment period" but "does not usually affect your ability to have an erection," while radiation therapy to the pelvis can make it difficult to get or keep an erection if blood vessels or nerves are damaged ([NCI, Sexual Health Issues in Men with Cancer](https://www.cancer.gov/about-cancer/treatment/side-effects/sexuality-men)). If low testosterone is part of the picture, our guide on [ED and low testosterone](/ed-and-low-testosterone) explains how the two connect. ### Finasteride and dutasteride Finasteride and dutasteride are both on the MedlinePlus list ([MedlinePlus](https://medlineplus.gov/ency/article/004024.htm)). The label for PROSCAR, the finasteride tablet used for an enlarged prostate, gives real numbers from a 4-year placebo-controlled trial of about 3,000 men treated for an enlarged prostate: in year 1, impotence that investigators judged possibly, probably or definitely drug related was reported by 8.1% of men on finasteride against 3.7% on placebo, and in years 2 to 4 "there was no significant difference between treatment groups in the incidences of impotence, decreased libido and ejaculation disorder" ([PROSCAR prescribing information, DailyMed](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6f988153-fc74-4ca4-b29a-111f750c4a4b)). The label also lists rare postmarketing reports of sexual problems, including erectile dysfunction, that continued after treatment stopped. It is careful about what those reports can show: most of the men "were older and were taking concomitant medications and/or had co-morbid conditions," and "the independent role of PROSCAR in these events is unknown." That is the honest state of the evidence, and it is a reasonable thing to ask a prescriber about before starting. Our guide to [finasteride and ED](/finasteride-and-ed) covers both drugs and the hair-loss version in more detail. ## Can antihistamines, painkillers or ulcer medicines affect erections? Yes, these are on the NIH list too, and several of them are sold over the counter. NIDDK names "antihistamines, or medicines for allergies or heartburn," "some pain relievers, such as nonsteroidal anti-inflammatory drugs, codeine, and oxycodone," "sedatives, or medicines that make you calm or sleepy," appetite suppressants and ulcer medicines ([NIDDK, Symptoms & Causes of ED](https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/symptoms-causes)). MedlinePlus fills in the names. Its antihistamine list includes diphenhydramine (Benadryl), hydroxyzine, meclizine, dimenhydrinate and promethazine, and it explains that "certain classes of antihistamines are also used to treat heartburn," listing cimetidine (Tagamet), nizatidine and ranitidine alongside them. Its other lists include H2 blockers (Tagamet, Zantac, Pepcid), NSAIDs such as ibuprofen and naproxen, opioid painkillers including codeine, oxycodone, morphine, hydromorphone and methadone, diazepam (Valium) and lorazepam (Ativan) in its mental health list, cyclobenzaprine (Flexeril) and pseudoephedrine (Sudafed) ([MedlinePlus](https://medlineplus.gov/ency/article/004024.htm)). The practical point is that over-the-counter products count. When a clinician asks what you take, a nightly allergy or sleep tablet, regular ibuprofen or a heartburn medicine belongs on the list as much as a prescription does. ## Can opioid painkillers or kratom affect erections? Long-term opioid use can, through hormones. Prescription opioid labels carry a warning on androgen deficiency: the OxyContin (oxycodone) label says that using opioids for an extended period "may influence the hypothalamic-pituitary-gonadal axis, leading to androgen deficiency that may manifest as low libido, impotence, erectile dysfunction, amenorrhea, or infertility." The same label is careful about cause, saying "the causal role of opioids in the clinical syndrome of hypogonadism is unknown," because many medical, physical, lifestyle and psychological stressors can affect hormone levels in people taking them ([OxyContin prescribing information, sections 6.2 and 12.2, DailyMed](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=bfdfe235-d717-4855-a3c8-a13d26dadede)). NIDDK names codeine and oxycodone on its list, and MedlinePlus adds morphine, hydromorphone, methadone, fentanyl and meperidine ([NIDDK](https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/symptoms-causes); [MedlinePlus](https://medlineplus.gov/ency/article/004024.htm)). This is a group where stopping on your own is risky. The OxyContin label says not to rapidly reduce or abruptly discontinue it in a patient who is physically dependent, because rapid reduction or abrupt discontinuation of opioid painkillers "has resulted in serious withdrawal symptoms, uncontrolled pain, and suicide" ([OxyContin prescribing information, DailyMed](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=bfdfe235-d717-4855-a3c8-a13d26dadede)). If erection changes or low desire started on long-term pain medicine, the prescriber can check hormone levels and talk through options. Status: Not FDA-approved for ED in the US; FDA says there are no FDA-approved kratom drug products. Source: FDA, checked 2026-10-17. Kratom is a plant product whose compounds act on the same brain receptors as opioid drugs, according to the FDA, which says kratom is not lawfully marketed as a drug or as a dietary supplement and warns of serious adverse events including liver toxicity, seizures and substance use disorder ([FDA and Kratom](https://www.fda.gov/news-events/public-health-focus/fda-and-kratom)). Research on kratom and erections is thin. One online survey of 165 men who used kratom found erectile function scores that were statistically lower during kratom use than before it but, in the authors' words, clinically similar, while many reported a longer time to ejaculation ([Deebel et al., Res Rep Urol 2023](https://pubmed.ncbi.nlm.nih.gov/36798621/)). A self-selected survey that asks men to recall how things were before cannot show cause. Kratom belongs on the list you share with a clinician, and the FDA notes that people have had withdrawal symptoms when they stopped using it. ## Can benzodiazepines and other sedatives affect erections? They can. "Sedatives, or medicines that make you calm or sleepy" are on the NIH list ([NIDDK, Symptoms & Causes of ED](https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/symptoms-causes)), and MedlinePlus names diazepam (Valium), lorazepam (Ativan), clorazepate and barbiturates among the medicines that may cause erection problems ([MedlinePlus](https://medlineplus.gov/ency/article/004024.htm)). The Ativan (lorazepam) label lists "change in libido, impotence, decreased orgasm" among other adverse reactions to benzodiazepines, after noting that the most frequent reactions were sedation, dizziness, weakness and unsteadiness ([Ativan prescribing information, DailyMed](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=89057c93-8155-4040-acec-64e877bd2b4c)). The same label carries a boxed warning that abrupt discontinuation or rapid dosage reduction after continued use "may precipitate acute withdrawal reactions, which can be life-threatening," and that a gradual taper is used to stop ([Ativan prescribing information, DailyMed](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=89057c93-8155-4040-acec-64e877bd2b4c)). That is a clear case for raising erection changes with the prescriber rather than cutting back alone. ## Do metformin or blood thinners cause ED? Neither is on the NIH or MedlinePlus lists of medicines that can affect erections ([NIDDK](https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/symptoms-causes); [MedlinePlus](https://medlineplus.gov/ency/article/004024.htm)). We also checked current labels for metformin, warfarin (Jantoven) and rivaroxaban (Xarelto), and none lists erectile dysfunction or impotence among its adverse reactions ([metformin tablets label](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=2387a618-24d8-4813-aa83-9114edb35374); [Jantoven label](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=19a69a72-ac5d-45d5-a94d-a5aaecbe4730); [Xarelto label](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=10db92f9-2300-4a80-836b-673e1ae91610)). A label that does not list a side effect is not proof it never happens, but it does mean the label's trials and reports did not flag it. The conditions these medicines treat are a different story. NIDDK says more than half of men with diabetes will get ED, through damage to blood vessels and nerves ([NIDDK, Diabetes, Sexual, & Bladder Problems](https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/sexual-bladder-problems)), and heart and blood vessel disease is on its list of ED causes. So for a man on metformin or a blood thinner, the condition is usually the more useful thing to look at. Our guides to [diabetes and ED](/ed-and-diabetes) and [heart disease and ED](/ed-and-heart-disease) cover those links. NSAIDs are a mixed case. NIDDK and MedlinePlus both name nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen, while the prescription ibuprofen label we checked does not list erectile dysfunction among its adverse reactions ([ibuprofen tablets label](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=00872852-680a-41b3-901b-b991b12a176d)). If you take a pain reliever most days, it is still worth putting on your list. ## What about ADHD medicines, gabapentin, statins and steroids? Each of these has its own page, because each has its own label and its own evidence: - **ADHD stimulants.** Our guide to [ADHD medicines and ED](/adhd-medications-and-ed) covers what the Adderall label lists and what its trials reported. - **Gabapentin and pregabalin.** Often prescribed for nerve pain; our guide to [gabapentin and ED](/gabapentin-and-ed) goes through both labels. - **Statins.** MedlinePlus lists lipid-lowering agents ([MedlinePlus](https://medlineplus.gov/ency/article/004024.htm)); our guide to [cholesterol, statins and ED](/cholesterol-statins-and-ed) weighs that against the trial evidence. - **Anabolic steroids.** Not a prescribed medicine for most men who use them; our guide to [steroids and ED](/anabolic-steroids-and-ed) covers how misuse affects the body's own testosterone. ## What happens in a medication review for ED? A medication review is a routine part of an ED evaluation. When a clinician takes your history, the NIH says "they may ask what prescribed and over-the-counter medicines, vitamins, and supplements you take," alongside questions about sexual function, mental health and your relationship ([NIDDK, Diagnosis of ED](https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/diagnosis)). As part of treatment, they "may review any medicines you are taking to see if a medicine you need for another health condition is causing ED," and may then suggest a different dose or a different medicine ([NIDDK, Treatment for ED](https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/treatment)). A few things make that conversation more useful: - **A complete list.** Prescriptions, over-the-counter medicines, vitamins and supplements, including anything taken only now and then. - **The timing.** When the erection changes began, and whether that lines up with starting, changing or stopping a medicine. The sertraline label singles out the timing of symptom onset as important ([ZOLOFT prescribing information, DailyMed](https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=fda754f6-d0f3-4dce-a17a-927d64f912f7)). - **What exactly changed.** Desire, getting an erection, keeping one, or ejaculation, since medicines and conditions can affect these differently. - **Alcohol and other substances.** Drinking too much alcohol and using recreational drugs are on the NIH list of lifestyle behaviors that may contribute to ED ([NIDDK, Symptoms & Causes of ED](https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/symptoms-causes)). Our guide to [alcohol, recreational drugs and other lifestyle factors in ED](/lifestyle-and-ed) covers them in more detail. A medication review is one part of a wider look at what may be behind ED, which can include blood vessel health, blood sugar and hormones. If you are unsure whether it is time to book that conversation, our guide on [when to see a doctor about ED](/when-to-see-a-doctor-about-ed) covers the signs that mean sooner rather than later, our guide to [talking to a doctor about ED](/talking-to-a-doctor-about-ed) has ways to raise it, and our page on [how ED is diagnosed](/how-ed-is-diagnosed) explains the tests that may follow. ## Sources Every clinical statement on this page traces to one of these sources: - NIDDK (National Institute of Diabetes and Digestive and Kidney Diseases, NIH), Symptoms & Causes of Erectile Dysfunction, last reviewed October 2024. The medicines list, and the conditions and lifestyle behaviors that can lead to ED: [niddk.nih.gov, ED symptoms and causes](https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/symptoms-causes) - NIDDK, Treatment for Erectile Dysfunction, last reviewed October 2024. Medication review, a different dose or a different medicine, and "Do not stop taking any medicines on your own": [niddk.nih.gov, ED treatment](https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/treatment) - NIDDK, Diagnosis of Erectile Dysfunction, last reviewed October 2024. Questions about prescribed and over-the-counter medicines, vitamins and supplements during the history: [niddk.nih.gov, ED diagnosis](https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/diagnosis) - MedlinePlus Medical Encyclopedia (National Library of Medicine), Drugs that may cause erection problems, review date January 2025. Named examples by class, the thiazide and beta blocker comparison, and the warning about stopping or changing medicines: [medlineplus.gov/ency/article/004024.htm](https://medlineplus.gov/ency/article/004024.htm) - ZOLOFT (sertraline) prescribing information and Medication Guide, DailyMed. Section 5.11 Sexual Dysfunction, section 5.5 Discontinuation Syndrome, and the timing-of-onset guidance: [dailymed.nlm.nih.gov, ZOLOFT label](https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=fda754f6-d0f3-4dce-a17a-927d64f912f7) - PROSCAR (finasteride) prescribing information, DailyMed. Year 1 drug-related impotence 8.1% vs 3.7% placebo in men with an enlarged prostate, no significant difference in years 2 to 4, and postmarketing reports with an unknown independent role: [dailymed.nlm.nih.gov, PROSCAR label](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6f988153-fc74-4ca4-b29a-111f750c4a4b) - National Cancer Institute, Hormone Therapy for Prostate Cancer, reviewed October 2024. Sexual side effects of androgen deprivation therapy and antiandrogens: [cancer.gov, prostate hormone therapy fact sheet](https://www.cancer.gov/types/prostate/prostate-hormone-therapy-fact-sheet) - National Cancer Institute, Sexual Health Issues in Men with Cancer, reviewed December 2022. Chemotherapy, radiation and hormone therapy effects on sexual function: [cancer.gov, sexual health issues in men with cancer](https://www.cancer.gov/about-cancer/treatment/side-effects/sexuality-men) - Silvestri A, et al. Report of erectile dysfunction after therapy with beta-blockers is related to patient knowledge of side effects and is reversed by placebo (European Heart Journal, 2003). 96 men with newly diagnosed cardiovascular disease starting atenolol; reported ED of 3.1%, 15.6% and 31.2% by what they were told: [pubmed.ncbi.nlm.nih.gov/14585251](https://pubmed.ncbi.nlm.nih.gov/14585251/) - VIAGRA (sildenafil citrate) prescribing information, DailyMed. Section 5.5, caution when taken with alpha blockers or other blood pressure medicines because of possible low blood pressure: [dailymed.nlm.nih.gov, VIAGRA label](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=0b0be196-0c62-461c-94f4-9a35339b4501) - OXYCONTIN (oxycodone) prescribing information, Knoa Pharma, revised 5/2026, DailyMed. Section 12.2 androgen deficiency with extended opioid use (low libido, impotence, erectile dysfunction; causal role unknown), section 6.2 postmarketing androgen deficiency, and section 2.9 on not abruptly discontinuing: [dailymed.nlm.nih.gov, OXYCONTIN label](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=bfdfe235-d717-4855-a3c8-a13d26dadede) - ATIVAN (lorazepam) tablets prescribing information, Bausch Health, DailyMed. Adverse reactions including change in libido and impotence; boxed warning on dependence and withdrawal reactions: [dailymed.nlm.nih.gov, ATIVAN label](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=89057c93-8155-4040-acec-64e877bd2b4c) - Labels checked for the absence of erectile dysfunction or impotence among adverse reactions, 2026-10-17: [metformin hydrochloride tablets (Granules)](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=2387a618-24d8-4813-aa83-9114edb35374), [JANTOVEN (warfarin)](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=19a69a72-ac5d-45d5-a94d-a5aaecbe4730), [XARELTO (rivaroxaban)](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=10db92f9-2300-4a80-836b-673e1ae91610) and [ibuprofen tablets (Aurobindo)](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=00872852-680a-41b3-901b-b991b12a176d), all on DailyMed - U.S. Food and Drug Administration, FDA and Kratom, content current as of 12/02/2025. No FDA-approved kratom drug products; not lawfully marketed as a drug or dietary supplement; opioid-receptor effects; serious adverse events and withdrawal: [fda.gov, FDA and kratom](https://www.fda.gov/news-events/public-health-focus/fda-and-kratom) - Deebel NA, et al. Investigating the impact of kratom (Mitragyna speciosa) use upon male sexual health (Research and Reports in Urology, 2023). Online survey of 165 men; erectile function scores statistically different but clinically similar during kratom use; longer time to ejaculation reported: [pubmed.ncbi.nlm.nih.gov/36798621](https://pubmed.ncbi.nlm.nih.gov/36798621/) - NIDDK, Diabetes, Sexual, & Bladder Problems. More than half of men with diabetes will get ED; blood vessel and nerve damage: [niddk.nih.gov, diabetes sexual and bladder problems](https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/sexual-bladder-problems) --- _Affiliate disclosure: some links on the web version of this site go to Bodybuilding Peptides (trybbpeptides.com), an affiliate destination, and we may earn a commission if you buy there. Our coverage is independent of that relationship. Details: https://theedreport.com/affiliate-disclosure/_