Which Meds Cause Erectile Dysfunction?

Numerous factors can cause erectile dysfunction (ED), and medication side effects represent a significant and often overlooked cause. According to the 2025 EAU Guidelines, several prescription medication classes have been identified as potential causes of erectile dysfunction.¹ Understanding which medications might be affecting your erectile function is essential, as it may allow for treatment adjustments that can improve your sexual health while still managing your underlying condition.

Antihypertensive medications (drugs that treat high blood pressure) are among the most common culprits. Specifically, thiazide diuretics and beta-blockers have been well-documented to cause erectile problems.¹ These medications can reduce blood flow to the penis or interfere with the nervous system signals necessary for erection. However, not all blood pressure medications carry the same risk, and some newer agents may have fewer sexual side effects.³

Psychiatric medications represent another major category of drugs that can cause erectile dysfunction. Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants, frequently cause sexual side effects, including erectile dysfunction.¹ Similarly, many antipsychotic medications can interfere with erectile function through their effects on hormone levels and neurological pathways involved in sexual response.²

Hormonal treatments, especially antiandrogens used in prostate cancer treatment, such as GnRH analogues and antagonists, as well as 5-alpha-reductase inhibitors (5-ARIs) used for benign prostatic hyperplasia, commonly cause erectile dysfunction by reducing testosterone levels or activity.¹ These medications directly affect the hormonal environment necessary for normal erectile function.

Recreational substances also significantly impact erectile function. The EAU Guidelines specifically mention that heroin, cocaine, marijuana, methadone, synthetic drugs, anabolic steroids, and excessive alcohol can all contribute to erectile dysfunction.¹ These substances may cause both acute effects on sexual function and long-term damage to the vascular and nervous systems necessary for erections.

If you suspect a medication is causing your erectile dysfunction, it’s important not to stop taking any prescribed medication without consulting your healthcare provider. In many cases, adjusting the dosage, switching to an alternative medication, or adding a treatment for erectile dysfunction can effectively address the problem while still managing your underlying condition.⁴ Your urologist can work with your other healthcare providers to find the optimal approach for your situation.

For men with medication-induced erectile dysfunction that cannot be resolved through medication changes, several effective treatment options exist, including PDE5 inhibitors (like sildenafil, tadalafil, and vardenafil), vacuum erection devices, or, in more severe cases, penile implants.⁵ These treatments can often restore satisfactory erectile function even when the causative medication must be continued.