There are many prescription and over-the-counter medications used today which have been known to promote erectile dysfunction in men. Erectile dysfunction, more commonly known as impotence, is a condition in which the man is unable to achieve a normal erection, or unable to develop an erection at all. Before going into a discussion about which medications may be linked to impotence, it is important to remember that one should always consult his physician before changing his medical regime.

There is a sensitive chemical balance in a healthy man’s body that regulates and oversees the normal functioning of his sexual drive, erectile and ejaculatory ability and even his ability to reproduce. If this balance is offset by the introduction of substances or medications from outside, it is highly possible that a problems related to normal functions, including those of the sexual organs, could be inhibited or altered. The substances implicated with upsetting this natural equilibrium are actually quite commonly used today. Ranging from the prescription drugs to recreational substances, and from tobacco to alcohol, chances are that any given man could be consuming something that might possibly interfere with his sexual life.

Drugs that cause impotence
Doctors may still prescribe certain medications known to cause impotence based on a well-calculated trade off. If a drug is, for example, better than any others in treating a certain problem, then it may still be necessary to prescribe it. Also, some medications cause impotence in only a portion of the men taking them, and it may be difficult to tell until a man begins the taking the drug. In the case of anti-hypertension medications, which are associated with erectile dysfunction, they are often used to prevent a condition that could ultimately lead to an even worse case of impotence. With any medical regime that might affect erectile function, it is important to maintain an open dialogue with one’s doctor concerning sexual function.

Anti-hypertension drugs designed to treat high blood pressure have routinely been the source of a man’s decreased potency as well as his altered ejaculatory ability. This is a disappointment considering that while high blood pressure can also be a cause of erectile dysfunction, the drugs to treat hypertension might lead to an even further breakdown of a man’s sexual ability. However, as mentioned earlier, there are some cases in which the cure is still better than the disease; if the drug causes a certain level of impotency, it may still be preferable to the more severe erectile dysfunction resulting from high blood pressure. For a man posed with this dilemma, it is of utmost importance to be frank about his erectile dysfunction when discussing medications with his doctor. There are many adjustments a physician can make in order to help curb these adverse side effects of the treatment for hypertension.

The list of different medications developed to treat high blood pressure is enormous. The following will attempt to outline just a few of them:

Methyldopa
The drug methyldopa works well against hypertension, but by replacing the body’s normal production of the hormone dopamine, this medication can adversely affect the nervous and chemical communication necessary for the functioning of normal sexual processes. It can be expected that nearly a quarter of those who undergo this treatment will be afflicted with lowered sex drive and erectile dysfunction.

Calcium channel blocking drugs including nifedipine, verapamil and diltiazem are relatively new drugs that act to lower blood pressure by altering the dilation of blood vessels. There have been some cases of impotence resulting from the use of these drugs, but not to the same degree as the older anti-hypertension medications.

Diuretics that can cause sexual dsyfunction
Diuretic medications like furosemide (Lasix) as well as hydrochlorothiazide and other thiazides are designed to clear out sodium, a known cause of hypertension, but also take with them potassium. A potassium deficiency has been associated with impotence, among other things. Unfortunately, the one diuretic medicine that is able to retain potassium while expunging sodium from the system has significant effects on the male libido. This spironolactone (Aldactone) causes the body to not react to the its own testosterone, thereby decreasing sexual drive.

Among the beta-blockers, propranolol (Inderal) and metoprolol (Lopressor) are known to adversely affect sexual function at higher dosages. Since men who suffer from higher blood pressure require these increased dosages, it is uncertain whether drug or the condition is more to blame for the decreased libido and reduced erectile functioning. The alpha-blockers such as guanethidine (Ismelin), prazsoin (Minipres), terazosin (Hytrin) and guanadrel (Hylorel) cause a neurological and physical impairments which can lead to impotence and ejaculations that fall back into the body instead of coming out the head. These are only used as a last resort in treating high blood pressure.

Reserpine was first used in among the ancient Hindus to treat certain psychoses and sleep disorders. Picked up by western medicine in the middle of the twentieth century under the name of Serpasil, this medication became the only antihypertensive drug of its time. But similar in its effects to methyldopa, reserpine was linked to impotence and libido reduction as well as depression. It is another medication used only when others come short of being effective.

Clonidine counteracts the hyperactivity of the brain, which is one cause of high blood pressure. But because it involves reducing neurological responses, it causes decreased reactive activity in other regions of the body, including an erectile and ejaculatory functioning. These adverse sexual effects afflict some patients at any dose while for others it hits them only at higher dosages.

In terms of how they affect the male sexual function, the most benign antihypertensive drugs are the ACE inhibitors like enalapril (Vasotec) and captopril (Capoten) that work by blocking the conversion of a chemical in the bloodstream into a secondary, high blood pressure causing component. These involve no sexual side effects while the longer lasting lisinopril causes decreased sex drive and cases of impotency in an extremely small portion of those who use it. So far, this antihypertensive medication is the least harmful to sexual activity.

Apart from anti-hypertension drugs, most of the medications used to treat psychiatric disorders are also linked to impotence and reduced libido in men. Similar to the dilemma of high blood pressure, someone who is excessively anxious, depressed or afflicted by some other mental illness rarely exhibits normal sexual function.

Although antidepressant medications may reduce impotence due to their treatment of depression, they usually bring along sexually inhibiting side effects themselves. One study concluded that among the users of such drugs as fluoxetine (Prozac), parolxetine (Paxil) and sertraline (Zoloft), over a third of the men found themselves impotent, less unable to be aroused or even incapable of producing an orgasm. Lithium, as well, has been implicated in causing about 20 percent impotence among users, although such studies are inconclusive.

Antacids and other medications that may reduce testosterone
In addition, some medications are known to indirectly inhibit a man’s libido due to their reduction of his testosterone levels. Cholesterol-lowering drugs such as clofibrate (Atromid-S) and possibly gemfibrozil (Lopid) lower testosterone production as well as cholesterol. Other testosterone-reducing medications include cimetidine (Tagamet) for ulcers (although Zantac has no sexual side effect), and some tranquilizers including diazepam (Valium), alprazolam (Xanax), chlordiazepoxide (Librium), lorazepam (Ativan) and clorazepate (Traxene).