Medications
About a quarter of all cases of impotence can be attributed to medications. Many drugs pose a risk for erectile dysfunction. Some experts think that nearly every drug, prescription or nonprescription, can be a cause of temporary erectile dysfunction.
Drugs that commonly cause impotence may include:
- Drugs used in chemotherapy.
- Many drugs taken for high blood pressure, particularly diuretics and beta-blockers.
- Most drugs used for psychological disorders, including anti-anxiety drugs, anti-psychotic drugs, and antidepressants, especially selective serotonin reuptake inhibitors (SSRIs). Newer antidepressants pose fewer problems.
- Anti-androgens, including drugs known as gonadotropin-releasing hormone agonists. They are used in prostate cancer and also for treating BPH.
Drugs that sometimes cause impotence include:
- Older anti-ulcer medications (cimetidine)
- Anticholinergic drugs (including some antihistamines)
- Antinausea drugs, particularly metoclopramide (Reglan)
- Antifungal drugs (especially ketoconazole)
- Nonsteroidal anti-inflammatory drugs (NSAIDs), when used on a daily basis
Physical Trauma, Stress, or Injury
Injury to the Spine. Spinal cord injury and pelvic trauma, such as a pelvic fracture, can cause nerve damage that results in impotence. Other conditions that can injure the spine and effect impotence include spinal cord tumors, spina bifida, and a history of polio.
Orthopedic surgery. Erectile dysfunction can sometimes result from orthopedic surgery. A study of young men who underwent surgical repair (“intramedullary nailing”) for a broken thighbone reported that about 40% of these patients experienced erectile dysfunction after surgery. The researchers theorized that the surgery affected pelvic nerves that play a key role in erection. Patients who received a higher dose of muscle relaxant during surgery had better sexual function outcomes.
Bicycling. Studies have indicated that frequent bicycling may pose a risk for erectile dysfunction by reducing blood flow to the penis. The greatest risk is in cyclers who sit upright while cycling. In addition, a 2004 report in the Journal of Urology found that long distance cyclers may reduce their risk by riding a road bike instead of a mountain bike and by choosing saddles without a cutout.
Previous Section
