Never stop, pause, reduce, or change a prescribed medicine because of anything on this page. Some of the medicines listed here are dangerous to stop suddenly, and the condition being treated does not pause while you experiment. Everything here exists to make your next conversation with a prescriber more specific — not to replace it.
Uncommonly reportedHeart and blood-pressure medicines
ACE inhibitors and ARBs and sexual side effects
These are among the blood-pressure medicines least associated with sexual side effects, and some studies of ARBs report sexual function improving rather than worsening on them. If you are on one of these and something has changed, the medicine is usually not the best first suspect — the underlying blood-pressure or vascular problem often is, and that is worth investigating rather than filing away.
What the rating means: This class is often blamed, but the evidence linking it to sexual effects is weak or mixed. Looking elsewhere first is usually the better use of a consultation.
What is reported
Editorial categories, not percentages. Published rates vary enormously depending on study design and on whether anyone thought to ask the question.
Erections that are slower, softer, or do not hold. Because this depends on blood vessels and nerves, it can also be an early signal of something cardiovascular — which is why it is worth a clinical conversation rather than only a product.
Wanting sex less often, or losing the spontaneous interest that used to arrive on its own. This is the effect people most often assume is psychological and most often is not only psychological.
Timing and reversibility
Where an effect is reported it usually appears early. A change that started long after the medicine did is more likely to have another explanation.
Each of these has its own sexual effects, separate from the medicine’s. Working out which half you are dealing with is usually the whole question.
DiabetesDamages the small blood vessels and nerves that arousal depends on.
High blood pressureDamages the vessels arousal depends on — before any treatment does.
Heart diseaseFear of the effort is usually a bigger obstacle than the effort.
What to ask the person who prescribed it
If it is probably not this tablet, what else should we be looking at?
Should my cardiovascular risk be reassessed given this symptom?
Are any of my other medicines a more likely explanation?
Things that help without touching the prescription
Being able to say which suspects have been ruled out makes a consultation much shorter and more productive.
Care signal
When the obvious medicine suspect is ruled out, new erection difficulty becomes more, not less, worth investigating — it can be the first visible sign of vascular disease.
Uncommonly reported for this class. These are among the blood-pressure medicines least associated with sexual side effects, and some studies of ARBs report sexual function improving rather than worsening on them. If you are on one of these and something has changed, the medicine is usually not the best first suspect — the underlying blood-pressure or vascular problem often is, and that is worth investigating rather than filing away.
How soon would ace inhibitors and arbs cause a change, and does it reverse?
Where an effect is reported it usually appears early. A change that started long after the medicine did is more likely to have another explanation.
What should I do if I notice this while taking ace inhibitors and arbs?
No. Never stop, pause, or reduce a prescribed medicine on your own because of a side effect — several medicines on this site are dangerous to stop suddenly, and the condition being treated does not pause while you experiment. Bring the observation to the person who prescribed it; a dose review, a different preparation, or a different approach may all be options, and only they can weigh them against what the medicine is doing for you.
What should I ask about ace inhibitors and arbs at my appointment?
A specific question gets a better answer than a general one. For this class: If it is probably not this tablet, what else should we be looking at? Should my cardiovascular risk be reassessed given this symptom? Are any of my other medicines a more likely explanation?
When is this worth an appointment rather than a wait-and-see?
When the obvious medicine suspect is ruled out, new erection difficulty becomes more, not less, worth investigating — it can be the first visible sign of vascular disease.
Educational information about categories of medicine only — not medical advice, not a diagnosis, and not a statement about your prescription. It does not cover doses, interactions between medicines, or alternatives, and it cannot know what else is going on with your health. Sexual symptoms often have more than one cause at once. Pain, bleeding, or a symptom that is new and unexplained always deserves assessment.