Loss of libido also known as sex drive is a common problem affecting up to one in five men – and even more women – at some point in their life. It’s often linked to professional and personal stress, or important life-changing events such as pregnancy, childbirth, or breastfeeding.
However, an unexpected loss of libido – especially when it lasts for a long time or keeps returning – can also indicate an underlying personal, medical, or lifestyle problem, which can be upsetting to both partners in a relationship.
How medications affect libido
Several medications can affect sex drive and lower libido in men and women, most of them do this by affecting the hormones that regulate sexual functions in men and women. For example, medications that lower the levels of testosterone in the body often result in low libido.
List of Medications that Lower Libido
Anti-Androgens: Androgens are a group of sex hormones. They help start puberty and play a role in reproductive health and body development. All genders make androgens, but males make more of them. Testosterone is the most common androgen. Anti-androgens block some aspects of these hormones. Doctors may prescribe them for several conditions, such as heartburn or prostate cancer.
Examples of anti-androgens that can cause sexual dysfunction include:
- Bicalutamide
- Enzalutamide
- Flutamide
- Ketoconazole
- Nilutamide.
SSRI antidepressants: Selective serotonin reuptake inhibitors (SSRIs) are a widely used type of antidepressant. They’re mainly prescribed to treat depression, particularly persistent or severe cases, and are often used in combination with a talking therapy such as cognitive behavioral therapy (CBT). However, Sexual dysfunction reportedly occurs in over 50% of people taking selective serotonin reuptake inhibitors (SSRI) antidepressants. Examples of SSRI that can cause sexual dysfunction includes:
- Paroxetine (Paxil)
- Fluoxetine (Prozac)
- Sertraline (Zoloft)
- Escitalopram (Lexapro)
- Citalopram (Celexa)
SNRI antidepressants: SNRI stands for serotonin-norepinephrine reuptake Inhibitor. These may also be called selective serotonin-norepinephrine reuptake Inhibitors (SSNRIs). SNRIs increase levels of serotonin and norepinephrine in the brain by blocking or delaying their reuptake by nerves. They are used for the treatment of both depression and fibromyalgia, these meds have almost the same incidence of decreased desire, difficulty with arousal, and difficulty achieving orgasm as the SSRIs.
Examples of SNRIs that can cause sexual dysfunction are:
Blood pressure and Cardiovascular medications: According to the CDC, nearly half of adults in the United States (47%, or 116 million) have hypertension, defined as a systolic blood pressure greater than 130 mmHg or diastolic blood pressure greater than 80 mmHg or are taking medication for hypertension. Anti-hypertensives are prescription medications to help lower blood pressure. Unfortunately, many of these medications can cause sexual issues, including decreased libido.
Examples that can cause sexual dysfunction include:
- Beta-blockers, such as metoprolol and atenolol
- Clonidine
- Spironolactone (Aldactone)
- Some diuretics, such as hydrochlorothiazide and furosemide.
Corticosteroids: Commonly referred to as steroids, corticosteroids are a type of anti-inflammatory drug. They are typically used to treat rheumatologic diseases, like rheumatoid arthritis, lupus, or vasculitis (inflammation of the blood vessels). Corticosteroids can affect sexual function because they mimic the effects of certain hormones inside the body. These drugs can also reduce testosterone levels. This may lead to decreased sexual desire and sexual function in some men.
Examples of corticosteroids that can cause sexual dysfunction include:
- Hydrocortisone
- Prednisolone
- Prednisone.
Immunosuppressants: Immunosuppressants are drugs that keep your immune system in check. The body’s immune system helps fight off infections that cause illness. But sometimes, the immune system mistakenly attacks healthy cells and tissues. Immunosuppressants can slow or stop this response. reduce the activity of the immune system. However, a potential side effect of immunosuppressants is impaired sexual function.
Examples of immunosuppressants that can cause sexual dysfunction include:
- Sirolimus
- Everolimus
- Tacrolimus
- Cyclosporine.
Antipsychotic Medications: Antipsychotics are drugs primarily prescribed for the treatment of psychosis. Studies have shown that sexual dysfunction is a common condition in patients taking antipsychotics, and is the most bothersome symptom and adverse drug effect resulting in a negative effect on treatment compliance.
Examples of antipsychotic medications that can cause sexual dysfunction include:
- Aripiprazole (Ability)
- Olanzapine (Zyprexa)
- Risperidone (Risperdal)
Epilepsy medications: Diminished libido and sexual dysfunction are unusually common among epileptic patients taking antiepileptic drugs (AEDs) which often induce androgen deficiency. Anti-epileptics are medications that doctors prescribe to help prevent epileptic seizures.
Examples of epilepsy medications that can cause sexual dysfunction include:
- Gabapentin (Neurontin)
- Topiramate (Topamax)
GnRH agonists: Gonadotropin-releasing hormone agonists are a relatively new class of drugs, which, when chronically administered, result in marked reductions in blood levels of testosterone and estrogen. (GnRH) agonists are sometimes prescribed to treat prostate cancer. They may reduce sexual desire in men.
Examples of GnRH agonists that can cause sexual dysfunction include:
- Goserelin (Zoladex)
- Leuprolide (Lupron)
Enlarged prostate medications: An enlarged prostate can cause sexual problems in men, such as Erectile dysfunction (the inability to attain and maintain an erection sufficient for sexual intercourse at least 25% of the time), Reduced sex drive. To further complicate matters, medications used in managing this problem can further dampen sexual function.
Tamsulosin (Flomax) a drug used to treat symptoms of an enlarged prostate can induce ejaculatory disorders in 11% of men. Propecia and Proscar (both finasteride) also have this problem but in 9% of men taking it.
GERD and ulcer medications: These medications are used to treat ulcers; gastroesophageal reflux disease (GERD), a condition in which backward flow of acid from the stomach causes heartburn and injury of the food pipe (esophagus); and conditions where the stomach produces too much acid, such as Zollinger-Ellison syndrome.
A good example of a drug in this class that causes sexual dysfunction is Cimetidine (Tagamet) because it blocks the androgen receptor in the pituitary or the hypothalamus, reducing sexual desire in individuals of both sexes and affecting arousal and orgasm.
Recreational drugs use: Recreational drug use is the use of a psychoactive drug to induce an altered state of consciousness either for pleasure or for some other casual purpose or pastime by modifying the perceptions, feelings, and emotions of the user. When a psychoactive drug enters the user’s body, it induces an intoxicating effect. Some recreational drugs can also affect sexual arousal and performance. Examples of recreational drugs that can cause sexual dysfunction include:
- Alcohol
- Hallucinogens
- Narcotics, such as heroin
- Stimulants, such as cocaine and methamphetamines
Note: Drugs to treat opioid addiction may also lead to erectile dysfunction. These drugs include methadone and buprenorphine.
