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What the Most Common Prescription Drugs Do to Your Sex Drive

This is your erection on antidepressants, painkillers and Lipitor

Of the laundry list of side effects that make up most commercials for prescription pills, the ones that have the most immediate impact on men watching tend to be those focused on their sex lives: Do I want to take this cholesterol medication if it’s going to deflate my libido? Is having less anxiety really worth the risk of potential erectile dysfunction? Just how possible is the “possible” in “possible side effects include…?”

To better understand what each of the most commonly prescribed kinds of drugs are doing to our sex drive, we spoke to Dr. Muhammad Mirza, medical director of Allied Medical and Diagnostic, and a specialist in male reproductive health. Here’s what he had to tell us…

Drug Type: Testosterone supplement
Most Popular Brand: AndroGel ($1.4 billion in sales annually worldwide)
What It’s For: Topical gels are a popular form for drugs aimed at treating low testosterone (especially since this kind of medication is toxic if taken orally). The testosterone, absorbed through the skin, boosts levels of the hormone that have declined as a result of age (or, more likely, bad health).
The Effect on Your Sex Drive: “Since testosterone is the main hormone for masculinity, an increase in testosterone would likely initially help your sex drive,” Mirza explains. But he cautions that “prolonged usage, or usage to the level of toxicity [anything exceeding the once-daily recommended dosage] could lead to a reduced sperm count.” This seems counterintuitive, but it’s all about how your body monitors itself: Once it realizes it’s receiving too much testosterone, it compensates by shutting down sperm production.

Drug Type: Antidepressants
Most Popular Brand: Lexapro (30 million prescriptions annually in the U.S.)
What It’s For: Antidepressants like Lexapro work by, essentially, strengthening the circuits in the brain, resulting in increased levels of the required brain chemicals. Most antidepressants — including Lexapro — increase serotonin, which helps to maintain mood balance.
The Effect on Your Sex Drive: “Antidepressants can cause sexual dysfunction, including loss of erection and lack of desire for sexual activity,” says Mirza. “They can also cause an inability to ejaculate or climax.” That lack of orgasm is the result of the drug numbing neurotransmitters in the brain associated with sexual performance and libido (something that can happen while it works to enhance other, weak neurotransmitters to fight depression). It also ignites a vicious cycle — i.e., it can lead to deeper depression, since few men feel good about having an unreliable libido.

Drug Type: Anti-anxiety medication
Most Popular Brand: Xanax (50 million prescriptions annually in the U.S.)
What It’s For: Utilizing the neurotransmitter in your brain known as GABA (that’s gamma amino butyric acid, brain chemistry fans!), Xanax enhances the brain’s natural calming effects, providing a general feeling of serenity.
The Effect on Your Sex Drive: “Much like antidepressants, anti-anxiety medication can impair the ability to achieve an erection, which could lead to an inability to ejaculate or orgasm,” Mirza says. The way it happens is very different, however: Because anti-anxiety medications work by relaxing the nervous system — “much like alcohol,” remarks Mirza — the drugs can basically give you a form of whiskey dick.

Drug Type: Cancer treatment
Most Popular Brand: Rituxan ($7.31 billion in sales annually worldwide)
What It’s For: Rituxan attaches itself to cancer-causing cells and forces them to commit the cellular equivalent of suicide.
The Effect on Your Sex Drive: “Cancer medications and chemotherapy often have sexual side effects, including a loss of sexual desire as well as an inability to perform,” says Mirza. Since cancer drugs are extremely toxic — designed, as they are, to attack cancer cells — they also damage your regular cells, too. “This includes reproductive tissue,” Mirza explains.

Drug Type: Opioid pain medication
Most Popular Brand: Vicodin (130 million prescriptions annually in the U.S.)
What It’s For: By binding itself to the opiate receptors in the brain — a series of proteins on the surface of brain cells that transmit the sensation of pain — drugs like Vicodin depress the nervous system, reducing the feeling of pain and often leading to a feeling of calm or euphoria.
The Effect on Your Sex Drive: “With someone who’s in pain, sexual desire will usually be reduced in general,” says Mirza. In other words, chances are a person’s sex drive will already be impacted by the time they’re prescribed a pain medication.

Of course, since there’s more than a few people purely taking prescription painkillers for fun, it’s worth noting the effects on a healthy body. Surprise! They’re not good. “Opioid medicines can lead to further sexual dysfunction with prolonged usage or abuse,” says Mirza. “They can impair sexual performance and the ability to achieve an erection.” More specifically, as with anti-anxiety medications, opioid painkillers can relax the nervous system so much that the libido takes a hit.

Drug Type: Cholesterol treatment
Most Popular Brand: Lipitor (45 million prescriptions annually in the U.S.)
What It’s For: A cholesterol treatment like Lipitor is what’s known as a “statin,” a medication that reduces the fats in our blood. They work by decreasing cholesterol production and enhancing the liver’s natural ability to remove cholesterol from the body.
The Effect on Your Sex Drive: First up, the good news: “Cholesterol medications themselves aren’t known to have any sexual side effects,” says Mirza. The bad news, however, is that if you’ve been prescribed this drug, you’re already at risk of sexual dysfunction. “Cholesterol is all about blood flow,” explains Mirza. “Just like someone can have poor blood flow in the heart, they may also have poor blood flow in the penis.”

And to finish off the roller-coaster ride that this has become, let’s end on some more good news: Since it improves your blood flow, cholesterol medication may, in theory, help with an erection after all.