Many things can affect your ability to achieve an erection, but erectile dysfunction generally boils down to one major issue — lack of blood flow. Either not enough blood comes into the penis or the blood leaves the penis too quickly to achieve or sustain an erection.
“When it comes to erectile dysfunction, the healthier the person, the healthier the sexual function,” says Dr. David Cozzolino, urologist with Christiana Care Health System and Brandywine Urology Consultants. “The healthier you are, the healthier your erection will be.”
The usual culprits — heart disease or lack of exercise — should be the first to blame; these will kill your sex quick. But many drugs can also do damage down there. Here are eight substances you might be using that can cause erectile dysfunction.
Antidepressants
Antidepressants are some of the biggest culprits for erectile dysfunction. Some antidepressants — like Prozac, Paxil, and Lexapro — can decrease libido and actually delay ejaculation. This is written in the patient information handouts that come with these prescriptions. However, the fact that these drugs delay ejaculation also makes them an effective treatment option for men who suffer from premature ejaculation.
Smoking
Cigarette and cigar smoke damage blood vessels and reduce blood flow to penile tissue. When restricted, blood flows to the more vital organs first, making the penis one of the last organs to receive blood — even during sex. This side effect is not gender-specific: Regular tobacco use affects sexual function in women, too.
Blood Pressure Medication
Blood pressure medications decrease blood flow to the penis, which can exacerbate the effects of blood vessels that have already been damaged by high blood pressure. Several studies indicate that blood pressure medications can cause erectile dysfunction, but some blood pressure medications are meds bigger offenders than others. Water pills like hydrocholorothiazide are perhaps the worst culprit, according to several studies, followed by beta blockers like propranolol and calcium channel blockers like nifedipine. Beta blockers both decrease blood flow and also lower the heart rate, making blood flow to the penis even more difficult. The science doesn’t explain why water pills are worse, but studies show that sexual function improves in patients taking water pills after they lose weight.
Statins
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Some older studies suggest that statins might decrease sex drive by reducing the body’s production of its own cholesterol, the common precursor to sex hormones including testosterone. But more recent studies suggest otherwise. “There’s conflicting data,” explains Dr. Mohit Khera, Associate Professor of Urology and Director of Andrology at Baylor College of Medicine. “Statins may cause erectile dysfunction in the short-term, but they may actually improve sexual function in long-term treatment … because they improve lipid function.” Decreasing cholesterol levels improves overall circulation in the body and increases blood flow to the penis.
Antihistamines
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Antihistamines as a whole decrease blood flow to the penis and are well known to cause erectile dysfunction. To add to that, they’re also more common than you think. Sure, you know Benadryl, Claritin, and Zyrtec, but doctors also often prescribe these drugs to manage nausea, relax stiff muscles, and induce sleep. Examples of these drugs include Phenergan, Flexeril, and Unisom.
Recreational Drugs
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Just about any illegal substance can have an impact in the bedroom. “Substances like cocaine, methadone, and marijuana can impair the ability to get an erection, [by decreasing the arousal response to stimuli in the brain],” says Dr. Mohit Khera, Associate Professor of Urology and Director of Andrology at Baylor College of Medicine. However, a more recent study suggest that marijuana might actually improve sexual function in some people.
Alcohol
Like other recreational substances, alcohol can dull the brain’s ability to respond to sexual stimulation, but it also has some additional risks associated with long-term use. People who drink heavily for long periods of time put themselves at risk for liver damage, which can precipitate a cascade of health issues, including erectile dysfunction by decreasing testosterone levels.
Soy and Soy-Containing Products
Soy contains several chemicals that are structurally similar to estrogen, which decreases libido. It’s also possible that the estrogen-like compounds found in soy may also down-regulate sexual activity in the brain. However, the effects of soy tend to be bigger issues for vegans and vegetarians who consume large quantities of soy products like tofu or edamame as sources of protein or meat substitutes. But even if you’re not a vegan or training to be the next Arnold Schwarzenegger, Cozzolino says it’s still virtually impossible to avoid soy completely, since soy-based products are commonly used in many food-grade seasonings and emulsifiers.
Frieda Wiley wrote this for Men’s Journal.
