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Can Anastrozole Cause Erectile Dysfunction?

Kristin Hall, FNP

Reviewed by Kristin Hall, FNP

Written by Our Editorial Team

Published 12/23/2022

Is anastrozole erectile dysfunction a thing? You’re not the first guy to wonder about this.

Chances are, you know hormones play a role in sex drive and sexual function. When it comes to male sex drive, testosterone is most commonly thought of as the main driver behind lust and libido.

Less thought about when it comes to men? Estrogen.

But guys actually have estrogen flowing through their bodies. If these hormones are out of whack, it can impact sexual function, and you may be put on medication to balance things out.

One such medication is called anastrozole, which can impact hormone levels.

Some say anastrozole erectile dysfunction is a thing. Interestingly, others claim you can take anastrozole for erectile dysfunction.

So which is it? Read on to find out.

Understanding Anastrozole

Anastrozole decreases estrogen levels. It’s in a class of prescription drugs called nonsteroidal aromatase inhibitors.

It’s most commonly given to menopausal women as a form of breast cancer treatment. However, anastrozole is sometimes given to men as well.

Aromatase inhibitors like anastrozole can be used to improve testosterone levels in adult men.

How Does Anastrozole Work?

To understand how anastrozole works, you need a bit of a biology lesson. We’ll make it quick — we promise.

Aromatase (also called estrogen synthetase) is a naturally occurring enzyme in the body. The aromatase enzyme helps androgens convert to estrogen. 

While estrogen is often mistakenly thought to be a female hormone, it exists within men too — just like how testosterone also runs through women’s bodies.

Men with low estrogen may have low bone mineral density, which could impact overall bone health. Too much estrogen can result in a low conversion of testosterone.

For men, it’s very rare to be low in estrogen — it’s far more common to have high estrogen.

Aromatase inhibitors (such as anastrozole) can help boost testosterone levels in men with lower levels of this hormone. It’s thought that taking an aromatase inhibitor to raise testosterone production may be a good alternative to testosterone replacement therapy.

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Is Anastrozole Safe?: Adverse Side Effects to Consider

Generally, anastrozole is considered safe. Side effects of anastrozole include headaches, sweating, diarrhea, weight gain, mood changes and nausea.

Another concern with taking aromatase inhibitors is that it could cause issues with bone loss, such as osteoporosis. Because of this, if you’re on anastrozole, a healthcare provider may monitor you closely.

Does Anastrozole Cause Erectile Dysfunction? 

It’s unlikely anastrozole will cause erectile dysfunction.

In fact, it may even help improve sexual function — but on the other hand, it’s not impossible for anastrozole erectile dysfunction to occur.

If erectile dysfunction does occur while taking anastrozole, it could mean your hormones are out of whack. Perhaps you’re taking it and no longer need it, so your estrogen and testosterone levels have gone wonky.

Just as testosterone is needed for a healthy sex life, so is estrogen. In fact, estradiol (a prominent form of estrogen) is a key component of sexual function and the ability to get and maintain an erection.

As mentioned, anastrozole prevents testosterone from being converted into estrogen. This is good for someone who doesn’t have enough testosterone.

But if you do have enough, it can lead to not having enough estrogen. In that case, you may start suffering from erectile dysfunction.

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Can Anastrozole Treat Erectile Dysfunction?

While anastrozole erectile dysfunction is rare, it can happen. On the flip side, some say

taking anastrozole for erectile dysfunction is a very real thing. 

It makes sense if you think about it. When your hormones aren’t balanced, and there’s too much conversion of testosterone to estrogen, you may notice a lack of erectile function. Taking anastrozole can help rectify this.

Not only is anastrozole thought to help with erection issues, but many also believe it can be beneficial for other issues of sexual dysfunction, such as an improvement in sperm production and sperm recovery rates.

One thing to note is that no clinical trials have proven anastrozole to be a definitive solution for erectile dysfunction.

How to Treat Erectile Dysfunction From Anastrozole

Let’s say luck isn’t on your side, and you aren’t taking anastrozole for erectile dysfunction but rather suffering from anastrozole-induced erectile dysfunction. 

If you’re taking anastrozole and it’s causing the transformation of too much testosterone into estrogen, you may suffer from erectile dysfunction. If this is the case, there are a number of treatments for erectile dysfunction you could try.

The first step is to speak with a healthcare professional. They may take you off anastrozole, which could improve your sexual function. It’s also possible they’ll recommend medication for erectile dysfunction.

Here are some of the more common ED medications

Sildenafil 

Sildenafil is the generic version of Viagra®. It’s a phosphodiesterase type 5 inhibitor (PDE5 inhibitor) that relaxes the muscles in the penis, allowing blood to flow to the area more easily when sexually aroused.

Sildenafil is as popular as it is partly because it works within 30 minutes and lasts about four hours.

Tadalafil 

Also a PDE5 inhibitor, tadalafil is another commonly prescribed ED medication. The brand name for this medication is Cialis®.

Both the generic and brand name version last up to 36 hours. Some even call it the “weekend” ED medication.

Vardenafil 

Vardenafil is the active ingredient in the brand name medication Levitra®. Like sildenafil, it works fairly quickly — usually within 30 to 60 minutes of taking it. As for how long it lasts? You can expect it to last for about five hours.

A clinical trial found that 75 percent of men maintained an erection good enough for sex after using the 10-milligram dose. A 20-milligram dose was even more effective, with 80 percent saying they got an erection and were able to have sex after taking it.

Avanafil 

Often referred to by the brand name Stendra®, avanafil is also a PDE5 inhibitor. Oh, and it’s even quicker to work than sildenafil, taking just 15 minutes to kick in.

Another benefit: It’s thought to have few adverse effects. 

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Anastrozole and Erectile Dysfunction

Anastrozole is a medication that can be used if you have a testosterone deficiency. It boosts testosterone by reducing elevated estradiol levels.

Estradiol is a form of estrogen. By lowering estrogen levels, testosterone can balance out. 

Since the medication impacts these two hormones, many think it can either help erectile dysfunction or cause it.

If you’re taking anastrozole to boost your bioavailable testosterone levels, you could be dealing with ED. And once those levels even out, you may notice your ED dissipate.

But if you’re taking anastrozole unnecessarily, it could boost estradiol levels and cause ED.

If you’re dealing with ED, the best way to get to the bottom of it is to speak with a healthcare provider. Hims offers online consultations that make the process quick, easy and private. 

11 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

  1. Anastrozole. Medline Plus. Retrieved from https://medlineplus.gov/druginfo/meds/a696018.html
  2. De Ronde, W., Jong, F., (2011). Aromatase inhibitors in men: effects and therapeutic options. Reproductive Biology and Endocrinology. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3143915/
  3. Schulster, M., Bernie, A., Ramasamy, R., (2016). The role of estradiol in male reproductive function. Asian Journal of Andrology. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854098/
  4. Male Fertility Drugs. Health University of Utah. Retrieved from https://healthcare.utah.edu/fertility/treatments/male-fertility-drugs.php
  5. Sildenafil (2018). Medline Plus. Retrieved from https://medlineplus.gov/druginfo/meds/a699015.html
  6. Tadalafil (2016). Retrieved from https://medlineplus.gov/druginfo/meds/a604008.html
  7. Smith BP, Babos M. Sildenafil. [Updated 2020 Jun 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK558978/
  8. Food and Drug Administration. (2018). https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/021368s030lbl.pdf
  9. Food and Drug Administration. (2017). https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021400s020lbl.pdf
  10. Food and Drug Administration (2007). https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/021400s010lbl.pdf
  11. Food and Drug Administration. (2018). https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/202276s018lbl.pdf

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.