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Anastrozole for Erectile Dysfunction: Is It Effective?

Kelly Brown MD, MBA

Reviewed by Kelly Brown MD, MBA

Written by Steph Coelho

Published 12/23/2022

Updated 03/27/2024

Wondering about anastrozole for erectile dysfunction (ED)? 

If you’re having trouble getting and staying hard, it’s probably messing with your sex life. So, what’s a guy to do? 

Many factors can influence whether you develop erection issues, including hormonal imbalances. Hormones play a major role in sex drive and sexual function. You’re probably thinking, Oh yeah, testosterone! 

Sure, testosterone is a biggie when it comes to libido, but another hormone can impact your ability to get an erection. We’re talking about estradiol, a form of estrogen.

That’s right — guys have estrogen flowing through their bodies. And too much of it could be a problem, erection-wise. 

Anastrozole is a medication that can influence hormone levels. It might help if your ED is due to out-of-whack hormones.

Below, we’ll go into more detail about anastrozole, including how it works, whether it can help with erectile function and the potential side effects. We’ll also touch on other ED treatments to consider.

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Anastrozole is a prescription medication. It’s in a class of drugs called nonsteroidal aromatase inhibitors — say that ten times fast.

Healthcare professionals typically prescribe anastrozole (or the brand name Arimidex) and other aromatase inhibitors to treat breast cancer in menopausal women. But they may also prescribe it off-label for men with high estradiol levels — which can lead to low testosterone (low T) — as an alternative to testosterone replacement therapy (TRT).

Here’s a breakdown of how anastrozole works:

  • Your body naturally produces aromatase (aka estrogen synthetase), an enzyme responsible for converting androgens (male sex hormones) to estrogen.

  • Aromatase enzyme inhibitors, like anastrozole, can help boost testosterone levels by blocking the action of aromatase and preventing the enzyme from making more estrogen.

Anastrozole is available in tablet form. The typical dosage is once a day, with or without food.

Blood tests can confirm whether you have high estrogen. Some possible signs of this condition include:

  • Gynecomastia (enlargement of breast tissue, specifically in men)

  • Male infertility

  • Low libido

  • Hot flashes

Keep reading to learn more about anastrozole and ED.

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FYI: Not all erection issues have to do with hormones.

Anastrozole isn’t usually a first-line treatment for ED, but if your symptoms are the result of a hormone imbalance, it might help.

A small study from 2017 looked at 86 men with low T who received a 1-milligram daily dose of anastrozole. Roughly 95 percent of participants saw increases in testosterone production and decreases in estrogen levels.

The same study also found that daily treatment with anastrozole significantly increased sperm production.

Similarly, a 2004 study involving 37 older adult men with hypogonadism (or low testosterone) found that anastrozole helped restore hormone levels to the normal range typically seen in younger, healthy men.

Yep, most medications have potential side effects. But side effects aren’t a list of things that will definitely happen to you — they might occur in some people. 

Still, it’s good to be aware of the possible adverse effects so you can spot them and mention them to your healthcare provider ASAP. 

You don’t need to live with unpleasant side effects, no matter how mild. In many cases, a healthcare professional can recommend an alternative medication or even suggest adjusting your dose.

Here are some possible side effects of anastrozole:

  • Headaches

  • Hot flashes

  • Weakness

  • Sweating

  • Diarrhea or constipation

  • Heartburn

  • Stomach pain

  • Weight gain

  • Appetite changes

  • Mood changes

  • Nausea or vomiting

  • Joint or muscle pain

  • Breast pain

  • Problems with sleep

  • Nervousness

  • Burning, pain or tingling in the extremities

  • Hair thinning

  • Dry mouth

If you experience any of the following less common but more serious effects when taking anastrozole, see medical care right away:

  • Chest pain

  • Signs of infection, including swelling, redness and fever

  • Pain or difficulty when urinating

  • Yellowing of your skin or eyes (jaundice)

  • Vision changes, like blurred vision

  • Upper-right stomach pain

  • Rash or skin lesions

  • Itching

  • Trouble swallowing

  • Shortness of breath

Anastrozole can also affect bone mineral density issues (also known as bone loss). Since this can lead to osteoporosis, your healthcare provider might want to monitor you closely while you take the drug.

Choose your chew

Although it’s true anastrozole can influence male sex hormones, it’s pretty unlikely to lead to ED symptoms.

That said, if you develop erection issues while taking anastrozole, it’s possible the medication is causing your estrogen levels to dip too low — a sign you may no longer need the medication.

Anastrozole might help with erection problems, but it’s not the first-line treatment for erectile dysfunction.

Here are a few tried-and-true medications (plus, they’re FDA-approved!) for treating ED symptoms:

All these medications belong to a class of drugs known as PDE5 inhibitors. They help increase blood flow to the penis, making it easier to get and maintain an erection. 

Read more about PDE5 inhibitors and how they work for erectile dysfunction in our guide to PDE5 inhibitors.

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Erectile dysfunction can take a serious toll on your sex life and impact you emotionally. Thankfully, treatments are available.

Anastrozole isn’t a typical treatment for ED, but it might be prescribed in certain cases. Here’s what to remember:

  • High estrogen levels in men can impact the production of testosterone, influencing sex drive and function.

  • Anastrozole can help lower estrogen levels and treat low T. 

  • It’s pretty safe to use but does come with potential side effects.

  • Rarely, anastrozole can cause ED symptoms when estrogen levels dip too low.

The idea of talking to a healthcare professional about your sex life might make you squeamish, but know you’re not alone. ED is a common issue affecting millions of men in the U.S. alone.

Ready to get help? Connect virtually with a Hims healthcare provider to get discreet advice and effective treatment for ED today.

7 Sources

  1. De Ronde, W., & de Jong, F. H. (2011). Aromatase inhibitors in men: effects and therapeutic options. Reproductive biology and endocrinology : RB&E, 9, 93. Retrieved from
  2. Schulster, M., Bernie, A. M., & Ramasamy, R. (2016). The role of estradiol in male reproductive function. Asian journal of andrology, 18(3), 435–440. Retrieved from
  3. Anastrozole. (2018, January 15).
  4. Delgado, B., et al. (2023, June 26). Estrogen. Retrieved from
  5. Shoshany O, Abhyankar N, Mufarreh N, Daniel G, Niederberger C. Outcomes of anastrozole in oligozoospermic hypoandrogenic subfertile men. Fertil Steril. 2017 Mar;107(3):589-594. Retrieved from
  6. Leder B, et al. (2004). Effects of aromatase inhibition in elderly men with low or borderline-low serum testosterone levels. The Journal of Clinical Endocrinology & Metabolism. 89(3): 1174-1180. Retrieved from
  7. Definition & facts fo erectile dysfunction. (2017, July). Retrieved from
Editorial Standards

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. See a mistake? Let us know at [email protected]!

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.

Kelly Brown MD, MBA
Kelly Brown MD, MBA

Dr. Kelly Brown is a board certified Urologist and fellowship trained in Andrology. She is an accomplished men’s health expert with a robust background in healthcare innovation, clinical medicine, and academic research. Dr. Brown is a founding member of Posterity Health where she is Medical Director and leads strategy and design of their Digital Health Platform, an innovative education and telehealth model for delivering expert male fertility care.

She completed her undergraduate studies at University of North Carolina at Chapel Hill (go Heels!) with a Bachelor of Science in Radiologic Science and a Minor in Chemistry. She took a position at University of California Los Angeles as a radiologic technologist in the department of Interventional Cardiology, further solidifying her passion for medicine. She also pursued the unique opportunity to lead departmental design and operational development at the Ronald Reagan UCLA Medical Center, sparking her passion for the business of healthcare.

Dr. Brown then went on to obtain her doctorate in medicine from the prestigious Northwestern University - Feinberg School of Medicine and Masters in Business Administration from Northwestern University - Kellogg School of Management, with a concentration in Healthcare Management. During her surgical residency in Urology at University of California San Francisco, she utilized her research year to focus on innovations in telemedicine and then served as chief resident with significant contributions to clinical quality improvement. Dr. Brown then completed her Andrology Fellowship at Medical College of Wisconsin, furthering her expertise in male fertility, microsurgery, and sexual function.

Her dedication to caring for patients with compassion, understanding, as well as a unique ability to make guys instantly comfortable discussing anything from sex to sperm makes her a renowned clinician. In addition, her passion for innovation in healthcare combined with her business acumen makes her a formidable leader in the field of men’s health.

Dr. Brown is an avid adventurer; summiting Mount Kilimanjaro in Tanzania (twice!) and hiking the incredible Torres del Paine Trek in Patagonia, Chile. She deeply appreciates new challenges and diverse cultures on her travels. She lives in Denver with her husband, two children, and beloved Bernese Mountain Dog. You can find Dr. Brown on LinkedIn for more information.

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