Erectile dysfunction, or ED, is a common sexual health issue. In fact, it affects an estimated 30 million men in the United States.
If you suffer from ED, you might find it difficult to get or maintain an erection that’s firm enough to have sex. Alternatively, you might be able to get an erection occasionally, but it won't happen every time you want to have sex.
A variety of things can cause erectile dysfunction, including medical conditions and medications used to treat them.
One class of medications that can occasionally cause ED are beta blockers — medications that are used to treat hypertension, or high blood pressure.
If you’re prescribed a beta blocker, you may notice changes in your ability to get an erection, as well as other aspects of your sexual function.
Below, we’ve discussed what beta blockers are, as well as how they can sometimes contribute to erectile issues and other forms of sexual dysfunction.
We’ve also explained your options if you’re prescribed a beta blocker and think that it may have a negative impact on your erectile function and sexual performance.
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Beta-adrenergic receptor antagonists, or beta blockers, are medications that work by reducing the effects of certain chemicals, such as epinephrine and norepinephrine, on receptors found throughout your body.
More specifically, beta blockers prevent these substances from attaching to beta receptors — a class of receptors that are found in your heart and other organs.
Epinephrine and norepinephrine are adrenal hormones and neurotransmitters, or chemicals used within your nervous system to send messages. Norepinephrine, for example, is involved in stimulating your heart rate and increasing your blood pressure levels.
Your body needs these naturally-occurring chemicals in order to properly respond to stressful or dangerous situations. They’re part of your “fight-or-flight” response for dealing with danger when it occurs.
Norepinephrine is also involved in breaking down fat, regulating your sleep-wake cycle, allowing you to focus on specific tasks and regulating your emotions.
Although epinephrine and norepinephrine are critical for your health, having high levels of these hormones could cause your heart to work harder than it should. This can contribute to elevated blood pressure, panic attacks and hyperactivity.
By blocking the effects of epinephrine and norepinephrine on your heart, beta blockers can slow down your heart rate, reduce blood pressure and provide relief from some physical symptoms of anxiety.
Your healthcare provider may suggest taking a beta blocker if you have:
An overly fast heart rate (tachycardia)
High blood pressure (hypertension)
Had a previous heart attack (myocardial infarction)
High thyroid hormone levels (hyperthyroidism)
Coronary artery disease (CAD)
Congestive heart failure
Aortic dissection (AD)
Beta blockers are also occasionally used to treat and prevent migraines, which are moderate and severe headaches that occur frequently and cause discomfort.
Common beta blocker medications include:
Our guide to beta blockers discusses these medications in more detail, including how they work, popular uses, potential drug side effects, interactions and more.
Like all medications, beta blockers can cause side effects, including sexual performance issues such as erectile dysfunction.
If you’re prescribed a beta blocker as a blood pressure medication, you may notice that it’s more difficult for you to get an erection that’s firm enough for sexual intercourse than before you started using the medication.
Experts aren’t aware of precisely why or how beta blockers can cause erectile dysfunction, but research suggests it’s likely related to the effects of these medications on blood flow to the soft tissue inside the penis.
Erections depend on healthy, consistent blood flow. When you experience sexual desire, blood flows to the erectile tissue inside your penis, resulting in a penile erection.
This blood flow to your penis is what gets you hard and helps you stay that way during sex. A range of medical conditions and medications that reduce blood flow can make getting an erection harder and contribute to ED.
We’ve discussed how erections work, as well as how important blood flow is for healthy sexual function, in our guide to what erections are and how they work.
Because there are several different kinds of beta blockers, and ED can vary significantly in severity, there’s no one-size-fits-all relationship between beta blocker therapy and difficulties related to erections and sexual performance.
However, research into several beta blockers commonly prescribed as antihypertensive drugs does show they can lead to an increased risk of ED in men.
For example, as we’ve discussed in our guide to metoprolol and ED, research shows that men who use the beta blocker metoprolol to treat high blood pressure have higher rates of ED than men who use other treatments.
Other scientific research, including one 2017 study published in the journal Annals of Thoracic and Cardiovascular Surgery, has found a link between the use of the beta blockers metoprolol and nebivolol and erectile dysfunction in men with ischemic cardiac disease.
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If you’re prescribed a beta blocker or other blood pressure drug and think that it’s more difficult for you to get and stay hard during sex, it’s important to keep in mind that your medication may not be the only factor involved in your erectile dysfunction.
Beta blockers are commonly prescribed to treat high blood pressure and heart health problems, including after cardiovascular events such as a heart attack.
Because blood flow is essential for healthy erections, many conditions that affect your heart can also cause or contribute to erectile dysfunction.
For example, common physical causes of erectile dysfunction include atherosclerosis (clogged arteries), heart and blood vessel disease, elevated blood pressure, type 2 diabetes and chronic kidney disease.
Many of these conditions can directly affect your heart function and blood flow, which as we’ve discussed, can lead to ED.
In addition to cardiovascular health issues, a range of other factors can affect your ability to get and maintain an erection sufficient for sex. These include:
Injuries to your penis, spinal cord, bladder, prostate and/or pelvis
Complications from prostate surgery, bladder surgery or radiation therapy
Mental health issues, such as depression, stress or sexual performance anxiety
Feelings of guilt or worry about having sex
Smoking, drinking alcohol or using illicit drugs
Being overweight and/or physically inactive
Other medications, including antidepressants, antiandrogens, sleeping pills, ulcer medications and appetite suppressants, may also cause or contribute to drug-related erectile dysfunction.
Our guide to the causes of erectile dysfunction goes into more detail about the factors that can contribute to ED, from physical health conditions to unhealthy habits, psychological issues and more.
Whether it develops as a side effect of therapy with beta blockers, as the result of performance anxiety or due to a physical health issue, erectile dysfunction is almost always treatable.
If you take a beta blocker and feel like you’re less able to get and/or maintain an erection than before starting treatment, it’s important to let your healthcare provider know.
They may adjust the dosage of your beta blocker medication, switch you to a different type of cardiovascular medication or suggest other changes that you can make to reduce the risk of ED and other unwanted, negative effects.
It’s important not to abruptly stop taking your beta blocker without talking with your healthcare provider first. Stopping treatment suddenly can reverse the beneficial effects of treatment with beta blockers and may cause your blood pressure, heart health or anxiety to worsen.
In some cases, your healthcare provider may recommend taking medication to increase blood flow to your penis and improve your erections.
Popular medications for treating ED include sildenafil (the active ingredient in Viagra®), tadalafil (Cialis®), vardenafil (Levitra®) and avanafil (Stendra®), which are part of a class of drugs called PDE5 inhibitors.
ED medications are safe and effective for most men. However, they can cause interactions with certain medications, including nitrates and other types of medication for heart disease and high blood pressure.
As such, it’s important to talk to your healthcare provider about all medications you currently use or have recently used before considering any type of prescription medication for ED.
Your healthcare provider will tell you how to use this type of medication safely to treat erectile dysfunction and improve your sexual performance.
Beyond taking medication, making changes to your habits and daily life can often improve your ability to get an erection.
Because erections are all about healthy blood flow, many habits that are good for your erections can also offer benefits for your heart health and blood pressure.
Good habits for treating erectile dysfunction include limiting your alcohol consumption, giving up smoking, avoiding illicit drugs, keeping yourself physically active and maintaining a healthy body weight.
When ED is caused by a psychological issue, such as stress or anxiety, taking part in therapy is also often helpful.
Our full guide to maintaining an erection naturally covers more about how you can change your habits for better blood flow, erections and sexual function. You can also learn more about how ED is treated in our full guide to the most common forms of treatment for erectile dysfunction.
Beta blockers are common medications that are usually prescribed to treat high blood pressure, heart disease and certain physical symptoms of anxiety.
Although beta blockers offer plenty of benefits as cardiovascular medications, the effects of beta blockers may also increase your risk of erectile dysfunction.
If you’re prescribed a beta blocker and feel like your sexual performance has suffered since you started taking it, be sure to let your healthcare provider know. They may suggest adjusting your dosage, switching to a different beta blocker or taking a second medication to treat ED.
With the right treatment approach, many men who are prescribed beta blockers are able to experience a significant improvement in erectile function.
Interested in getting started? You can view our range of ED medications online and take part in an erectile dysfunction consultation to discuss your treatment options with a licensed healthcare provider.
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Dr. Vicky Davis is a board-certified Family Nurse Practitioner with over 20 years of experience in clinical practice, leadership and education.
Dr. Davis' expertise include direct patient care and many years working in clinical research to bring evidence-based care to patients and their families.
She is also an active member of the American Academy of Nurse Practitioners.