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Enjoy sex like you used to
Life gets more complicated when you have medical issues. High blood pressure adds extra caution to your day, the medications you use to treat health conditions come with side effects, and side effects rarely seem to make sense without a medical degree. That brings us to gabapentin.
If you’re taking gabapentin for any number of reasons — seizures, neuropathic pain, etc. — you likely know what it does. But understandably, you could be confused about how a medication for your brain might affect your sexual health.
How, in other words, does an anticonvulsant cause erectile dysfunction (ED)? Does it at all?
These are important questions. We’ll answer them below and go over what gabapentin does, whether ED from gabapentin is permanent, and how to deal with it if it’s a side effect you experience.
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Gabapentin is marketed under the brand names Neurontin®, Gralise® and Horizant®. All three medications and the generic version effectively do the same things. These anticonvulsant medications are used to treat seizures in people with epilepsy, as well as for the treatment of restless leg syndrome (RLS) and postherpetic neuralgia (a form of nerve and skin pain that’s a complication of shingles).
Gabapentin is sometimes used in an off-label capacity, meaning healthcare providers prescribe it for things the FDA (U.S. Food and Drug Administration) hasn’t approved it for.
When used off-label, gabapentin can treat a large range of conditions and their symptoms according to the NIH (National Institutes of Health), including:
Fibromyalgia
Depression and other mood disorders
Irritable bowel syndrome (IBS)
Alcohol withdrawal
Migraines
Insomnia
Gabapentin works by acting on your neurotransmitters — chemicals that transmit messages among nerve cells — specifically serotonin, which encourages happiness and a sense of well-being.
Regardless of why gabapentin is prescribed, there’s potential for various side effects. A fair amount of research suggests that erectile dysfunction may be one of them — sometimes referred to as gabapentin-induced sexual dysfunction.
If you started experiencing ED after using gabapentin, you’re not alone. Several drugs used to treat epilepsy, including gabapentin, may cause sexual dysfunction in men.
Gabapentin could cause erectile dysfunction, sexual desire changes and ejaculatory dysfunction.
There’s evidence that gabapentin may affect a man’s ability to reach orgasm (either by causing premature ejaculation or delayed ejaculation), especially if he’s older.
That said, lots of research suggests that the conditions gabapentin can treat also cause ED, either by a reduction of adequate blood flow, effects on your nervous system or in the form of psychological ED. This makes for somewhat of a “chicken or egg” question for healthcare professionals.
A pre-existing medical condition (potentially the one gabapentin was prescribed to treat) could be the culprit of erectile dysfunction. However, if your ED starts after taking gabapentin, the medication is likely the cause.
The good news? Currently, no scientific evidence suggests that gabapentin causes permanent sexual dysfunction.
That said, in most cases of gabapentin-induced anorgasmia (delayed ejaculation or inability to orgasm), you’ll need to stop using the medication to return to normal sexual function.
If you experience erectile dysfunction after starting treatment with gabapentin, it’s crucial to talk to your healthcare provider.
You may be able to treat gabapentin-induced erectile dysfunction by adjusting your dosage, switching to a different epilepsy medication or using another type of medication to treat and manage your ED.
Keep scrolling for tips and recommendations.
Until the anticonvulsant medication leaves your system, you’re not going to escape the common side effects. Gabapentin has a half-life of around five to seven hours and takes two days on average to completely be eliminated from your body.
Once it’s out of your system, you might be feeling like your old self again. But here’s our disclaimer: Don’t stop taking gabapentin without a healthcare provider’s guidance.
While talking to a healthcare professional about these issues, you might want to ask about switching to another antiepileptic drug, as a different medication may not cause the same sexual side effects.
Other drugs for epilepsy — like oxcarbazepine, lamotrigine or levetiracetam — may actually improve sexual function in people with sex-related symptoms.
Medications referred to as PDE5 inhibitors increase blood flow to your penis. They include sildenafil (the active ingredient in Viagra®), tadalafil (Cialis®), vardenafil (Levitra®) and avanafil (Stendra®).
FYI: There are currently no known interactions between gabapentin and PDE5 inhibitors, but let your provider know if you’re taking them or have any other medical conditions just to be safe.
ED may not be caused solely by your medication but rather other health issues, such as:
Heart disease
Atherosclerosis (clogged arteries)
Hypertension (high blood pressure)
Physical injuries to the penis
Chronic kidney disease
Multiple sclerosis
Peyronie’s disease (curved, painful erections due to scar tissue)
Type 2 diabetes
Prescription medications for high blood pressure and antidepressants can cause ED as well.
Making certain lifestyle changes might help, like getting more physical activity, improving your diet and sleep habits, and avoiding drinking and drug use.
Speaking of — depression, sexual performance anxiety and stress can also cause ED and will require other treatment options than what we’ve listed here.
For a bigger picture of how well-being impacts sexual function, check out our guide to maintaining an erection.
The incidence of erectile dysfunction is higher than you’d think. And when you’re on a daily dose of medication for epilepsy or neuropathic pain, it doesn’t take a PubMed review to tell you your risk of side effects is heightened.
If your sex life is suffering and your erectile function isn’t what it used to be, consider the facts as you make a decision about what’s next:
Research suggests that several medications for seizures can cause or worsen erectile dysfunction, including gabapentin.
The link between gabapentin and erectile dysfunction may be due to gabapentin’s effects on neurotransmitters.
Gabapentin is also associated with other sexual side effects, like difficulty reaching orgasm, although the science on this link isn’t totally clear.
ED from gabapentin isn’t permanent. It’s possible to treat the issue by changing the way you use your medication — or by using a form of treatment for ED.
Worried about ED? You can find out more about managing erectile dysfunction in our guide to the most common ED treatments and drugs.
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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 was previously Medical Director of a male fertility startup where she lead 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.
Education & Training
Andrology Fellowship, Medical College of Wisconsin
Urology Residency, University of California San Francisco
M.D. Northwestern University Feinberg School of MedicineB.S. in Radiologic Science, Chemistry Minor, University of North Carolina at Chapel Hill
Published as Kelly Walker
Cowan, B, Walker, K., Rodgers, K., Agyemang, J. (2023). Hormonal Management Improves Semen Analysis Parameters in Men with Abnormal Concentration, Motility, and/or Morphology. Fertility and Sterility, Volume 118, Issue 5, e4. https://www.sciencedirect.com/journal/fertility-and-sterility/vol/120/issue/1/suppl/S
Walker, K., Gogoj, A., Honig, S., Sandlow, J. (2021). What’s New in Male Contraception? AUA Update Series, Volume 40. https://auau.auanet.org/content/update-series-2021-lesson-27-what%E2%80%99s-new-male-contraception
Walker, K., Shindel, A. (2019). AUA Erectile Dysfunction Guideline. AUA Update Series, Volume 38. https://auau.auanet.org/content/course-307
Walker, K., Ramstein, J., & Smith, J. (2019). Regret Regarding Fertility Preservation Decisions Among Male Cancer Patients. The Journal of Urology, 201(Supplement 4), e680-e681. https://www.auajournals.org/doi/10.1097/01.JU.0000556300.18991.8e
Walker, K., & Smith, J. (2019). Feasibility Study of Video Telehealth Clinic Visits in Urology. The Journal of Urology, 201(Supplement 4), e545-e545. https://www.auajournals.org/doi/10.1097/01.JU.0000556071.60611.37