Gabapentin and Erectile Dysfunction: What's the Link?

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.

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

• Anxiety

• 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.

Wait It Out

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.

Look Into Alternatives to Gabapentin

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.

Talk to Your Healthcare Provider About ED Medication

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.

Take Steps to Improve Your General Health

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.