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Metoprolol and Erectile Dysfunction: What Is the Connection?

Katelyn Brenner FNP

Reviewed by Katelyn Hagerty, FNP

Written by Geoffrey C. Whittaker

Published 02/25/2021

Updated 09/28/2023

As we age, health problems tend to get worse. You may have been in great health in your 20s and 30s (or maybe not), but at some point, prescription medications will likely enter your body’s group chat — and they’re only going to keep adding friends.

Maybe you were recently diagnosed with high blood pressure, experienced angina (chest pain) or even had a heart attack. For whatever reason, your healthcare provider prescribed you metoprolol, and now you’re looking for answers to critical questions, like whether your penis will still work if you take this stuff.

Erectile dysfunction (ED) and your heart are well connected — and it doesn’t take a cardiology expert to explain that erectile function requires healthy blood flow. 

Below, we’ll explain the metoprolol-penile connection, why ED may happen and what to do if it does.

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What Is Metoprolol for?

First, let us quickly cover some background info.

Metoprolol is a beta-blocker that relaxes blood vessels and slows down your heart rate to reduce blood pressure. The result is better, healthier blood flow — and generally, metoprolol is safe and effective at doing this.

Metoprolol is sold under several brand names like Lopressor®.

This cardioselective beta-blocker works by latching onto beta-1 receptors in your heart cells to block adrenaline — a hormone that typically causes your heart to beat faster and harder.

Beta-blockers like metoprolol also relax your blood vessels to reduce blood pressure. Similar to nebivolol and other beta-blockers, metoprolol is used to treat high blood pressure (aka hypertension) and angina, chest pain that occurs when your heart isn’t getting enough oxygen-rich blood.

Metoprolol is also prescribed after a myocardial infarction (heart attack) because it’s been shown to improve survival and reduce the risk of further complications.

Does Metoprolol Cause ED (Erectile Dysfunction)?

Unfortunately, there’s an established connection between beta-blockers and erectile dysfunction.

Since beta-blockers like metoprolol affect your blood pressure, they may cause related side effects. This includes things like lightheadedness and, sometimes, erectile dysfunction.

One clinical trial concluded that the use of beta-blockers like metoprolol increases the risk of ED in men with ischemic heart disease.

While a link between metoprolol and ED would seem pretty straightforward, there’s some reason to think it may be more in your head than your blood.

Research on men with arterial hypertension found that their reactions differed based on whether or not they were told ED could be a side effect. Nearly a third of participants who were told this experienced ED, while only eight percent of those who weren’t reported erectile dysfunction problems.

A similar study of another beta-blocker called atenolol produced a similar outcome.

It’s fairly common for ED to have both physiological and psychological triggers. But because of the blood pressure overlap, there’s definitely reason to believe it’s not all in your head if you’ve seen signs.

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What to Do If You Experience ED After Taking Metoprolol

According to the NIH (National Institutes of Health), some 30 million men in the United States are affected by ED — which may or may not be because of the medications they take. 

ED can vary in cause and in severity. So whether you’re prescribed metoprolol or not, if you’re struggling to get or maintain an erection, your best bet is to talk to your healthcare provider.

They’ll likely suggest one of the following treatments to deal with sexual dysfunction, whether you’re one of the hypertensive men in question or not.

Switch Medications

Switching from metoprolol to a different medication may help with ED. But talk to your healthcare provider first — don’t just dump the pills. That’ll help you to avoid serious complications that can come with suddenly abandoning a necessary medication.

Some issues that could develop or worsen if metoprolol is suddenly stopped are angina, myocardial infarction, increased heart rate and hypertension, among others.

Treat Your ED With Medication

ED is usually treatable with certain prescription medications. These improve blood flow to your penis and make erections easier.

Currently, several FDA-approved medications called phosphodiesterase-5 enzyme inhibitors (or PDE5 inhibitors) are available specifically to treat ED and restore erectile function:

Some of the most common PDE5 inhibitors include:

  • Sildenafil. Sildenafil is both the generic version and active ingredient in Viagra®, sildenafil. It works quickly and provides relief from ED for roughly four hours per dose.

  • Tadalafil. Tadalafil is the generic version and active ingredient in Cialis. A dose of this long-lasting medication can provide relief from ED for up to 36 hours.

  • Vardenafil. Vardenafil is the generic version of Levitra®. It treats ED for slightly longer per dose than sildenafil.

  • Avanafil. Sold under the brand name Stendra, avanafil is a newer ED medication that starts working rapidly and is less likely to cause certain side effects than other PDE5 inhibitors

We offer several ED meds online, following a virtual consultation with a healthcare provider who’ll determine if a prescription is appropriate. You can even get chewable ED hard mints that contain the same active ingredients as FDA-approved medications.

Just be careful mixing these with beta-blockers and medications like nitrates or certain nitric oxide supplements, as it could cause a dangerous drug interaction. We’ve discussed these safety issues in more detail in our guide to ED treatments for men with heart disease.

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Make Lifestyle Changes for Better Sexual Health

Medication is often the first line of defense, but making changes to your habits and lifestyle can help improve erectile health too.

Try to:

  • Deal with mental blocks. Anxiety and low self-esteem can be part of the problem, as can depression. If you’re struggling, talk to someone with online therapy.

  • Exercise frequently. Regular exercise can improve blood flow, which will help your penis too. Just make sure to discuss exercise with a healthcare professional if you’re taking metoprolol.

  • Maintain a healthy weight. While research shows that being obese or overweight increases erectile dysfunction risk, it also shows that losing weight can reverse it. Try to stay at a healthy weight based on your height — or a healthy BMI (body mass index) between 18.5 and 24.9.

  • Eat a balanced diet. What you eat matters, so consume nutrient-rich foods like fruits, whole grains, fish, vegetables and lean protein.

  • Quit smoking. Smoking damages blood vessels, making blood flow to your penis less efficient. So put out the cigarette if you want to put out.

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The Bottom Line on Metoprolol and ED

Your health is crazy important. And while your sex life is undoubtedly also important, your heart has to keep pumping more than, well…you do. 

We know some of the side effects of medication can be difficult to deal with. And antihypertensive drugs like alpha-blockers and beta-blockers can certainly make healthy sexual function hard.

If you’re seeing problems, remember this:

  • When used as prescribed, medications like metoprolol can improve your general health and quality of life if you have a cardiovascular health issue. 

  • Beta-blockers can cause erectile dysfunction, but ED could also be due to a psychological effect.

  • If you’re taking metoprolol and struggling to get or maintain an erection, talk to a healthcare provider.

  • Your provider can prescribe medications and offer personalized medical advice, which can help you avoid cross-over conflicts between drugs for ED and heart health.

Want to learn more about erectile health? We can help.

Check out our guides to erectile dysfunction treatments and medications that cause ED to understand the delicate balance your prescriptions may be striking and the risk factors for ED that can come with medications.

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  5. HIGHLIGHTS OF PRESCRIBING INFORMATION: VIAGRA® (sildenafil citrate) tablets, for oral use . (n.d.-h).
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  8. Silvestri, A., Galetta, P., Cerquetani, E., Marazzi, G., Patrizi, R., Fini, M., & Rosano, G. M. (2003). Report of erectile dysfunction after therapy with beta-blockers is related to patient knowledge of side effects and is reversed by placebo. European Heart Journal, 24(21), 1928-1932.
  9. Sharp RP, Gales BJ. (2017). Nebivolol versus other beta blockers in patients with hypertension and erectile dysfunction. Ther Adv Urol.
  10. Gür, Ö., Gurkan, S., Yumun, G., & Turker, P. (2017). The Comparison of the Effects of Nebivolol and Metoprolol on Erectile Dysfunction in the Cases with Coronary Artery Bypass Surgery. Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia, 23(2), 91–95.
  11. Goldberger JJ, et al. (2015) Journal of the American College of Cardiology. Vol. 66 No. 13.
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