Metoprolol and Erectile Dysfunction: What's the Connection?

Metoprolol is a common beta-blocker used to treat high blood pressure. It’s sometimes linked with one particularly unwanted side effect: erectile dysfunction (ED). 

Sold under several brand names, like Lopressor ^®, metoprolol is a beta-blocker that works by slowing the heart rate and reducing the force of contraction, which lowers the heart’s workload and reduces blood pressure. It may also relax blood vessels . 

The result is better, healthier blood flow, and generally, metoprolol is safe and effective. In some men, the medication can also reduce the reliability of erections through the same method of action it uses to protect you from cardiovascular disease and heart failure.

Should you be concerned? Does metoprolol cause ED? Here’s what to know about the connection and what to do if it’s affecting you.

If you were recently diagnosed with high blood pressure, experienced angina (chest pain), or even had a heart attack, you might be prescribed metoprolol.

Metoprolol is a cardioselective beta-blocker that works by latching onto beta-1 receptors in your heart’s cells to block adrenaline, a hormone that typically causes your heart to beat faster and harder.

Beta-blockers like metoprolol also relax blood vessels to reduce blood pressure. Like nebivolol and others, metoprolol is used to treat high blood pressure (aka hypertension) and angina.

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.

But what about metoprolol and erectile dysfunction? Is it a thing? Maybe. Keep scrolling to learn why metoprolol can cause ED.

Unfortunately, there’s a connection between beta-blockers and erectile dysfunction. But it’s important to keep in mind that for men taking these medications, ED usually has more than one cause and it most likely is not a direct result of taking a beta-blocker. Because these medications are prescribed for heart and blood vessel problems, the underlying cardiovascular disease itself — along with factors like diabetes, age, and other health issues — can all contribute to ED. 

But it’s true that since beta-blockers like metoprolol affect blood pressure, they may cause related side effects that come with lower blood pressure. This includes symptoms like lightheadedness and, sometimes, impotence.

One clinical trial concluded that the use of beta-blockers like metoprolol increases the risk of ED in men with ischemic heart disease (a weakened heart from reduced blood flow to the organ).

How Common Is ED With Metoprolol?

Erectile dysfunction is a known side effect of beta-blockers like metoprolol, but the exact prevalence varies. One systematic review of available research looked at more than 35,000 people, and found that about 21.6% of those taking beta blockers reported sexual side effects, compared to 17.5% of people who took a placebo. However, this research looked at beta blockers as a whole and didn’t focus on metoprolol specifically.

Other studies have found that the incidence of developing ED is higher among men using metoprolol compared to other beta-blockers, like nebivolol, which appear to have fewer adverse effects on erectile function. 

However, the risk may be even higher in men with existing cardiovascular conditions like hypertension or ischemic heart disease, the very conditions metoprolol is prescribed to treat.

Not all beta-blockers affect sexual function equally. If you're concerned about ED while on metoprolol, talk to your healthcare provider about alternative medications or treatment options.

While a link between metoprolol and ED would seem pretty straightforward, there’s potential for the side effect to start “in your head” first. 

Some men may experience ED simply because they expect to. Studies have shown that patients told ED is a possible side effect of beta-blockers like atenolol or nebivolol were more likely to report it. This is a phenomenon called the nocebo effect.

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’re experiencing symptoms.

According to the NIH (National Institutes of Health), some 30 to 50 million men in the United States are affected by ED, which may or may not be a result 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 or approaches to deal with sexual dysfunction.

Switch Medications

Switching from metoprolol to other blood pressure medications may help with ED. 

But talk to your cardiology expert or 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 for hypertensive patients 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 prescription medications. These drugs improve blood flow to the penis and make sexual intercourse easier. Some of them even started out as blood pressure drugs.

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 ^® . The ED drug works quickly and provides relief from ED for roughly four hours per dose. Is it safe to take Viagra with metoprolol? Taking metoprolol and Viagra together might cause a drug interaction, so consult your healthcare provider.

• 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. Taking Cialis and metoprolol together might be a minor drug interaction risk, so check with your provider.

• 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.

Can You Take Viagra With Metoprolol?

Taking Viagra with metoprolol can lower your blood pressure more than usual, meaning it could create a drug interaction that makes your blood pressure drop. Check with your provider to see if this combination is safe, or if there are other ED treatments that might work better for you.what other ED meds might be safe.

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 similar ingredients to FDA-approved medications.

Is Metoprolol a Nitrate?

No, but like nitrates, it’s used to treat high blood pressure.

Be careful mixing erectile dysfunction drugs 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.

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 you trust or seek professional help.

• Exercise regularly. Regular exercise can improve blood flow, which will help your cardiovascular and sexual health. Just make sure to discuss exercise with a healthcare professional if you’re taking metoprolol.

• Maintain a healthy weight. Research shows that having overweight or obesity increases erectile dysfunction risk, and that achieving a healthier 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. (Check out our BMI calculator).

• 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.

While not all cases of ED from metoprolol can be prevented, there are steps you can take to reduce your risk. 

Maintaining a healthy lifestyle, such as prioritizing the habits we listed above, can help improve blood flow and support erectile function.

In some cases, switching to a different beta-blocker with fewer sexual side effects may be an option. 

Always talk to your healthcare provider before making changes to your medication. Open communication about side effects can help you find a treatment plan that supports both your heart health and your sex life.

We know some of the side effects of medications can be difficult to deal with. It’s tough when you benefit from medication but it comes at the cost of something else.

Antihypertensive drugs like alpha-blockers and beta-blockers can certainly make healthy sexual function hard. And metoprolol side effects may include erectile dysfunction.

Here’s what to keep in mind: 

• Metoprolol can contributeto ED. While the exact mechanisms are not fully established and ED is often multifactorial, it might be due to the beta-blocker’s effects on blood pressure and circulation.

• Psychological expectations may also play a role in sexual side effects.

• Talk to your healthcare provider about switching medications or treating ED with approved drugs. It’s dangerous to stop or change your blood pressure medicine without talking to your healthcare provider

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.