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Metoprolol and Erectile Dysfunction: What's the Connection?

Kelly Brown MD, MBA

Reviewed by Kelly Brown MD, MBA

Written by Geoffrey C. Whittaker

Published 02/25/2021

Updated 05/22/2024

As health problems crop up or worsen with age, pharmacology introduces new names to your day-to-day life. One name you may have heard is metoprolol — and its possible link to erectile dysfunction (ED).

Sold under several brand names like Lopressor®, 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.

It can also reduce the reliability of erections — through the same method of action it uses to protect you from cardiovascular disease and heart failure.

The metoprolol-penile connection is very real. So, should you be worried? Should you not take metoprolol to make sure you can perform? Does metoprolol cause ED? We’ll answer these questions below.

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

Metoprolol is a cardioselective beta-blocker that 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 blood vessels to reduce blood pressure. Like nebivolol and other beta-blockers, metoprolol is used to treat high blood pressure (aka hypertension) and angina (chest pain 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.

Is metoprolol erectile dysfunction a thing? Maybe. Keep scrolling to learn why metoprolol can cause ED.

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

Since beta-blockers like metoprolol affect 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 (a weakened heart from reduced blood flow to the organ).

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 to nebivolol 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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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 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 could cause a moderate drug interaction that makes your blood pressure drop, so check with your provider to see 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 the same active ingredients as 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.

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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 you trust or seek professional health.

  • 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.  Research shows that having overweight or obesity increases erectile dysfunction risk — and 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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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. So does metoprolol cause ED? Antihypertensive drugs like alpha-blockers and beta-blockers can certainly make healthy sexual function hard. And metoprolol side effects may include erectile dysfunction.

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 or unhealthy lifestyle habits.

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

  • Your provider can prescribe medications and offer personalized medical advice to 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.

12 Sources

  1. Centers for Disease Control and Prevention (CDC). (2022). Assessing your weight. https://www.cdc.gov/healthyweight/assessing/index.html
  2. Dhaliwal A, et al. (2023). PDE5 Inhibitors. https://www.ncbi.nlm.nih.gov/books/NBK549843/
  3. Goldberger JJ, et al. (2015). Effect of Beta-Blocker Dose on Survival After Acute Myocardial Infarction. https://www.jacc.org/doi/full/10.1016/j.jacc.2015.07.047
  4. Gür Ö, et al. (2017). The Comparison of the Effects of Nebivolol and Metoprolol on Erectile Dysfunction in the Cases with Coronary Artery Bypass Surgery. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5422634/
  5. Harte CB, et al. (2008). Acute effects of nicotine on physiological and subjective sexual arousal in nonsmoking men: a randomized, double-blind, placebo-controlled trial. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2864030/
  6. METOPROLOL SUCCINATE extended-release capsules, for oral use. (n.d.). https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/210428s000lbl.pdf.
  7. Moon KH, et al. (2019). Obesity and Erectile Dysfunction: From Bench to Clinical Implication. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6479091/
  8. Morris J et al. (2023). Metoprolol. https://www.ncbi.nlm.nih.gov/books/NBK532923/
  9. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). (2017). Definition & Facts for erectile dysfunction. https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/definition-facts
  10. Sharp RP, et al. (2017). Nebivolol versus other beta blockers in patients with hypertension and erectile dysfunction. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5298412/
  11. Silvestri A, et al. (2003). Report of erectile dysfunction after therapy with beta-blockers is related to patient knowledge of side effects and is reversed by placebo. https://academic.oup.com/eurheartj/article/24/21/1928/450074
  12. VIAGRA® (sildenafil citrate) tablets, for oral use . (n.d.). https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/20895s039s042lbl.pdf.
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Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Kelly Brown MD, MBA
Kelly Brown MD, MBA

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.

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