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Sexual Side Effects of Strattera®: Does it Cause ED?

Vicky Davis

Reviewed by Vicky Davis, FNP

Written by Nicholas Gibson

Published 03/13/2023

Attention-deficit/hyperactivity disorder, or ADHD, is a common neurodevelopmental disorder that affects an estimated 4.4 percent of all US adults.

If you have ADHD, your healthcare provider may recommend that you use medication to help you gain control of your symptoms and improve your quality of life. One common medication for ADHD is Strattera®, which contains the active ingredient atomoxetine. 

Strattera is a safe and effective medication for most people with ADHD. However, like many other prescription medications, it can have side effects. For some people, these may include sexual side effects such as changes in your sex drive, ejaculation issues and erectile dysfunction (ED).

The good news is that it’s usually possible to treat these side effects while keeping your ADHD under control, either by adjusting your dosage or making other adjustments to the way you use your medication. 

Below, we’ve explained what Strattera is, as well as how it works as a treatment option for managing the symptoms of ADHD.

We’ve also looked into the link between Strattera and sexual dysfunction, including issues such as erectile dysfunction.

Finally, we’ve covered what you can do if you’re prescribed Strattera and think that it may have a negative effect on your ability to have sexual intercourse.

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What is Strattera?

Strattera is a prescription medication for ADHD. It belongs to a class of medications referred to as selective norepinephrine reuptake inhibitors and works by increasing levels of the hormone norepinephrine, a naturally-occurring chemical that’s found in your brain.

As a neurotransmitter — a messenger chemical in your brain — norepinephrine plays a significant role in regulating your behavior. By increasing your levels of norepinephrine, Strattera can reduce the severity of your ADHD symptoms and improve your ability to function throughout the day.

If you have ADHD, your healthcare provider may prescribe Strattera on its own or for use with other ADHD medications.

Other widely-used medications for ADHD include:

  • Ritalin®, which contains the active ingredient methylphenidate

  • Concerta®, which contains an extended-release form of methylphenidate

  • Adderall XR®, which contains the active ingredient amphetamine

  • Vyvanse®, which contains the active ingredient lisdexamfetamine dimesylate

Many of these are stimulant medications, which work by increasing activity in your central nervous system. But Strattera is different — it’s a nonstimulant medication that works by increasing neurotransmitter levels in certain parts of your brain.

Your healthcare provider may prescribe Strattera if you prefer to use a nonstimulant medication to treat adult ADHD, or if you previously experienced persistent or intolerable side effects while taking a stimulant to treat your symptoms.

Both Strattera and its generic version atomoxetine come in capsule form and can be prescribed in several doses, including 10mg, 18mg, 25mg, 40mg, 60mg, 80mg and 100mg. 

Strattera is also different from other ADHD medications in that it doesn’t always start working right away. If you’re prescribed this medication, you may need to take a daily dose consistently for several weeks before you notice any improvements in your ADHD symptoms.

Like many other medications for mental health and behavioral disorders, Strattera is also used off-label for certain psychiatric disorders. 

For example, it’s occasionally prescribed off-label to treat depressive symptoms in people who don’t respond fully to conventional antidepressant medications. It’s also being examined as a potential treatment for eating disorders and certain forms of cognitive dysfunction.

Side Effects of Strattera

Like other medications for ADHD, Strattera can cause adverse effects. Most of the side effects from Strattera are mild and manageable, although some side effects caused by this medication may be more severe and persistent.

Common side effects of atomoxetine and Strattera include:

  • Vomiting

  • Heartburn

  • Upset stomach

  • Loss of appetite

  • Weight loss

  • Stomach pain

  • Constipation

  • Dry mouth

  • Dizziness

  • Tiredness

  • Headaches

  • Mood swings

  • Muscle pain

  • Difficulty urinating

  • A burning and/or sensation in the hands, arms or legs

  • Unusual dreams

  • Hot flashes

  • Sweating

  • Gas

It’s important to inform healthcare your provider if you experience any severe or persistent side effects after starting treatment with Strattera. 

Strattera and generic atomoxetine may also cause more serious side effects. You should seek medical attention as soon as you can if you notice any of the following adverse reactions or signs of an allergic reaction after taking Strattera:

  • A fast heart rate or pounding heartbeat

  • Slowed speech and/or difficulty speaking normally

  • Swelling in your face, throat, tongue, lips or limbs

  • Severe feelings of dizziness, faintness or weakness

  • Chest pain, shortness of breath or numbness

  • Pain in the upper right part of your stomach

  • Difficulty breathing and/or swallowing

  • Abnormal thoughts and/or hallucinations

  • Yellowing of your skin and/or eyes

  • Hives, rash and/or itchy skin

  • Flu-like symptoms

  • Hoarse voice

  • Dark colored urine

  • Seizures

Strattera can also have negative effects on blood pressure levels. Your healthcare provider will monitor your blood pressure and cardiovascular health while you’re using Strattera to minimize your risk of bad side effects and health issues.

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Can Strattera Cause Sexual Side Effects?

Sexual side effects can occur with almost all prescription medications for ADHD, and Strattera is no exception. 

Sexual side effects of Strattera and generic atomoxetine include:

  • Changes in your sex drive and/or sexual performance

  • Weak erections, or difficulty getting an erection

  • Ejaculation disorders, such as difficulty ejaculating

  • Painful, prolonged erections called priapism

In women, Strattera may also cause side effects related to the menstrual cycle, including painful and/or irregular periods.

Research from clinical trials suggests that sexual dysfunction occurs in around two percent of all adults who take Strattera to treat ADHD. 

After beginning treatment with Strattera, you may notice that sexual side effects develop over the course of several weeks. You may feel less interested in sex, or notice that it’s harder to get or stay hard while you’re using this medication.

If you develop a painful or long-lasting erection after starting Strattera (for example, an erection that lasts for several hours), it’s important to seek medical attention as soon as you can.

This side effect is called priapism, and it can cause permanent damage to the tissue inside your penis if it’s left untreated. Call your healthcare provider or visit your local emergency department if you develop an erection that feels painful and/or doesn’t go away on its own.

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How to Treat Sexual Side Effects From Strattera

If you’re prescribed Strattera and start to experience sexual side effects, it’s important to let your healthcare provider know. 

In some cases, your healthcare provider may adjust your dosage of Strattera to reduce your risk of experiencing side effects. For example, if you’re prescribed a moderate or high dose of Strattera and experience side effects, your healthcare provider may reduce it slightly to see if your side effects improve. 

It’s important not to lower your Strattera dosage or stop taking this medication without talking to your healthcare provider beforehand, as this may cause your ADHD symptoms to come back or become more severe.

If these dose adjustments don’t work, your healthcare provider may suggest trying a different type of medication for ADHD. 

In some cases, they may also suggest using medication to improve your sexual function, such as erectile dysfunction medication.

Currently, several medications are used to treat ED, including sildenafil (the active ingredient in Viagra®), tadalafil (Cialis®) and avanafil (Stendra®).

These medications, which belong to a class of drugs called PDE5 inhibitors, work by improving blood flow into your erectile tissue. This can make it easier to get hard when you feel sexually aroused and maintain your erection during sex.

You can access medication for ED by talking to your healthcare provider about your symptoms, including related sexual function issues. Make sure to inform your healthcare provider that you take Strattera, as well as tell them about any other medications you currently use or have recently used.

We also offer several medications for erectile dysfunction online, following a consultation with a healthcare provider who will determine if a prescription is appropriate. 

In addition to adjusting your dosage of Strattera or taking medication to treat ED, you can often also improve your erectile function and sexual performance by making certain changes to your habits and lifestyle.

These include keeping yourself physically active, eating a balanced diet, reducing your alcohol consumption and, if you currently smoke, making an effort to quit.

If a mental health disorder, such as major depression, sexual performance anxiety or stress, is contributing to your sexual issues, taking part in behavioral therapy can also be an effective treatment.

We offer online therapy as part of our range of mental health services, allowing you to connect with a provider for one-on-one sessions from the privacy and comfort of your home. 

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The Bottom Line on Strattera and Sexual Side Effects

Sexual side effects can occur with several common medications for ADHD, including Strattera and generic atomoxetine. 

While using Strattera, you may notice changes in your level of interest in sex, your ability to get and/or maintain an erection and your ability to reach orgasm and ejaculate, as well as your general sexual function. 

If you have severe or persistent sexual side effects after starting Strattera, make sure to let your healthcare provider know. 

These side effects are treatable, and often, making small changes to the way you take Strattera or using an additional medication for ED can prevent them from affecting your sex life.

Interested in learning more about treatment options for ED? Our guide to erectile dysfunction goes into more detail about this common sexual health issue, from causes and risk factors to the most effective options for improving your erections and sexual performance.

8 Sources

  1. Attention-Deficit/Hyperactivity Disorder (ADHD). (n.d.). Retrieved from https://www.nimh.nih.gov/health/statistics/attention-deficit-hyperactivity-disorder-adhd
  2. Atomoxetine. (2022, May 15). Retrieved from https://medlineplus.gov/druginfo/meds/a603013.html
  3. Fedder, D., Patel, H. & Saadabadi, A. (2022, May 2). Atomoxetine. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK493234/
  4. Dadashova, R. & Silverstone, P.H. (2012). Off-label use of atomoxetine in adults: is it safe? Mental Illness Journal. 4 (2), e19. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4253379/
  5. Christmas, A.L., Fermo, J.D. & Markowitz, J.S. (2004, August). Atomoxetine, a novel treatment for attention-deficit-hyperactivity disorder. Pharmacotherapy. 24 (8), 1020-1036. Retrieved from https://pubmed.ncbi.nlm.nih.gov/15338851/
  6. Silberman, M., Stormont, G., Leslie, S.W. & Hu, E.W. (2022, December 5). Priapism. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK459178/
  7. Dhaliwal, A. & Gupta, M. (2022, May 20). PDE5 Inhibitors. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK549843/
  8. Treatment for Erectile Dysfunction. (2017, July). Retrieved from https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/treatment
Editorial Standards

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.

Vicky Davis, FNP

Dr. Vicky Davis is a board-certified Family Nurse Practitioner with over 20 years of experience in clinical practice, leadership and education. 

Dr. Davis' expertise include direct patient care and many years working in clinical research to bring evidence-based care to patients and their families. 

She is a Florida native who obtained her master’s degree from the University of Florida and completed her Doctor of Nursing Practice in 2020 from Chamberlain College of Nursing

She is also an active member of the American Academy of Nurse Practitioners.

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