Viagra® on Steroids: Is It a Dangerous Combination?

Is using Viagra® on steroids dangerous? Here’s everything you need to know.

Erectile dysfunction, or ED, is a common sexual health issue affecting an estimated 30 million men in the United States.

If you’re one of these men, you might have considered using a medication such as sildenafil, the active ingredient in Viagra, to improve your erections.

Viagra and similar medications for ED are generally safe and effective, though they can cause side effects and interact with certain drugs. They may also present safety risks when used with other medications, including steroids.

If you’re prescribed steroids for low testosterone or inflammation or use steroids illicitly for performance enhancement, it’s important to be aware of these risks before you use medications such as Viagra.

Below, we’ll explain what Viagra is, as well as how it and similar medications work to reduce your risk of experiencing erectile dysfunction.

We’ll also discuss how both anabolic-androgenic steroids (AAS) and corticosteroids used to treat inflammation can potentially cause health issues, some of which may be of note if you use medications like Viagra to treat ED.

Finally, we’ll explain what you can do to improve your sexual health if you take steroids and think you’ve developed erectile dysfunction.

Viagra is a medication for erectile dysfunction. It contains the active ingredient sildenafil, which belongs to a class of medications called PDE5 inhibitors.

PDE5 inhibitors work by improving blood flow to the tissue in your penis. When you experience sexual stimulation, this flow of blood causes the erectile tissue to expand and harden, resulting in increased penile blood flow, improved erections and better sexual performance.

Viagra is available as a brand-name medication and as generic sildenafil. Other medications for treating ED include tadalafil (the active ingredient in Cialis®), vardenafil (Levitra®) and avanafil (Stendra®).

The sildenafil in Viagra takes 30 to 60 minutes to start working, meaning this medication is used shortly before sex.

The term steroids is largely used to refer to anabolic steroids, or anabolic-androgenic steroids — medications derived from the male hormone testosterone. These drugs are generally used to treat low testosterone levels in men, or “low-T.”

Many steroids are also used by athletes, often illicitly, as performance-enhancing substances for building muscle mass, increasing strength and boosting endurance.

Your healthcare provider may prescribe an anabolic-androgenic steroid — usually a form of testosterone — if you have clinically low testosterone levels. They may also prescribe it to promote muscle growth if you have a form of muscle wasting that makes normal weight gain difficult.

Anabolic steroids come in several forms, including injectable medications, oral medications, skin patches and subdermal pellets.

Although the word steroids is generally associated with anabolic drugs, it’s also used to refer to corticosteroids — medications that reduce inflammation and some types of activity in your immune system.

Your healthcare provider might prescribe a corticosteroid, such as cortisone, hydrocortisone or prednisone, if you have one of the following conditions:

• Asthma

• Arthritis

• A skin condition, such as rashes or eczema

• An autoimmune disease, such as lupus or multiple sclerosis (MS)

• Certain forms of cancer

If you’re prescribed either type of steroid, it’s crucial to listen to your healthcare provider’s advice and take your medication exactly as prescribed.

What about taking Viagra on steroids? Can prednisone cause erectile dysfunction?

Both anabolic steroids and corticosteroids can cause adverse effects, ranging from sexual side effects to more general side effects that may be harmful to your overall health.

For example, potential side effects of anabolic steroid use include:

• Acne

• Gynecomastia (male breast growth)

• Hypertension (high blood pressure)

• Heart disease and risk of heart attack

• Mood changes and aggressive behavior

• Changes in your cholesterol levels

• Liver disease, including liver cancer

• Shrinking of your testicles

• Damage to your kidneys

• Enlarged prostate gland

• Reduced sperm count

Steroid use may also cause or contribute to male pattern baldness. Many steroids act on the androgen receptors in your scalp responsible for hair follicle miniaturization. 

Anabolic steroids can result in specific side effects in women, too, such as facial and body hair growth, menstrual cycle changes, hair thinning and voice changes.

Your risk of experiencing adverse effects from steroids may be higher if you use these medications without a prescription, particularly if you abuse steroids by taking an excessive dose.

Some anabolic steroids may cause erectile dysfunction, either while you’re using these drugs or when you stop taking them.

In a 2018 study published in the journal Translational Andrology and Urology, researchers found that men who used anabolic steroids mostly reported normal erectile function during use but were likely to experience ED after stopping treatment. They also found that stopping steroids was associated with other changes in sexual function, including reduced sex drive and natural sex hormone production. 

These side effects may occur as a result of changes in your body’s testosterone levels that can occur when you take artificial sex hormones. 

Since using anabolic steroids can lead to high blood pressure, it could also damage your blood vessels, affecting blood flow to your penis and making it harder to get an erection. 

Our guide to avoiding erectile dysfunction from steroids goes into more detail about the common link between steroid use and sexual dysfunction.

Corticosteroids can also cause side effects, including some that may affect your sexual function and performance. Potential side effects of corticosteroids include:

• Weakened bones

• Cataracts (cloudy areas in your eyes)

• Reduced adrenal hormone production

• Hypertension (high blood pressure)

• Dyspepsia (indigestion), gastritis and peptic ulcer disease

• Skin atrophy, irritation and damage

• Diabetes and hyperglycemia

• Immunosuppression

• Psychiatric disturbances

• Growth suppression

• Cushing syndrome

• Muscle weakness

• Glaucoma

Some corticosteroids may affect your production of testosterone, a hormone that plays an important role in promoting a healthy sex drive and sexual function.

For example, a study published in the Journal of Rheumatology in the 1990s found that men with rheumatoid arthritis who used prednisone showed significantly lower levels of testosterone than their peers, including men with rheumatoid arthritis who didn’t use prednisone.

This drop in testosterone levels may contribute to a reduced sex drive, as well as sexual health issues such as erectile dysfunction.

Taking Viagra on steroids could be a health concern. ED medications such as Viagra can cause drug interactions, including some that can seriously affect your physical health and overall well-being.

For instance, Viagra and other medications for erectile dysfunction can potentially interact with prescription medications for high blood pressure, including nitrates and alpha-blockers. When used together, these medications may cause a sudden, severe drop in your blood pressure.

Common nitrates include amyl nitrate, amyl nitrate and butyl nitrate. These ingredients are also commonly used in recreational and illicit drugs, such as “poppers.”

Right now, there’s no scientific research showing that Viagra interacts with anabolic steroids such as testosterone. However, it’s important to consider that the scientific research we have on many steroids is far from complete, as not all steroids used for performance enhancement are approved by the FDA (U.S. Food and Drug Administration) or subject to large-scale clinical trials.

This means some steroids used for performance enhancement may have negative effects that we aren’t fully aware of yet.

Viagra is a prescription medication, meaning you shouldn’t use it to treat ED without first talking to your healthcare provider. 

When you discuss Viagra with your healthcare provider, it’s vital to inform them about any medications you’re currently taking or have recently taken, including anabolic steroids and corticosteroids such as cortisone, hydrocortisone or prednisone.

They’ll let you know if it’s OK to use Viagra or similar medication, as well as the steps you can take to keep yourself safe while using medication for ED.

Both anabolic steroids and corticosteroids can cause side effects, including problems that may affect your sex drive and sexual function.

Long-term use of anabolic steroids may also contribute to heart problems, which could make it less safe to use Viagra or engage in vigorous sexual activity.

If you’re prescribed testosterone, use any type of corticosteroid, or take steroids recreationally for performance enhancement, it’s important to let your healthcare provider know before using Viagra or other medications for ED.

They’ll be able to check that it’s safe to use ED medication and let you know if there are any interactions you should be aware of. 

If you’re interested in trying erectile dysfunction treatments, you can access Viagra, generic sildenafil and other FDA-approved ED medications online via our telehealth service, following a consultation with a licensed healthcare provider who’ll determine if a prescription is appropriate.

You can also learn more about your options for preventing ED and improving your sexual health in our detailed guide to the most common treatments for erectile dysfunction. Get started today.