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Is Xanax Causing Me Erectile Dysfunction Issues?

Xanax (Alprazolam) is a commonly prescribed medication that is used to treat anxiety as well as panic disorders. It is a fast-acting drug which affects the brain and body, and it is thought that this results in a possible change in one’s sexual perfomance ability, including the occurrence of Erectile Dysfunction (ED). In this article, we explore how Xanax may cause ED, the various possible factors that may contribute to ED, and the ways you can treat ED based on what’s causing it.

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What Is Xanax?

Alprazolam is a prescription medicine known by the brand name Xanax. It belongs to a group of drugs called benzodiazepines, which work by affecting neurotransmitters in the brain to suppress the activity of nerves in the brain and spinal cord. One of these neurotransmitters is gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter which promotes calmness, produces a sense of relaxation, and works to decrease muscle tremors and anxiety. 


Xanax is used to treat anxiety disorders, anxiety caused by depression, and panic disorders. It is a very powerful and commonly prescribed medication, with several side-effects ranging from common ones like drowsiness to more severe ones like mania.


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What Is Erectile Dysfunction?

Erectile Dysfunction (ED) refers to the persistent inability or difficulty to get or maintain an erection, even when sexually aroused. ED can happen when there is insufficient blood flow into the penis, when the penis cannot trap blood during an erection, or when nerve signals from the brain do not reach the penis. ED also can have different levels of severity, ranging from mild, to moderate, to severe, and has a range of possible causes including both physiological and/or psychological factors. 


ED is the most common sexual problem in men, affecting up to one third of men throughout their lives. The incidence of ED increases with age and can negatively impact one’s intimate relationships, quality of life, and self-esteem. However, ED is usually treatable with medication, therapy, or surgery and there are many treatments for the condition that are both effective and safe. 


Does Xanax Cause Erectile Dysfunction?

Xanax is a depressant that slows down the central nervous system, affecting nerve impulses throughout the body. This suppression can cause a decrease in libido (sexual drive), making it more difficult to get or maintain an erection.  


In general, many medications have been associated with ED, such as medications used to treat hypertension, depression, and other psychiatric disorders. In fact, about 25% of ED cases are related to medication side effects. In particular, the use of benzodiazepines was reported to have a number of adverse reactions, including changes in libido, dystonia (the uncontrollable contraction of muscles), loss of coordination and fatigue. 


Currently, scientific research regarding the relationship between Xanax and ED remains minimal and overall inconclusive. However, in a placebo-controlled clinical trial of Xanax, 7% of patients given Xanax experienced sexual dysfunction compared to 4% of patients who were given a placebo treatment. ED is just one example of the numerous forms of sexual dysfunction. Sexual dysfunctions include a wide range of conditions that cause a hindrance in either a person’s ability to respond to sexual stimulus or to experience seuxal pleasure. 


The results of a study of 32 patients who received Xanax treatment for several weeks supported the contention that Xanax may be associated with a decline in sexual functioning. The majority of patients in the study experienced adverse sexual side effects such as decreased libido. A number of patients also reported erectile difficulties, ejaculatory inhibition, or orgasmic dysfunction. 


Generally, there have also been a few studies reporting an association of benzodiazepines with ED. For example, the Massachusetts Male Aging Study (MMAS), a longitudinal study that occurred from 1987 to 1997, found that the use of benzodiazepines was positively associated with ED. Similarly, the 2013 Boston Area Community Health (BACH) Survey of 2,301 men aged 30 to 79 found that the use of benzodiazepines had a two-to-three-fold increase in the odds of ED occurring. 


However, further studies are needed to determine whether the association between Xanax and sexual dysfunctions are independent of underlying health conditions, and to further explore the relationship between benzodiazepines like Xanax and ED. 


Could My Anxiety Be Causing Erectile Dysfunction?

There are many factors that could cause ED and it could even be a sum of factors. In some cases, Xanax may not be the reason for your ED. If you're taking Xanax to treat your anxiety or depression, it may be that psychological condition that is causing ED. 


At the same time, even if you’re not consuming Xanax or any other medication, it could be your anxiety that’s causing ED. Having ED may worsen your anxiety, creating a vicious cycle. When men start to become preoccupied by negative thoughts, this leads to more failures and increased anxiety which worsen one’s sexual performance. 


Sexual performance anxiety is one of the most common sexual issues and is also one of the leading causes for ED. When you become anxious, your body releases stress hormones such as adrenaline (epinephrine), norepinephrine and cortisol to your bloodstream. This causes your muscles to tense up and your heart to beat rapidly. When blood vessels in your penis contract, blood flow into the penis is reduced, leading to difficulty in achieving or maintaining an erection. 


In a U.S. study involving 2,660 sexually active men aged 18 to 31 years old, it was discovered that anxiety was associated with a higher chance of moderate-to-severe erectile dysfunction. 


If you are experiencing ED, it's important to have an assessment conducted by your doctor to identify the root of the problem. If you’ve just started taking Xanax, you might want to wait for some time, as Xanax might help resolve ED if depression or anxiety is the cause of the issue. 

What Else Could Cause Erectile Dysfunction? 


Besides medication and anxiety, there are numerous other possible causes of ED. These could include physiological reasons, psychological reasons or a combination of both. 


Physiological causes of ED include hypertension, cardiovascular diseases, diabetes, obesity and aging. Blood flow to the penis is what makes for healthy, hard erections, and these conditions are directly affected by blood circulation in the body. The excessive use of a number of substances may also lead to ED, including smoking cigarettes and chronic alcoholism. 


Psychological causes of ED include depression, anxiety, and stress disorders. These can affect one’s overall mood, libido and sexual satisfaction. Emotional or relationship problems could also cause or worsen ED.



What Should I Do If I Experience Erectile Dysfunction?

Fortunately, ED is a treatable condition. If you are experiencing ED, you should meet with your doctor to help evaluate the cause of the issue in order to decide the best course of action to take. There are numerous treatments available in Singapore, including prescription oral medication, therapy, penile injections, and more. 


Oral medications are often the first line of treatment for ED. Cialis (Tadalafil) and generic Viagra (Sildenafil) are commonly prescribed medications for ED that have little side effects. They reverse ED by enhancing the effects of nitric oxide, promoting blood flow into the penis. 


For instance, generic Viagra works by increasing blood flow to the penis in combination with sexual stimulation or arousa and usually takes 30 to 60 minutes to work for ED. The most common side effects include headaches, dizziness, and nausea, but many men also experience mild or no side effects.


Overall, your lifestyle can also greatly affect your ED. Adopting healthy behaviours such as weight reduction, consistent exercise, smoking cessation, and treatment for substance use problems can help improve your sense of wellbeing, overall health, and the health of physiological problems related to the sexual response cycle.


With Noah, a digital health clinic for men in Singapore, you can speak to a doctor and get the ED treatment you need from the comfort of home. Doctors on our platform are best equipped with the knowledge to help you ascertain the root cause of your erectile dysfunction. They can also determine which course of treatment is best suited for you and prescribe you with the right medication should you require it.


References

Calzo J.P., et.al., 2021. Erectile Dysfunction in a Sample of Sexually Active Young Adult Men from a U.S. Cohort: Demographic, Metabolic and Mental Health Correlates. The Journal of Urology, 205(2), pp. 539-544. (Link)


Cunha, J. P., 2021. Side effects of Xanax (alprazolam), warnings, uses. RxList. Retrieved December 27, 2021. (Link


Derby, C.A. et.al., 2001. Drug Therapy and Prevalence of Erectile Dysfunction in the Massachusetts Male Aging Study Cohort. American College of Clinical Pharmacy, 21(6) pp. 676-683. (Link)


Kupelian, V., Hall, S. A., & McKinlay, J. B. (2013). Common prescription medication use and erectile dysfunction: results from the Boston Area Community Health (BACH) survey. BJU international, 112(8), pp.1178–1187. (Link)


Lydiard, R.B. et.al., 1987. Sexual side effects of alprazolam. American Journal of Psychiatry, 144(2), pp. 254b-255. (Link)


Miller, T.A., 2000. Diagnostic Evaluation of Erectile Dysfunction. American Family Physician, 61(1), pp. 95-104. (Link)


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Published On
January 10, 2022

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