If you’re taking Xanax (alprazolam) for anxiety, you may wonder if it can affect erections. Officially, Xanax does not cause erectile dysfunction (ED).
ED is not a side effect of Xanax. But, the FDA does mention that men who take Xanax (7.4% compared to 3.7% who don’t) are more likely to notice sexual dysfunction- which includes ED.
Two studies (here and here) from Boston, MA, showed that even when comparing men with similar health issues, those taking benzodiazepines (the group of medicines including Xanax) are about twice as likely to have erectile problems.
Yet, these studies don’t show that Xanax causes ED. Instead, it is possible that men who take Xanax have other issues (like anxiety) that make them more likely to have ED in the first place.
How could Xanax cause ED?
Xanax (and other benzodiazepines like Valium, Serax, Ativan, and Klonopin) depress our central nervous system, which includes the brain and large nerves in our spinal cord. Xanax works by increasing the effects of the brain’s main inhibitory neurotransmitter, gamma-aminobutyric acid (GABA).
Since Xanax slows down your brain cells, it helps you relax. It can help with anxiety, panic attacks, and also vertigo (a room-spinning sensation).
Erections require coordination between your senses, central nervous system, and mood, so it makes sense that slowing down your brain cells with Xanax might make it harder to have an erection.
Xanax can change libido– or our interest in sex. Importantly, Xanax can increase or decrease libido, although more men will notice a decrease. Some men with decreased libido may confuse this with ED.
A single-person report showed that increasing the Xanax dose can lead to anorgasmia or an inability to orgasm with sex. While it’s unclear why that happened, anorgasmia often occurs with erectile problems.
This research emphasizes that there is much we don’t know about Xanax and sexual function. More (and larger) research studies are needed to understand how Xanax affects erectile function.
Can Xanax cause permanent erectile dysfunction?
No. It’s unlikely that Xanax will cause permanent ED. Sexual problems usually go away once you stop taking Xanax. The risk of sexual problems also depends on if you take long-acting Xanax (taken once a day) or short-acting Xanax (taken occasionally for situational anxiety).
Can anxiety be the cause of my erectile dysfunction?
Yes, if you are taking Xanax to treat anxiety or depression, that underlying condition could cause ED. Performance anxiety– where a man has recurring negative thoughts that he won’t be able to perform in bed- can make it difficult to get an erection or cause him to lose his erection early.
It’s important to ask yourself if you had any problems with erections before you started taking Xanax, rather than blaming ED on Xanax.
Can Xanax help erectile dysfunction?
Yes, Xanax can help some cases of erectile dysfunction. Anxiety-induced ED is often a result of a vicious cycle in which anxious thoughts about losing an erection lead to loss of erection which creates more anxiety the next time.
Some men will notice that their performance anxiety-related ED gets better with Xanax. As their anxious thoughts resolve, they can relax and focus on the pleasure of sex, making it easier to have more reliable erections and break the cycle of performance anxiety.
But as we’ve talked about, Xanax can be associated with decreased libido and sexual issues that can increase performance anxiety.
Men may end up taking both Xanax and Viagra for performance anxiety. Men using these two medicines should have a doctor supporting them since both medicines can cause an unsafe drop in blood pressure, and certain medicines or foods change how Xanax and Viagra work in your body.
It can be easy to get addicted to Xanax. Men on Xanax should get a doctor’s prescription and make sure they can safely stop taking Xanax.
It’s often best to take Xanax briefly as a bridge to other methods (such as mindfulness based cognitive-behavioral therapy) to treat your anxiety.
How can I treat erectile dysfunction while taking Xanax?
First, ask yourself if your ED began before taking Xanax. If you have performance anxiety, treat it with psychotherapy, mindfulness meditation, or other sex therapies.
If your ED began after taking Xanax, talk to your doctor. You can try lowering your Xanax dose or taking other anxiety medicines without sexual side effects like Trazadone or Wellbutrin.
Can you take Viagra while on Xanax? Yes, it is possible to take Xanax to decrease anxiety while taking Viagra to improve erections. But these two medicines can lower your blood pressure, so talk with your doctor first.
Summary
If you are one of the many men taking Xanax, you should be aware of its association with sexual problems. While Xanax may not cause erectile dysfunction directly, many men who take Xanax can have underlying depression or anxiety, causing ED. Even if that’s not the case for you, there are many alternatives to Xanax, like sex therapy or switching to other medicines, that can help.
