Does Gabapentin Cause Sexual Side Effects?

Each year, more than 10.5 million people are prescribed gabapentin (Neurontin). It’s a medication that’s FDA approved to treat seizures and nerve pain from shingles. But gabapentin is often prescribed for off-label uses, too, such as hot flashes and nerve pain from diabetes (diabetic neuropathy).

Sexual side effects aren’t common with gabapentin, but they're possible. Here, we’ll explain what’s known about gabapentin sexual side effects and how to manage them if they happen to you.

Does gabapentin cause sexual side effects?

Not usually, but it’s possible. There have been reports of gabapentin causing sexual side effects, including:

• Changes in libido

• Ejaculation problems

• Difficulty reaching orgasm

However, many reports of sexual problems with gabapentin involve a single person or just a few people. And when it comes to your sexual health, many factors can come into play. 

For example, many medical conditions can cause sexual problems, including several of the conditions gabapentin treats. Examples include:

• Hot flashes during menopause

• Epilepsy (seizure disorder)

• Diabetic neuropathy

• Anxiety-related disorders

• Chronic pain, including fibromyalgia and nerve pain

• Alcohol use disorder

• Insomnia (trouble sleeping)

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Several medications can also impact your sex life. Examples include opioids, benzodiazepines, and some seizure medications.

How common are sexual side effects with gabapentin?

It’s uncommon to experience sexual side effects from gabapentin. If you’re taking gabapentin and having sexual problems, there’s a chance that gabapentin isn’t the cause. About 40% of women experience sexual problems at some point in their lives. And over 50% of men 40 years and older have symptoms of erectile dysfunction or ED (trouble getting or keeping an erection). 

That being said, gabapentin may have some effect on sexual functioning. So if you’re experiencing sexual problems with this medication, it’s worth talking to your prescriber about. This may feel uncomfortable or intimidating. But having the conversation can help you figure out what’s going on so your concerns can be addressed. Your prescriber may be able to recommend several tips to try at home, therapies, or medications to help.

Sexual side effects of gabapentin in men

Erectile dysfunction is the most commonly reported sexual side effect in men. A 2022 review found 139 reports of erectile dysfunction believed to be caused by gabapentin, over a 10-year period. 

Still, the link between gabapentin and erectile dysfunction isn’t clear. Other seizure medications, such as carbamazepine (Tegretol) and topiramate (Topamax, Eprontia), are considered more likely to cause sexual problems than gabapentin.

Gabapentin's effects on brain chemistry might cause sexual side effects in several ways:

• Boosting a natural chemical in the body called gamma-aminobutyric acid (GABA): Increasing GABA can interfere with having an erection or orgasm. 

• Changing how nerves communicate with each other: This may interfere with the relaxation of smooth muscle in the penis, which can block an erection from forming.

• Increasing serotonin: Gabapentin increases serotonin, which is another brain chemical. Too much serotonin could lead to ED symptoms as well.

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Sexual side effects of gabapentin in women

There are reports of gabapentin causing orgasm difficulties in women. On the other hand, there are some cases where gabapentin may improve sexual functioning. 

To put it simply, if you have a health condition that causes sexual problems, and gabapentin effectively treats this condition, your sexual issues may improve.

For example, vulvodynia is a condition involving stinging pain and a burning ache in the vulva area. It can cause low desire and painful sex. It can also lead to vaginismus (tightening of the vaginal muscles), which can cause painful sex. But gabapentin may help. One placebo-controlled study of 66 women with vulvodynia found that gabapentin use led to improvements in sexual desire, arousal, and satisfaction. 

Do sexual side effects from gabapentin go away?

If you experience sexual side effects from gabapentin, they may not go away on their own. Your prescriber may recommend decreasing your dose or stopping gabapentin altogether to see if your symptoms improve. If your sexual issues remain, it’s likely that gabapentin isn’t the cause.

How can you manage sexual side effects from gabapentin?

If gabapentin is determined to be the cause for your sexual issues, lowering your dose or stopping it altogether may be the best solution. But don’t make any changes without talking to your prescriber first. 

Stopping gabapentin may not be an option. In these situations, there may be other possibilities. For example, medications like Viagra (sildenafil) and Cialis (tadalafil) are the go-to treatments for erectile dysfunction. Your prescriber may recommend taking these along with gabapentin.

When are sexual side effects from gabapentin dangerous?

Gabapentin has been linked to rare reports of priapism — painful erections lasting 4 or more hours. Priapism is more likely if you take gabapentin with other medications that can cause it, too, like antidepressants or ED medications. 

Talk with your prescriber if you have an erection that doesn’t go away. But if it’s been 4 hours, get medical attention right away. Treatment may be needed to prevent permanent damage.

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Written by:

Daphne Berryhill, RPh

Daphne Berryhill, RPh, has two decades of experience as a clinical pharmacist. She spent most of her career in the Chicago area practicing in-home infusion.

Edited by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Karen Hovav, MD, FAAP

Karen Hovav, MD, FAAP, has more than 15 years of experience as an attending pediatrician. She has worked in a large academic center in an urban city, a small community hospital, a private practice, and an urgent care clinic.

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