Does Metoprolol Cause ED? What to Know About the Sexual Side Effects of Metoprolol
Key takeaways:
Metoprolol (Lopressor, Toprol XL, Kapspargo Sprinkle) is a beta blocker that treats certain heart-related conditions. It may cause sexual side effects, such as erectile dysfunction, low libido, and trouble orgasming in both men and women.
We don’t know exactly why sexual side effects happen with metoprolol (and other beta blockers). But reduced blood flow, hormone changes, and other medication side effects may play a role. Worrying about sexual side effects can also make them more likely.
If sexual issues occur while taking metoprolol, talk to your prescriber. Options to manage them include lifestyle changes, adjusting your dosage or medication, and adding treatments such as sildenafil (Viagra) or flibanserin (Addyi).
Table of contents
Metoprolol (Lopressor, Toprol XL, Kapspargo Sprinkle) is a prescription medication that treats high blood pressure and other heart-related conditions. Like other beta blockers, it reduces heart rate and helps relax blood vessels. This lowers blood pressure and makes it easier for your heart to pump.
While metoprolol can be very effective for heart health, it can also cause side effects. But do these side effects include negative effects on your sex life? And does metoprolol cause erectile dysfunction (ED)? Let’s look at the sexual side effects of metoprolol and what you can do about them if they occur.
Does metoprolol cause erectile dysfunction and other sexual side effects?
Yes, metoprolol can cause sexual side effects for both men and women.
Metoprolol may cause or worsen ED. You may have trouble getting or keeping an erection while you’re taking it.
Metoprolol may also be linked to low libido (reduced sex drive) and trouble achieving an orgasm while you’re taking it.
Why can metoprolol cause sexual side effects?
The reason metoprolol affects sexual function isn’t completely understood. But here are a few possible explanations:
Blood flow: Metoprolol may lead to reduced blood flow to your genitals. This can affect your ability to achieve an erection or feel sexually aroused.
Hormones: Metoprolol and other beta blockers may affect hormone levels. This may lead to a lower libido or trouble achieving an orgasm, especially in women.
Side effects: Metoprolol side effects include fatigue, dizziness, and a reduced tolerance to exercise. These side effects may make you feel less interested in sexual activity or make it harder for you to enjoy it.
Also, worrying about sexual side effects while taking metoprolol may make them more likely. In one study, men who were informed about ED as a potential metoprolol side effect experienced it more often than those who weren’t. ED also resolved for some people after taking medication to “treat” it. But the medication was actually a placebo (pill with no medication in it).
How common are sexual side effects with metoprolol?
We don’t know for sure exactly how often sexual side effects occur while taking metoprolol. ED, lower libido, and trouble orgasming weren’t among the side effects reported in initial clinical studies. Later studies confirmed that there is a connection between beta blockers and sexual side effects in some people. But they don’t seem to be as common as other metoprolol side effects.
A review of over 35,000 people found that about 22% experienced sexual side effects while taking a beta blocker, compared with 18% of people taking a placebo. But this study was looking at beta blockers in general, not metoprolol specifically.
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A study of women found that almost 70% reported sexual side effects with beta blockers, compared with about 43% in those not taking a beta blocker. But several other studies didn’t find a link between sexual side effects and beta blockers in women. So the actual chance of these side effects happening is unclear.
Keep in mind that sexual side effects are also commonly associated with high blood pressure and heart failure. These are both conditions metoprolol treats. So the underlying condition may be causing your symptoms, rather than the medication you’re taking.
The risk of ED and other sexual side effects goes up if you’re taking metoprolol along with other medications that may cause these side effects. This includes diuretics (“water pills”) and antidepressants.
Do sexual side effects from metoprolol go away?
Sexual side effects from metoprolol may go away on their own as your body adjusts to the medication. If you’re living with high blood pressure, metoprolol may help improve erectile function as it helps manage your blood pressure.
But this isn’t the case for everyone. If sexual side effects are interfering with your quality of life, don’t hesitate to tell your prescriber.
Is metoprolol more likely to cause sexual side effects than other beta blockers?
Sexual side effects seem to be possible with most beta blockers. This includes metoprolol as well as propranolol (Inderal LA, Innopran XL), carvedilol (Coreg), and atenolol (Tenormin). We don’t know if metoprolol is more or less likely to cause sexual side effects than other beta blockers, with one clear exception.
Nebivolol (Bystolic) is a third-generation (newer) beta blocker that isn’t associated with sexual side effects. It may even improve ED caused by high blood pressure or other beta blocker medications. That’s because it works differently from other beta blockers. Nebivolol may actually improve blood flow to the genitals, rather than reduce it.
How can you manage sexual side effects from metoprolol?
If you’re having sexual side effects while taking metoprolol, tell your healthcare team. They may recommend a dosage or medication adjustment. Nebivolol is a beta blocker that isn’t associated with sexual side effects. Ask your prescriber if it may be an alternative option for you.
If adjustments don’t help, your prescriber may recommend treatment options for your specific sexual symptom. Sildenafil (Viagra) and tadalafil (Cialis) are highly effective ED medications. And flibanserin (Addyi) and bremelanotide (Vyleesi) are treatments for low libido in women.
Keep in mind that lifestyle changes, such as exercising regularly, eating a balanced diet, and managing stress, can also help improve sexual health.
The bottom line
Metoprolol (Lopressor, Toprol XL, Kapspargo Sprinkle) is a beta blocker that treats high blood pressure and other heart conditions. But it can cause sexual side effects in some people — including erectile dysfunction, low sex drive, and trouble orgasming.
We don’t know exactly why metoprolol and other beta blockers cause sexual side effects. But reduced blood flow, hormone changes, and other medication side effects may play a role. Worrying about sexual side effects can also make them more likely.
Sexual side effects from metoprolol aren’t as common as other side effects. And they may fade over time as your body adjusts to the medication. But if sexual side effects from metoprolol are affecting your quality of life, don’t hesitate to reach out to your healthcare team. They can offer treatment options, such as lifestyle changes, a dosage or medication adjustment, or an additional treatment, such as sildenafil (Viagra) or flibanserin (Addyi).
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References
Cocco, G. (2009). Erectile dysfunction after therapy with metoprolol: The Hawthorne effect. Cardiology.
Corradetti, S., et al. (2022). β-blockers and erectile dysfunction in heart failure. Between myth and reality. Reviews in Cardiovascular Medicine.
Ferrario, C. M., et al. (2008). Sexual dysfunction in patients with hypertension: Implications for therapy. The Journal of Clinical Hypertension.
Nicolai, M. P. J., et al. (2013). A review of the positive and negative effects of cardiovascular drugs on sexual function: A proposed table for use in clinical practice. Netherlands Heart Journal.
Nunes, K. P., et al. (2012). New insights into hypertension-associated erectile dysfunction. Current Opinion in Nephrology and Hypertension.
RedPharm Drug. (2023). Metoprolol succinate- metoprolol succinate tablet, film coated, extended release [package insert].
Rosman, L., et al. (2014). Sexual health concerns in patients with cardiovascular disease. Circulation.
Viigimaa, M., et al. (2014). Management of erectile dysfunction in hypertension: Tips and tricks. World Journal of Cardiology.
Zhong, Q., et al. (2022). Management of hypertension with female sexual dysfunction. Medicina.
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