Buspirone side effects sexually: does buspirone cause ED?

Many anti-anxiety medications are known to cause sexual side effects, so you might be wondering: does buspirone cause erectile dysfunction (ED)? 

The short answer is buspirone isn’t commonly linked to ED, but it can happen in rare cases. 

Buspirone is a prescription anxiety medication that works differently from selective serotonin reuptake inhibitors (SSRIs). Unlike many other anxiety medications, it doesn’t appear to cause sexual side effects in most people. In fact, some providers prescribe buspirone to help offset sexual side effects caused by SSRIs, which are commonly used to treat anxiety and depression. 

Buspirone can cause erectile dysfunction, but it’s not common. In clinical trials, impotence was reported as a “rare” occurrence, affecting fewer than 1 in 1,000 patients. In contrast, a large FDA adverse event analysis found that erectile dysfunction was the most frequently reported male sexual adverse event across several SSRIs, the medications most commonly used to treat anxiety and depression.

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Buspirone may improve SSRI-induced erectile dysfunction and other sexual side effects in some people by influencing serotonin and dopamine signaling, though the exact mechanism isn’t fully understood. And it’s important to note that most research has looked at broader sexual side effects, not at ED specifically. 

Because of this potential effect, buspirone is sometimes prescribed off-label as an add-on to an existing SSRI to help reduce medication-related sexual dysfunction.  

In a placebo-controlled study, 58% of patients taking buspirone reported improvement in SSRI-induced sexual dysfunction compared to 30% in the placebo group, though later research has produced mixed results. 

Bupropion (Wellbutrin) is another medication sometimes used to help offset sexual dysfunction caused by SSRIs and other antidepressants.

While not at all common, buspirone may cause other sexual side effects, such as:

• Decreased libido

• Increased libido

• Delayed ejaculation

Like ED, these other sexual side effects are infrequent or rare, occurring in 1% or fewer people in clinical trials.

Compared to anti-anxiety medications like SSRIs, SNRIs (serotonin and norepinephrine reuptake inhibitors), and some tricyclic antidepressants, buspirone is generally less likely to cause sexual side effects. 

SSRIs and SNRIs are commonly associated with sexual side effects like decreased libido, ejaculatory disorders, and erectile dysfunction. And tricyclic antidepressants can also contribute to sexual side effects due to their effects on serotonin.

Studies also show that benzodiazepines like Xanax, which are widely prescribed for anxiety, have been associated with sexual dysfunction, including ED. Their effects on the central nervous system may interfere with arousal, libido, and sexual performance. However, because benzodiazepine use often overlaps with sleep disorders and mood conditions, it can be hard to separate medication-related effects from underlying health factors.

Buspirone is not a benzodiazepine nor an antidepressant. Because it works differently from these medications, buspirone is often considered a distinct option with a lower risk of sexual side effects.

There are many ways to treat ED, whether it’s caused by buspirone (which is unlikely) or not. These include prescription ED medication, therapy, healthy lifestyle changes, and more.

1. Talk to your provider about prescription ED medication

Sildenafil (Viagra) and tadalafil (Cialis) are two of the most commonly prescribed medications for ED. They belong to a class of drugs called phosphodiesterase type 5 (PDE5) inhibitors, which help improve blood flow to the penis to support erections.

Sildenafil is typically taken as needed before sex, while tadalafil can be taken daily or as needed, depending on your treatment goals.

The same active ingredients are also available through Ro in alternative formulations, including Daily Rise Gummies and dissolvable Ro Sparks. While the United States Food and Drug Administration (FDA) does not specifically approve these compounded formulations, they do approve their active ingredients for the treatment of ED. 

Although there are no known direct drug interactions between buspirone and PDE5 inhibitors, it’s always a good idea to check with your healthcare provider before combining medications.

2. Consider therapy or counseling

Your mental health can play a significant role in both anxiety and erectile dysfunction. Ongoing stress, depression, relationship issues, or performance-related anxiety can all contribute to psychological ED, which is more common in men under 40. In fact, if you recently started buspirone, giving it more time to work (at least 2 to 4 weeks) may help relieve anxiety and improve anxiety-related sexual dysfunction.

Individual or couples therapy may help you learn better coping methods for stress, address unhealthy patterns around sex, or resolve issues between you and your partner.

3. Review all your medications with your provider

If buspirone seems to be impacting your erections, there may be other options to consider. Your provider might adjust your dose or switch you to another anxiety medication to see if symptoms improve. 

There’s also a chance that another medication is contributing to the issue. Let your provider know about all your current medications and supplements to help them pinpoint the root cause of your ED.

4. Address lifestyle factors that affect blood flow

Many lifestyle habits can impact how well blood flows throughout the body, including to the arteries that support healthy erections.

Lifestyle habits that may improve blood flow and erectile function include:

• Following a healthy diet: A diet rich in leafy greens, fruits, grains, nuts, legumes, fish, and olive oil (like the Mediterranean diet or a plant-based diet) help enhance nitric oxide production, reduce inflammation, and improve healthy blood flow, which can benefit both ED and overall cardiovascular health.

• Getting regular exercise: Regular aerobic exercise, like jogging, swimming, or cycling, can improve blood vessel health, increase nitric oxide production, reduce inflammation, and enhance penile blood flow to promote better erections.

• Quitting smoking: Tobacco smoke damages blood vessels and reduces healthy blood flow, increasing the risk of ED. Quitting may help improve erectile function over time.

• Improving your sleep: Poor sleep can throw your hormones out of whack, increase inflammation, and negatively affect sexual function. Prioritizing high-quality sleep may help support both erections, anxiety levels, and your overall health. Also, if you snore loudly or feel excessively tired during the day, talk to your provider about screening for sleep apnea.

5. Check for underlying health issues

Erectile dysfunction can sometimes signal an underlying medical condition. It’s worth checking in with your healthcare provider to rule out issues such as:

• Cardiovascular disease 

• High blood pressure

• High cholesterol

• Diabetes and metabolic syndrome

• Low testosterone

• Thyroid disorders

• Obesity

• Sleep apnea

• Neurologic conditions

• Enlarged prostate

• Depression and other mental health issues

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If you’re taking buspirone and worried about how it’ll affect your sex life, the good news is ED isn’t a common side effect. In fact, compared to other anxiety medications, buspirone is generally less likely to cause any sexual side effects, and in some cases, it may even offset them. Here’s what to keep in mind:

• ED from buspirone is rare. In clinical trials, ED occurred in fewer than 1% of people, making it much less common than with SSRIs and some other antidepressants.

• Buspirone may actually help with SSRI-related sexual side effects. Some providers prescribe buspirone off-label in addition to an SSRI to reduce medication-related sexual dysfunction.

• Sexual side effects are uncommon overall. Changes in libido or ejaculation can occur, but they’re infrequent and only reported in 1% or fewer people.

• If ED does happen, it’s treatable. Prescription ED medications, therapy, lifestyle changes, and medication adjustments can all help improve sexual function.