Does Wellbutrin cause erectile dysfunction — or help it?

Like many medications, antidepressants can come with some unwanted side effects. Some are known to cause weight gain, insomnia, gastrointestinal issues, and even sexual dysfunction. If you’re concerned about the sexual side effects of Wellbutrin (bupropion), you may wonder: Does Wellbutrin cause erectile dysfunction (ED)?

The good news is Wellbutrin is less likely to cause ED than other antidepressants. In fact, research suggests it may actually increase sex drive. It’s approved by the United States Food and Drug Administration (FDA) for depression, seasonal affective disorder (SAD), and smoking cessation, but Wellbutrin is also sometimes prescribed off-label for antidepressant-induced sexual dysfunction. 

If you’re experiencing sexual side effects from another antidepressant, Wellbutrin may be a good alternative. Read on to better understand the possible sexual effects of Wellbutrin, plus some alternative ED treatments.

Note: This medication is available as a generic and has been sold under several brand names, such as Wellbutrin SR, Wellbutrin XL, Zyban, Aplenzin, Forfivo XL, and others. For simplicity, we’ll refer to it as Wellbutrin or bupropion throughout this article.

Can Wellbutrin cause ED? The risk is relatively low. 

This is a refreshing contrast to most other antidepressants, which can cause sexual dysfunction — so much so that some people stop taking their medication because of it. 

The antidepressant medications that typically cause sexual dysfunction include selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). SSRIs work by selectively inhibiting the reuptake of serotonin. This increases the availability of serotonin, which may affect testosterone and potentially contribute to sexual dysfunction. SNRIs also increase serotonin and can have similar sexual side effects. 

Bupropion is considered an atypical antidepressant. It doesn’t belong to the classes of medications commonly associated with sexual side effects. More specifically, bupropion is  a norepinephrine-dopamine reuptake inhibitor (NDRI), and it’s believed to work by increasing the availability of norepinephrine and dopamine in the brain. 

Because it works through a different mechanism of action, bupropion is associated with less risk of ED than SSRIs or SNRIs. The risk of sexual dysfunction with bupropion is virtually identical to that of placebo, research has found. Though bupropion has less impact on sexual functioning — and may even enhance sexual function — more research is ultimately needed.

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Many antidepressants can cause low libido or low sex drive, but this isn’t a common side effect of Wellbutrin. 

Some cases of increased libido and decreased libido have been reported, according to the drug’s prescribing information, but it seems that bupropion may increase male libido, sexual desires, and frequency of engaging in sexual activity. Researchers believe that bupropion may alleviate the loss of sexual desire by blocking the reuptake of norepinephrine and dopamine and increasing testosterone levels.

Keep in mind that depression itself can cause you to lose interest in sex, among other activities you may have previously enjoyed. And, in many cases, getting effective treatment for your depression can restore sexual desire.

Wellbutrin may also affect female sex drive. The research on this is limited, but suggests bupropion may improve hypoactive sexual desire disorder (HSDD) in women who aren’t clinically depressed.

Not only is Wellbutrin unlikely to cause ED, it may even help alleviate it. Small studies have shown that bupropion may improve sexual dysfunction induced by SSRIs, though further studies are needed. 

Wellbutrin’s positive effects on sexual functioning may be related to its mechanism of action. By blocking the reuptake of norepinephrine and dopamine, more of these chemicals are available in the brain. Increases in dopamine have been shown to improve sexual activity. Similarly, norepinephrine promotes sexual arousal and erections.

Treating sexual dysfunction isn’t one of the FDA-approved uses of bupropion, however, and it’s not generally used to treat ED on its own. But it can be used off-label in addition to (or in place of) another antidepressant if you’re experiencing sexual side effects.

Sexual side effects are common with antidepressants. They’re more common in SSRIs and SNRIs compared to NDRIs like Wellbutrin. While Wellbutrin is less likely to cause ED and may even increase libido, sexual side effects are still possible.

People who have taken Wellbutrin have reported the following adverse sexual effects: 

• Abnormal ejaculation

• Genital pain during or after sexual intercourse (dyspareunia)

• Gynecomastia

• Painful erection

• Changes in sex drive 

Because Wellbutrin’s sexual side effects were reported outside of controlled clinical trials, their frequency is unknown.

Common side effects of Wellbutrin

Aside from sexual side effects (which aren’t very common with Wellbutrin), the most commonly reported side effects of Wellbutrin include:

• Headache

• Dry mouth

• Nausea (taking it with food helps)

• Trouble sleeping

• Dizziness

• Sore throat

• Constipation

Serious side effects of Wellbutrin 

Wellbutrin can cause serious side effects in some cases, which can include:

• Increased risk of suicidal thinking and behavior

• Seizure risk

• Increased blood pressure

• Activation of mania and hypomania

• Psychosis 

• Angle-closure glaucoma

• Allergic reactions

You should seek immediate medical attention if you experience any of the following side effects of Wellbutrin:

• Fever

• Rash, blisters, itching, or hives

• Swelling

• Confusion, hallucinations, or irrational fears

• Muscle or joint pain

• Chest pain

• Rapid or irregular heartbeat

• Hoarseness

• Difficulty breathing or swallowing 

Wellbutrin can cause side effects that are mild or manageable, but contact your healthcare provider if you experience any side effects that are serious or won’t go away.

Aside from Wellbutrin, sexual dysfunction may also be improved with therapy, prescription medications, and lifestyle changes.

Therapy

There’s a strong correlation between sexual function and mental health — in both directions. Mental health conditions, such as depression and anxiety, can increase the risk of ED, and sexual function can also influence one’s mental health, research shows. 

Prescription medications

Conditions like ED are common but treatable with medication. There are many safe and effective treatments for ED, including:

• Viagra (sildenafil)

• Cialis (tadalafil)

• Stendra (avanafil)

• Vardenafil

You can also consider alternative prescription formulations, such as Ro Sparks (a dissolvable tablet that contains sildenafil and tadalafil) or Ro’s Daily Rise Gummies (a gummy containing tadalafil). While these formulations aren’t FDA-approved, their active ingredients are FDA-approved for treating erectile dysfunction. 

If you’re interested in taking medication for ED, talk to your healthcare provider.

Lifestyle changes

Certain lifestyle modifications may help ED. Since ED is linked to risk of cardiovascular disease (CVD), many of the recommended lifestyle changes overlap with those that also support heart health. 

These can include:

• Improving dietary choices

• Increasing physical activity

• Quitting smoking

• Maintaining a healthy body weight

• Reducing stress 

These lifestyle changes help prevent the risk factors that contribute to ED and CVD — high blood pressure, high cholesterol, diabetes, smoking, and increased body mass index (BMI).

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Wellbutrin is considered an atypical antidepressant, and one thing that’s surely atypical about it is the fewer sexual side effects associated with it. Where other antidepressants are commonly associated with sexual dysfunction, Wellbutrin is less likely to cause ED and may even increase libido in the process. That’s why it’s sometimes prescribed off-label for antidepressant-induced sexual dysfunction.

Here are some things to keep in mind about Wellbutrin and erectile dysfunction:

• Bupropion is less likely to cause ED than other antidepressants, particularly SSRIs and SNRIs. Bupropion is an NDRI, so it works differently, which may lend to its reduced incidence of ED.

• Bupropion has also been shown to increase sex drive. This could be because it helps balance chemicals and hormones linked to sexual function, including norepinephrine, dopamine, and testosterone.

• It’s not FDA-approved for treating sexual dysfunction, but it may help. When other antidepressants induce sexual dysfunction, bupropion may be prescribed off-label to help alleviate it.

• Wellbutrin isn’t free from its own side effects. Some people have reported other sexual side effects of Wellbutrin (like pain during sex), though we don’t know how frequently these effects happen. This medication can also cause some serious side effects. If you have any concerns while taking Wellbutrin, be sure to inform your healthcare provider.

• There are other ways to alleviate ED. There’s evidence that Wellbutrin may help ED, but it’s not the only option. Alternatives to Wellbutrin for ED include therapy, lifestyle changes, and other prescription medications, such as Viagra.