Does gabapentin cause erectile dysfunction?

Gabapentin is a prescription medication that can help manage nerve pain, seizures, and anxiety. But some folks may notice another effect they didn’t expect: trouble getting or keeping an erection. So, does gabapentin cause erectile dysfunction (ED)? 

It’s not a common side effect, but yes, some men taking gabapentin notice changes in sexual desire, arousal, or their ability to get or maintain an erection.

Understanding how gabapentin works and how it may influence sexual function can help you have an informed conversation with your provider about what’s happening and what to do next.

While not a common side effect, gabapentin may cause erectile dysfunction in some cases. 

Researchers aren’t exactly sure why this can happen, but it may be related to gabapentin’s effects on hormones and nerve signaling in the brain. Gabapentin calms overactive nerves to reduce pain and prevent seizures. But those same nerves also play a role in arousal and erections.

More research is needed to better understand how and why gabapentin erectile dysfunction can happen. Here’s what we know so far:

• In clinical trials, ED was reported by 2% of people taking gabapentin, versus 1% of those taking a placebo.

• One review on antiepileptic drugs found that several medications in this class — including gabapentin — have been linked to sexual side effects like erectile dysfunction, low sex drive, and difficulty with ejaculation.

• Another case report found that gabapentin could cause sexual side effects even at relatively low doses, including loss of sex drive, trouble ejaculating, difficulty reaching orgasm, and erectile dysfunction. These effects appeared to be dose-dependent, meaning they worsened as the dose increased.

Still, these sexual side effects are rare. If you do notice them, it’s worth mentioning to your healthcare provider. ED can have many possible causes, so figuring out what’s really behind it can help you get the right treatment.

It’s also worth noting that other factors — like anxiety, depression, and chronic pain — can play a role in your sexual health.

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ED appears to be an uncommon side effect of gabapentin. According to the prescribing information, ED isn’t listed as a common side effect. Instead, impotence (another term for erectile dysfunction) was reported in only 2% of people taking gabapentin in clinical trials for seizures, compared with 1% of those taking a placebo.

Also, changes in libido, trouble reaching orgasm, and ejaculation problems have been noted in postmarketing reports — cases voluntarily submitted after the drug was already on the market. Because these reports come from an unknown number of users, it’s difficult to know how common the issue is or whether gabapentin was directly responsible.

Beyond those reports, most of what’s known about gabapentin and sexual side effects comes from older studies or individual case reports rather than large-scale research. For instance, one review found that gabapentin and similar antiepileptic drugs were linked to ED or low libido. However, the research is limited, so more studies are needed to better understand this connection.

Some reports suggest the risk may increase with higher doses or when gabapentin is combined with other medications that can affect sexual function (for example, antidepressants). The person’s overall health also matters: Conditions such as diabetes, heart disease, and high blood pressure can independently increase the risk of ED.

Gabapentin may cause erectile dysfunction because it can affect the nerve signals involved in helping you get and stay hard, including libido, nerve activity, and hormone levels. The medication works by calming overactive nerves, which helps with pain and seizures. But those same nerves also play a role in arousal and erections. When that signaling slows down, sexual response can, too.

Here are a few ways gabapentin may contribute to ED:

• Decreased nerve activity: Gabapentin decreases the release of excitatory neurotransmitters, which are chemicals that help your brain and body respond to stimulation. This quieter nerve activity may make it harder to trigger or sustain an erection.

• Lower testosterone levels: Some early animal studies suggest gabapentin might reduce testosterone or alter hormone balance, though strong evidence in humans is limited. 

• Increased sex hormone–binding globulin (SHBG): Elevated SHBG binds to free testosterone, leaving less available for the body to use. This could potentially lower sex drive and make erections harder to sustain.

• Fatigue: Feeling drowsy or sluggish is one of gabapentin’s most common side effects, and low energy can make sex feel less appealing or more difficult.

• Reduced libido: Gabapentin acts on the GABA system, which helps calm the nervous system. This same effect may dull sexual excitement or responsiveness, contributing to ED or lower libido.

Based on the available research, it does not appear that gabapentin-related ED is permanent. 

Even when gabapentin sexual side effects happen, they usually fade after lowering the dose or stopping the medication under a healthcare provider’s guidance. Indeed, larger reviews of other drugs linked to ED describe these effects as reversible, meaning the erectile dysfunction is temporary and tends to go away once the drug is out of your system. 

That said, recovery time can vary. Things like your gabapentin dose, how long you’ve been taking it, other medications you use (including common prescriptions like Xanax or Adderall), and your overall health can all play a role. Sometimes ED isn’t caused only by the medication — it can also stem from the condition you’re treating with gabapentin (like chronic pain, nerve problems, or anxiety), other health issues, or natural changes with age.

If you think gabapentin might be affecting your erections, the first step is to talk to your healthcare provider. Don’t stop the medication suddenly on your own. They can help confirm whether gabapentin is the likely cause and work with you to find solutions that don’t compromise management of the condition(s) for which you’re taking gabapentin.

Here are a few common approaches your provider might recommend:

• Adjusting your dose or switching medications: Sometimes lowering the dose can ease side effects without losing the benefits of treatment. In other cases, your clinician may recommend an alternative medication that’s less likely to affect sexual function. 

• Adding an erectile dysfunction treatment: Prescription ED medications like sildenafil (Viagra) or tadalafil (Cialis) can help restore normal erections while you and your provider adjust your gabapentin plan. These medications are generally safe to take with gabapentin, but your provider will confirm what’s appropriate for you.

• Addressing other contributing factors: Health conditions like diabetes, high blood pressure, and depression can all make ED worse. Managing those alongside any medication changes often improves symptoms faster.

• Lifestyle changes that support sexual health: Getting enough sleep, exercising regularly, limiting alcohol, quitting smoking, and reducing stress can all improve blood flow, hormone balance, and sexual function.

Gabapentin is linked to other sexual side effects in men besides erectile dysfunction, including lower sex drive and delayed ejaculation. However, these are also considered uncommon. 

Other sexual side effects that have been reported with gabapentin include:

• Reduced libido: Some people may experience a decreased sex drive while taking it.

• Delayed ejaculation or anejaculation: Some men report trouble ejaculating or not ejaculating at all.

• Anorgasmia (difficulty reaching orgasm): Taking gabapentin may make it harder for some people to reach climax, even with normal arousal. This side effect may be more likely in older adults or with higher doses, according to one report.

• General sexual dysfunction: In some cases, men have experienced a combination of sexual issues, like loss of libido, trouble getting or maintaining an erection, and difficulty ejaculating.

If you’re noticing changes in your sex drive, orgasm, or ejaculation while taking gabapentin, you’re not stuck with these unwanted side effects. They’re usually reversible and can often be managed with a few adjustments.

Here are some steps your healthcare provider might suggest:

• Talk openly about what’s happening: It can feel awkward to bring up sexual side effects, but your provider needs to know what you’re experiencing to help. Be specific about when symptoms started and how they’ve changed since you began taking gabapentin.

• Adjust your medication: Sometimes lowering the dose or switching to a different medication can make a big difference. Never make these changes on your own, though — gabapentin should always be tapered safely under medical supervision.

• Check for other causes: If you’re also taking antidepressants, opioids, high blood pressure medications, or other prescription drugs, these can contribute to sexual side effects, too. Your provider can review your medications and see if something else might be playing a role.

• Consider short-term treatments: Depending on your symptoms, your provider might recommend ED medications or other therapies to help restore sexual function while adjusting your gabapentin plan.

• Support overall sexual health: Regular exercise, good sleep, balanced nutrition, and stress management all help maintain healthy hormone levels, blood flow, and general well-being. These simple habits can amplify the benefits of any medical changes you make.

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Gabapentin can cause sexual side effects, but these are uncommon and usually temporary. Most people who take the medication don’t experience changes in sexual function, and when issues do happen, they often improve after adjusting the dose or switching medications under a healthcare provider’s guidance. Here’s what to keep in mind: 

• Gabapentin-related erectile dysfunction is uncommon but possible, and it typically improves once the medication is changed or adjusted.

• The cause may involve nerve and hormone effects, such as lower testosterone or reduced sexual stimulation.

• Other sexual side effects, like low libido, delayed ejaculation, or difficulty having an orgasm, can also occur while taking gabapentin.

• Talk to your healthcare provider before making any medication changes. They can help pinpoint the cause and find the best solution.