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SexRx: Calcium Channel Blockers and Your Sex Life

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Brand Names of Calcium Channel Blockers include:

  • Amlodipine
  • Diltiazem
  • Felodipine
  • Flunarizine
  • Isradipine
  • Nicardipine
  • Nifedipine
  • Nimodipine
  • Nisoldipine
  • Verapamil

What They Are Most Often Prescribed For:

How They Work:

Calcium channel blockers (CCBs) affect the movement of calcium into the cells of your heart and blood vessels. As a result, CCBs relax blood vessels and reduce the heart's workload.

Possible Sexual Side Effects:

Compared to most other blood pressure drugs, CCBs seem to cause fewer sexual problems. However, several case reports have shown that CCBs have the potential to cause sexual dysfunction in both men and women. Specific effects include:

  • Decreased desire (in both men and women)
  • Decreased erectile rigidity, and in some cases impotence
  • Problems with ejaculation
  • Breast enlargement in men—gynecomastia
  • Abnormal discharge of milk from the nipple—galactorrhea

How They May Cause Sexual Problems

CCBs block calcium activity, which causes blood vessels to dilate and lowers blood pressure. The same mechanism that causes this decrease in blood vessel constriction can also decrease the contractions essential for penile rigidity and orgasmic sensation.

Other possible mechanisms by which CCBs may affect sexual activity include:

  • Decreasing dopamine activity, which can lead to an increase in prolactin. Increased prolactin can have the following effects:
    • Reduced sex drive
    • Impotence
    • Galactorrhea
    • Infertility
  • Blocking the actions of excitatory peptides that are involved in genital sensation

Few sexual effects from CCBs have been reported in women with normal sexual functioning. However, for women who already have sexual difficulties, side effects of CCBs that indirectly affect sexual function may worsen the problem. For example, headache, flushing, swelling, bloating, lightheadedness, and weakness can dampen sexual desire and response for many women.

Treatment Options

Wait It Out

As you adjust to your new medication, the sexual side effects may go away.

Change the Drug or Dose

There are many CCBs, and some may be more likely to affect sexual function than others.

Ask your doctor if you should try a different CCB. You might also discuss the option of lowering the dosage with your doctor. Never change the dose or stop taking your medication without guidance from your doctor.

Switch Medications

Depending on your condition, there may be other medications that can manage your medical symptoms without affecting sexual function. For example, ACE inhibitors can sometimes be used in place of CCBs.

Try an Antidote

This involves maintaining your current level of CCB while adding a second medication to offset the sexual side effects. This option is generally less desirable since antidotes frequently have their own side effects and may adversely interact with the primary medication you are taking. Drugs that may be prescribed as antidotes include:

  • Sildenafil—This medication is prescribed to men who have erectile dysfunction.
  • Bupropion—This is an antidepressant that is sometimes prescribed to help correct sexual problems.

Consider Herbal Supplements

The efficacy of herbal supplements to treat the sexual side effects of CCBs is not clear. Care should also be taken with herbal products because, unlike medications, they are not strictly regulated. It is very important to talk to your doctor before using herbal supplements. Yohimbine, a supplement sometimes used to treat sexual side effects, should not be used by people with high blood pressure or those who are taking medications such as CCBs for high blood pressure.

  • American Heart Association

    http://www.heart.org

  • National Institutes of Health

    http://www.nih.gov

  • Canadian Urological Association

    http://www.cua.org

  • Sexuality and U - The Society of Obstetricians and Gynaecologists of Canada

    http://www.sexualityandu.ca

  • Bupropion. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 18, 2013. Accessed July 18, 2014

  • Crenshaw TL. Sexual Pharmacology: Drugs That Affect Sexual Function. WW Norton & Company; 1996.

  • Dusing R. Sexual dysfunction in male patients with hypertension: influence of antihypertensive drugs. Drugs. 2005;65(6):773-86.

  • Grimm RH Jr, Grandits GA, Prineas RJ, et al. Long-term effects on sexual function of five antihypertensive drugs and nutritional hygienic treatment in hypertensive men and women. Treatment of Mild Hypertension Study (TOMHS) Hypertension. 1997;29(1 Pt 1):8-14.

  • Hyperprolactinemia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 8, 2014. Accessed July 18, 2014.

  • Mosenkis A, Townsend R. Gynecomastia and antihypertensive therapy. J Clin Hypertens. 2004;6(8):469-70.

  • Pena K, Rosenfeld J. Evaluation and treatment of galactorrhea. Am Fam Physician. 2001;63(9):1763-1771.

  • Sildenafil. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 30, 2014. Accessed July 18, 2014.

  • Tanner LA, Bosco LA. Gynecomastia associated with calcium channel blocker therapy. Arch Intern Med. 1988 Feb;148(2):379-80.

  • Yohimbe. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/biomedical-libraries/natural-alternative-treatments. Updated August 22, 2013. Accessed July 18, 2014.