From the Guidelines
Gabapentin can potentially inhibit or delay orgasms in some individuals as a side effect. This medication, which is primarily used to treat seizures, nerve pain, and certain mood disorders, affects the nervous system by modulating calcium channels and GABA neurotransmitters, which can impact sexual function. The likelihood of experiencing sexual side effects varies between individuals and may depend on dosage, which typically ranges from 300-3600 mg daily divided into multiple doses. These sexual side effects are not universal and may be more pronounced at higher doses.
Some key points to consider:
- If you're experiencing this issue while taking gabapentin, don't stop the medication abruptly, but instead consult your healthcare provider 1.
- They may adjust your dosage, recommend taking the medication at different times relative to sexual activity, or consider alternative medications if appropriate for your condition.
- Sexual side effects often resolve when the medication is discontinued or reduced, though this should only be done under medical supervision.
- Some patients find that the sexual side effects diminish over time as their body adjusts to the medication.
- Treatment for sexual dysfunction should include risk factor modification, such as smoking cessation, weight loss, increasing physical activity, and avoiding excess alcohol consumption 1.
- Referrals to specialists (ie, psychotherapy, sexual/couples counseling, urology, sexual health specialist) should be made if appropriate and available 1.
It's also worth noting that other treatments may help with orgasm issues, such as vibratory therapy, pelvic physical therapy, and PDE5 inhibitors if not contraindicated 1. However, the evidence for these effects in patients with cancer and survivors is lacking.
In terms of specific guidance, the most recent and highest quality study 1 suggests that treatment of sexual dysfunction requires a multidimensional treatment plan that addresses the underlying issues, as guided by the specific type of problem.
Overall, while gabapentin can potentially inhibit or delay orgasms, there are various treatment options available to address this issue, and patients should consult their healthcare provider to determine the best course of action.
From the FDA Drug Label
The following adverse reactions have been identified during postmarketing use of gabapentin... Reproductive system and breast disorders: ... anorgasmia The FDA drug label reports anorgasmia as an adverse reaction, which is the inability to achieve orgasm.
- Gabapentin may prevent orgasms in some patients, as evidenced by the reported adverse reaction of anorgasmia 2.
From the Research
Gabapentin and Orgasms
- Gabapentin has been reported to cause sexual dysfunction, including anorgasmia, in various studies 3, 4, 5.
- A study published in 2011 found that gabapentin-induced sexual dysfunction, including anorgasmia, can occur at a total daily dose of 300 mg 3.
- Another study published in 2011 reported that anorgasmia with gabapentin use may be common in older patients, with 3 out of 15 patients experiencing dose-dependent anorgasmia 4.
- A review of antiepileptic drugs, including gabapentin, found that they can cause sexual dysfunction, including erectile dysfunction, hyposexuality, and ejaculatory dysfunction 5.
- However, a randomized, placebo-controlled trial published in 2019 found that gabapentin improved sexual function in women with provoked vulvodynia, including arousal and satisfaction, although overall sexual function remained lower than in control subjects 6.
Key Findings
- Gabapentin can cause anorgasmia and other sexual dysfunctions, particularly in older patients 3, 4.
- The incidence of gabapentin-induced anorgasmia may be higher than previously reported, particularly in older patients 4.
- Gabapentin may improve sexual function in certain populations, such as women with provoked vulvodynia 6.
- The exact mechanisms of gabapentin's effects on sexual function are not fully understood and require further study 7, 5.