From the Guidelines
Metoprolol can potentially cause sexual side effects, including difficulty achieving orgasm, in some patients, as evidenced by studies suggesting that beta-blockers like metoprolol can affect sexual function 1.
Background
Metoprolol is a beta-blocker medication commonly prescribed for high blood pressure, heart failure, and other cardiovascular conditions. It works by blocking certain receptors in the body that respond to adrenaline, which can inadvertently affect sexual function.
Sexual Side Effects
Sexual side effects, including difficulty achieving orgasm, occur in approximately 10-15% of patients taking beta-blockers like metoprolol. The mechanism behind these sexual side effects involves the medication's impact on blood vessel dilation and nerve signaling pathways that are important for sexual arousal and orgasm.
Management
If you experience difficulty with orgasm while taking metoprolol, do not stop the medication abruptly, as this can be dangerous. Instead, consult your healthcare provider, who may consider:
- Adjusting your dose
- Switching to a different beta-blocker with fewer sexual side effects (such as nebivolol)
- Prescribing an alternative medication class entirely
Recent Guidelines
According to the most recent guidelines, treatment of sexual dysfunction requires a multidimensional treatment plan that addresses the underlying issues, as guided by the specific type of problem 1. Referrals to specialists (ie, psychotherapy, sexual/couples counseling, urology, sexual health specialist) should be made if appropriate and available.
Key Points
- Metoprolol can cause sexual side effects, including difficulty achieving orgasm
- Sexual side effects occur in approximately 10-15% of patients taking beta-blockers like metoprolol
- Consult your healthcare provider if you experience difficulty with orgasm while taking metoprolol
- Treatment of sexual dysfunction requires a multidimensional treatment plan that addresses the underlying issues, as guided by the specific type of problem 1
From the FDA Drug Label
Central Nervous System ... reduced libido has also been reported, but a drug relationship is not clear
Potential Adverse Reactions A variety of adverse reactions not listed above have been reported with other beta-adrenergic blocking agents and should be considered potential adverse reactions to metoprolol ...
The FDA drug label does mention reduced libido, which could be related to sexual function, but it does not directly address the question of whether metoprolol can prevent orgasms. Therefore, based on the available information, it is not possible to draw a conclusion about the specific effect of metoprolol on orgasms 2.
From the Research
Metoprolol and Orgasms
- Metoprolol, a beta-blocker, has been studied for its effects on sexual function, including orgasms 3, 4, 5.
- A study comparing metoprolol to nebivolol found that metoprolol caused a significant decrease in IIEF-5 score, indicating a negative impact on sexual function, including orgasms 3.
- Another study suggested that the negative impact of metoprolol on sexual function may be due to psychological factors, such as fear of the disease and side effects of the prescribed drug, rather than a direct pharmacologic effect 4.
- A review of antihypertensive agents found that nonselective beta-adrenergic blockers, such as metoprolol, are associated with sexual dysfunction, including impotence and decreased libido 5.
Comparison to Other Medications
- A study comparing the effectiveness and safety of beta-blockers, calcium channel blockers, and angiotensin receptor blockers found that all three classes of medications had similar efficacy in reducing blood pressure, but calcium channel blockers were superior to beta-blockers and angiotensin receptor blockers in terms of safety 6.
- Another study found that nebivolol, a beta-blocker, was more effective than metoprolol in preserving sexual function, including orgasms, due to its ability to increase nitric oxide release 3.
Mechanism of Action
- The mechanism by which metoprolol affects orgasms is not fully understood, but it is thought to be related to its beta-blocking activity, which can decrease blood flow to the genital area and reduce sexual arousal 3, 5.
- The increase in nitric oxide release seen with nebivolol may help to counteract this effect and preserve sexual function, including orgasms 3.