Can gabapentin (Neurontin) cause erectile dysfunction (ED)?

From the Guidelines

Gabapentin can cause erectile dysfunction as a side effect, although the provided evidence does not directly address this issue. The American College of Physicians recommends treating erectile dysfunction with a PDE-5 inhibitor, which has high-quality evidence supporting its effectiveness 1. However, this does not directly relate to gabapentin's potential to cause erectile dysfunction. Some key points to consider when evaluating the potential for gabapentin to cause erectile dysfunction include:

• The medication's mechanism of action, which affects the nervous system and can potentially interfere with sexual function
• The dose-dependent nature of the risk, with higher doses more likely to cause problems
• The importance of consulting a healthcare provider if erectile dysfunction is experienced while taking gabapentin, as they may adjust the dosage or recommend alternative strategies to manage this side effect It is essential to note that the provided evidence focuses on the treatment of erectile dysfunction rather than its causes, and the decision to use gabapentin should be made with caution, considering the potential risk of erectile dysfunction as a side effect. If a patient is experiencing erectile dysfunction while taking gabapentin, their healthcare provider may consider alternative medications or adjustments to their treatment plan to minimize this side effect 1.

From the Research

Gabapentin and Erectile Dysfunction

• Gabapentin has been reported to cause sexual dysfunction, including erectile dysfunction, at a minimum total daily dose of 900 mg 2.
• However, a case report suggests that gabapentin-induced sexual dysfunction can occur at a total daily dose as low as 300 mg, resulting in total sexual dysfunction, including loss of libido, anejaculation, anorgasmia, and impotence 2.
• The exact mechanism of gabapentin-induced erectile dysfunction is not well understood, but it is thought to be related to its effects on the central nervous system.
• Other studies have focused on the treatment of erectile dysfunction using phosphodiesterase type 5 (PDE5) inhibitors, which are a different class of medications than gabapentin 3, 4, 5, 6.
• These studies suggest that PDE5 inhibitors are effective in treating erectile dysfunction, but they do not provide information on the potential effects of gabapentin on erectile function.

Comparison with PDE5 Inhibitors

• PDE5 inhibitors, such as sildenafil, tadalafil, and vardenafil, are commonly used to treat erectile dysfunction and have been shown to be effective in improving erectile function 3, 4, 5, 6.
• In contrast, gabapentin is not typically used to treat erectile dysfunction and may actually contribute to the development of sexual dysfunction, including erectile dysfunction 2.
• The choice of treatment for erectile dysfunction depends on various factors, including the underlying cause of the condition, the presence of any underlying medical conditions, and the patient's preferences and lifestyle 3, 4, 6.