Are there any medications, such as selective serotonin reuptake inhibitors (SSRIs), that can help eliminate erections?

Medications That Eliminate Erections

Yes, selective serotonin reuptake inhibitors (SSRIs), particularly paroxetine and sertraline, can significantly reduce or eliminate erectile function through their well-documented sexual side effects, including ejaculatory delay/failure (14% with sertraline), decreased libido (6% with sertraline), and impotence. 1

Evidence-Based Medication Options

SSRIs as Primary Agents

Paroxetine is the most effective SSRI for reducing sexual function, with the highest rates of sexual dysfunction among all SSRIs at 70.7%, significantly higher than other agents. 2 This medication provides an 8.8-fold increase in ejaculation delay and has the strongest effect on eliminating normal erectile and ejaculatory function. 3, 4

Sertraline is a well-documented alternative with FDA-confirmed sexual side effects including:

• Ejaculation failure (primarily delayed ejaculation): 14% vs 1% placebo 1
• Decreased libido: 6% vs 1% placebo 1
• Impotence: reported as "frequent" adverse event 1

The FDA explicitly states that "estimates of the incidence of untoward sexual experience and performance cited in product labeling are likely to underestimate their actual incidence" because patients and physicians are reluctant to discuss these issues. 1

Dosing Strategy

Daily SSRI therapy is more effective than as-needed dosing for producing consistent sexual dysfunction. 3 For sertraline, doses of 50-200 mg daily have been studied, with higher doses producing more pronounced sexual side effects due to the strongly dose-related nature of SSRI sexual dysfunction. 4

For paroxetine, doses of 10-40 mg daily are recommended, with 20 mg daily providing the greatest effect. 4

Treatment Algorithm

1. Start with paroxetine 20 mg daily if maximum sexual dysfunction is desired, as it has the highest rates (70.7%) among all SSRIs 2

2. Alternative: sertraline 50-100 mg daily if paroxetine is not tolerated, with documented 14% ejaculation failure rate and 6% decreased libido 1

3. Titrate upward if needed, as sexual side effects are strongly dose-related, with higher doses increasing frequency of erectile dysfunction and decreased libido 4

4. Expect onset within 1-2 weeks, as most sexual adverse effects emerge within the first few weeks of treatment 2

Critical Safety Considerations

These medications require careful medical supervision and should only be prescribed by a physician who understands your specific situation and goals. Important safety issues include:

• Serotonin syndrome risk when combining with other serotonergic medications, with symptoms including tremor, hyperreflexia, agitation, diaphoresis, fever, and in severe cases seizures 4

• Never combine SSRIs with MAOIs due to risk of potentially fatal serotonin syndrome 4

• Gradual taper required when discontinuing to prevent SSRI withdrawal syndrome (dizziness, nausea, headache, flu-like symptoms) 4

• Monitor for mood changes, particularly in patients under age 24, as there is elevated risk of suicidal ideation, though this has not been specifically found in non-depressed men 4

• Contraindicated in bipolar depression as SSRIs can trigger mania 3

Expected Outcomes and Persistence

Sexual dysfunction typically persists throughout treatment and symptoms often return after discontinuation, meaning the effects are generally reversible when the medication is stopped. 3 Approximately 40% of patients discontinue paroxetine within 12 months due to sexual side effects, cost, or treatment effects below expectations. 4

Important Caveats

This is an off-label use of these medications. SSRIs are FDA-approved for depression, anxiety disorders, and other psychiatric conditions—not for intentionally eliminating erectile function. 1 The sexual side effects described are considered adverse events in standard medical practice.

A thorough discussion with your physician is essential to understand your motivations, explore all options, and ensure this approach aligns with your overall health goals and psychological well-being. There may be underlying issues that would be better addressed through other means, including psychological counseling or other medical interventions depending on your specific situation.