Xanax (alprazolam) can cause sexual side effects, including low libido (sex drive) and erectile dysfunction (ED).1 Xanax is a prescription medication used to treat anxiety disorders, such as generalized anxiety disorder (GAD) and panic disorder. It is also sometimes used to treat insomnia, muscle spasms, and seizures.2
Xanax belongs to the benzodiazepine drug class, which works by slowing down central nervous system (CNS) activity. Some of the most common side effects of Xanax include drowsiness, dry mouth, irritability, dizziness, headache, and difficulty concentrating.2
This article will discuss why Xanax causes sexual dysfunction for some people, how to manage Xanax and ED, and more.
Does Xanax Cause ED?
Many prescription medications used to treat mental health conditions have sexual side effects. Recent research shows that Xanax (alprazolam) has been linked to erectile dysfunction (ED). ED can involve difficulty getting or sustaining an erection, abnormal ejaculation, and delayed or diminished orgasms.3
In clinical trials, people who were taking Xanax for symptoms of panic disorder experienced sexual dysfunction. Of the people who took Xanax, 7.4% reported having sexual side effects compared to 3.7% of people who were given a placebo (an inactive pill).4
In another study, people with panic disorder symptoms experienced a reduced sex drive, orgasm dysfunction, and ED when taking Xanax.5 Results from a Boston Area Community Health Survey in 2013 also associated long-term benzodiazepine use with increased ED symptoms among people aged 30 to 79.1
Xanax Sexual Side Effects
Xanax has been linked to a number of possible sexual side effects, including:
- Erectile dysfunction
- Anorgasmia (diminished ability to orgasm)
- Delayed ejaculation
- Low libido
- Orgasm dysfunction
The risk of sexual side effects from Xanax may increase for people who take it more often, for a longer period of time, and/or at a higher dose. A 2018 case study revealed that higher doses of alprazolam could raise the risk for anorgasmia among male patients.6
Causes of Erectile Dysfunction
It’s not entirely clear why Xanax sometimes causes ED. However, researchers believe that the answer could be related to how the drug affects the central nervous system (CNS).
Benzodiazepines like Xanax work by slowing down CNS activity and increasing the levels in the brain of certain neurotransmitters (chemicals that carry signals between nerve cells), specifically dopamine and gamma amino-butryric acid (GABA)—a neurotransmitter that acts as a sort of sedative.7
While this mechanism effectively reduces stress, it may have the same inhibitory effect on libido and sex drive. Low libido can lead to ED and other kinds of sexual dysfunction.
Even if your ED symptoms started around the time you began taking Xanax, it’s possible that your symptoms are due to another physical or mental health condition. Other common causes for ED may include:3
- Heart disease
- High blood pressure
- Thyroid conditions
- Diabetes
- Multiple sclerosis (MS)
- Low testosterone
- Taking other prescription medications
- Drug or alcohol use
- Stress
- Depression
- Relationship problems
- Lack of sleep
Most people take Xanax to treat symptoms of anxiety and other mental health conditions. Because anxiety and depression have both been linked to (and can exacerbate) ED, it’s important to address your underlying conditions as well as any sexual side effects you might experience from Xanax.8
Managing Erectile Dysfunction on Xanax
There are several possible ways to manage Xanax-related sexual dysfunction, including:
- Lowering your dose: Under the supervision of your healthcare provider, you might be able to take a lower dose of Xanax to decrease the severity of sexual side effects.6
- Taking Xanax less frequently: Chronic and frequent use of benzodiazepines is linked to higher rates of ED.1 Taking Xanax less often may improve your sexual functioning. Discuss your dosing schedule with your healthcare provider.
- Switching to another medication: Your healthcare provider might be able to prescribe another antianxiety medication with a lower risk of ED.
- Taking medications for ED: Taking prescription medications to treat ED may counteract the sexual side effects of Xanax.
- Treating underlying conditions: Treating the symptoms of underlying conditions, such as anxiety and depression, can improve your overall sexual health.
Talk to Your Healthcare Provider
If you experience ED or other sexual side effects while taking Xanax, talk to your healthcare provider. They may be able to prescribe another medication, lower your dose, or refer you to another specialist who can help.
Summary
Xanax (alprazolam) is a common prescription medication that belongs to the class of drugs known as benzodiazepines. Usually, Xanax is prescribed to treat anxiety disorders and panic disorder. It may also be prescribed to treat seizures, insomnia, and muscle spasms.
Some people who use Xanax report experiencing sexual side effects. In addition to erectile dysfunction (ED), some people with Xanax experience reduced sex drive, anorgasmia, problems with ejaculation, and orgasm dysfunction. These sexual side effects may be due to the drug’s effects on the central nervous system.
People who experience ED while taking Xanax should talk to their healthcare provider about how their treatment could be modified to reduce this side effect.
A Word From Verywell
If you are experiencing sexual side effects while taking Xanax, don’t be afraid to reach out to your healthcare provider. They can offer alternatives and other solutions to help you treat your condition while improving your sexual functioning.
Frequently Asked Questions
Antidepressant medications and other psychotropic drugs can cause erectile dysfunction (ED) by affecting the activity of hormones and neurotransmitters. For example, selective serotonin reuptake inhibitors (SSRIs) may cause sexual side effects due to the drug’s impact on serotonin, dopamine, and testosterone levels.9
Xanax (alprazolam), which is usually prescribed to treat anxiety, may cause ED and reduce sexual drive by slowing down central nervous system activity.7
In addition to sexual side effects such as erectile dysfunction and low libido, Xanax can cause side effects like headache, drowsiness, irritability, difficulty concentrating, difficulty urinating, dizziness, nausea, constipation, and changes in appetite.
More severe side effects may include difficulty breathing, skin rashes, problems with speech or coordination, seizures, and disorientation.2 If you have any of these side effects, seek medical attention immediately.
It’s unclear exactly how Xanax (alprazolam) affects testosterone levels, as research is limited. The only study found was an older one on rats that showed Xanax did not affect testosterone levels.10
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