ED Endocrine Risk Factors: Selective Serotonin Reuptake Inhibitors, Antihypertensive Agents, Statins
Selective Serotonin Reuptake Inhibitors Selective serotonin reuptake inhibitors (SSRIs) have gained notoriety as a common cause of several manifestations of sexual dysfunction. SSRI-induced ED rather than sexual dysfunction, though, is rarely reported in the literature and is limited mostly to case reports.
Antihypertensive Agents Several antihypertensive agents have been implicated in ED, yet the evidence is limited. Older thiazide diuretic treatments have been associated with mild effects on erectile function.
Many of these studies have limited clinical implications as they were conducted with chlorthalidone, a thiazide-like diuretic. A recent study suggested that beta-blocker-induced ED is likely psychogenic rather than organic. Clonidine is reported to cause ED in both human and animal studies through agonism of central alpha-2 adrenoreceptors.
Statins Statins are HMG-CoA reductase inhibitors that are a commonly used medication for the treatment of hyperlipidemia. Do et al. conducted a study to investigate the association between exposure to statins and the occurrence of ED. The study was limited to males age 18–30. They found a statistically significant association for statins with induction and worsening of ED. Further studies are needed to distinguish the severity of the effect on ED between the many different statin drugs that are currently in use.