Clinically verified byKatelyn Hagerty, FNP
Written by our editors
Last update on 02/26/2021
If you've been diagnosed with high blood pressure, angina, or a recent heart attack, your doctor may prescribe a drug called metoprolol.
Metoprololit is a beta blocker. It works by relaxing the blood vessels and slowing the heart, lowering blood pressure and improving circulation.
While metoprolol is generally safe and effective, it can cause some side effects, including erectile dysfunction.
Below we provide more information about metoprolol and how it works to treat high blood pressure and cardiovascular disease, as well as the risk of side effects such as erectile dysfunction.
We also explain what you can do to treat erectile dysfunction and improve your sexual performance if you are prescribed beta-blockers such as metoprolol.
What is metoprolol?
Metoprolol is a type of beta-blocker drug. It is marketed under several brand names, including Lopressor®.
Currently, metoprolol is used to treat high blood pressure (hypertension) and angina, a form of chest pain caused by an insufficient supply of oxygenated blood to the heart.
It is also prescribed after a myocardial infarction or heart attack to improve survival and reduce the risk of complications. Metoprolol is often used with other medications to treat other cardiovascular health problems, including heart failure.
As acardioselective beta-blocker, metoprolol works by binding to beta-1 receptors found on heart cells. it ishelps block the effectshormones like adrenaline, which normally make your heart beat faster and harder.
After taking a beta-blocker such as metoprolol, your heart usually beats more slowly and with better electrical conductivity. Beta blockers like metoprolol also help relax blood vessels and lower blood pressure throughout the body.
When used as directed, medications like metoprolol can improve your overall health and quality of life if you have cardiovascular disease.
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Does metoprolol cause erectile dysfunction?
Beta blockers like metoprolol are safe and effective for most people. However, like many other medications, they can have side effects. Common side effects of metoprolol include:
dizziness or lightheadedness
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to throw up
skin rash or itching
gas or bloating
Cold hands and/or feet
Because beta-blockers like metoprolol affect your blood pressure, they arecan cause erectile dysfunction.
Several studies have found that men taking metoprolol may have associated difficulties getting and maintaining an erection.
For example,a studypublished in Clinical and Experimental Pharmacology and Physiology, found that men with hypertension who used metoprolol had lower mean scores on an erectile function survey than men who used other treatments.
Aother studypublished in the Annals of Thoracic and Cardiovascular Surgery, concluded that the use of beta-blockers, including metoprolol, increases the risk of erectile dysfunction in men with ischemic heart disease.
While this may suggest that there is a clear link between metoprolol and erectile dysfunction, other research has suggested that the link may be psychological rather than physical.
For example,a study of men with hypertensionfound that their response to metoprolol varied depending on whether or not they were told before starting treatment that the drug could cause erectile dysfunction.
In the study, 114 men received metoprolol to treat high blood pressure. The men were divided into three groups.
The first group was told that they were being treated with metoprolol and that metoprolol could cause erectile dysfunction. The second group was partially informed, i. H. they were told they would receive metoprolol but were not informed of the possible risk of erectile dysfunction.
Men in the third group were not informed about the drugs they were receiving or their side effects.
After 60 days of treatment, 32% of the men in the first group (fully informed) reported erectile dysfunction as a side effect of metoprolol. In comparison, only 13% of men in the second group (partially informed) and 8% of men in the third group (unaware) reported erectile dysfunction.
Interestingly, men who reported erectile dysfunction were treated with either tadalafil (the active ingredient in the erectile dysfunction drug Cialis®) or a non-therapeutic placebo. Researchers found that both treatments were equally effective in treating erectile dysfunction.
A similar study of atenolol, another beta-blocker used to treat heart disease, achieved a similar result.
The results of these studies suggest that the erectile dysfunction experienced by some men taking metoprolol and other beta-blockers may be, at least in part, psychological.
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Treatment of Erectile Dysfunction (ED)
Erectile dysfunction is a common problem, both in men who take beta-blockers and in men in general.According to the National Institutes of Health, approximately 30 million men in the United States are affected by some degree of erectile dysfunction.
ED can vary in severity. You can get an erection sometimes, but not consistently enough to have sex whenever you want. Alternatively, you may find it difficult to get hard long enough to have satisfying penetration sex with your partner.
If you are prescribed metoprolol or any other beta-blocker and are finding it harder to get or keep an erection, it is best to talk to your doctor. Based on your needs and overall health, they may suggest one of the following treatment options.
change of medication
In some cases, you can treat erectile dysfunction and improve your sexual performance by switching metoprolol to another drug.
You should never switch medications or stop taking metoprolol on your own. Instead, contact your doctor to inform them that you have erectile dysfunction after starting treatment with metoprolol.
Based on your cardiovascular health and specific needs, your doctor may suggest switching from metoprolol to another drug that is less likely to affect your erectile health and sexual performance.
Using medication for ED
Erectile dysfunction is usually treatable with prescription drugs. These drugs work by increasing blood flow to the penis, making it easier for you to develop and maintain an erection when you are feeling sexually aroused.
Several medications are currently available specifically to treat erectile dysfunction:
Sildenafil.The active ingredient inViagra®, Sildenafil (generic for Viagra) is fast-acting and provides ED relief for about four hours per dose.
Tadalafil.The active ingredient in Cialis, Tadalafil, is a long-acting drug that can relieve erectile dysfunction for up to 36 hours per dose.
Vardenafil.The active ingredient in Levitra®, vardenafil, treats erectile dysfunction at a slightly longer dose than sildenafil.
Avanafil.Avanafil, sold under the brand name Stendra®, is a newer erectile dysfunction medication that works quickly and is less likely to cause certain side effects.
We offer differentED medicine, after consulting a doctor who will decide if a prescription is appropriate.
While erectile dysfunction medications are safe for most men, they can interact with some medications used to treat high blood pressure and other cardiovascular health problems.
For example, the use of erectile dysfunction drugs such as sildenafil and others with nitratescan cause a sudden drop in blood pressure. We discuss these security issues in more detail belowour guide to treating erectile dysfunction for men with heart disease.
Be sure to let your doctor know about all medications you are currently taking when discussing sildenafil, tadalafil, and other treatments.
make lifestyle changes
While erectile dysfunction is usually treated with medication, certain changes in your habits and lifestyle can improve your erectile health and make it easier for you to develop and maintain an erection.
Many of the same habits and lifestyle changes that can improve your erectile health also have benefits for your cardiovascular health. Attempt:
Train often.Regular exercise can improve blood flow to your body, making it easier to get and keep an erection.
If you have been given metoprolol to treat a cardiovascular health problem, talk to your doctor before you start exercising. They can advise you on how to exercise safely.
Eat a balanced diet.Try to eat a balanced diet based on nutrient-dense foods like fruits, vegetables, whole grains, fish, and lean protein sources.Seeksuggests that the Mediterranean diet may help improve erectile health in men.
Stop smoking.Smoking can damage blood vesselsmaking it harder for blood to flow to your peniswhen you are sexually aroused. Likewise, the nicotine in tobacco can have a negative effect on sexual arousal and erectile health.
If you are a smoker, try to quit. Learn more about the most effective ways to quit smokingour guide to quitting.
Our guide to protecting your erection naturallygoes into more detail about lifestyle changes and habits that can improve your erectile health.
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Studies suggest that beta-blockers like metoprolol can cause erectile dysfunction. However, we still don't know if this is a physical side effect of metoprolol and other beta-blockers or a psychological one.
If you have been prescribed metoprolol and are having trouble getting or keeping an erection, talk to your doctor.
Based on their advice, you may be able to treat your erectile dysfunction and improve your sexual performance by switching to a different beta-blocker, adjusting your dosage, or using erectile dysfunction medication.
Hims & Hers has strict sourcing policies to ensure our content is accurate and up to date. We rely on peer-reviewed studies, academic research institutions and medical associations. We strive to use primary sources and refrain from using tertiary references.
- metoprolol. (2017, September 15). recovered fromhttps://medlineplus.gov/druginfo/meds/a682864.html
- Beta blockers: Cardiac all-rounders. (2011, December). retrieved fromhttps://www.health.harvard.edu/heart-health/beta-blockers-cardiac-jacks-of-all-trades
- beta blockers. (n.d.). recovered fromhttps://www.texasheart.org/heart-health/heart-information-center/topics/beta-blockers/
- Drugs for blood pressure and erectile dysfunction: what you need to know. (2017, May). retrieved fromhttps://www.health.harvard.edu/mens-health/blood-pressure-drugs-and-ed-what-you-need-to-know
- Brixius, K., Middeke, M., Lichtenthal, A., Jahn, E. & Schwinger, R.H.G. (2007, April). Nitric oxide, erectile dysfunction and beta-blocker treatment (MR-NOED study): benefit of nebivolol over metoprolol in men with hypertension. Clinical and experimental pharmacology and physiology. 34(4), 327-31. retrieved fromhttps://pubmed.ncbi.nlm.nih.gov/17324145/
- Gür, O., Gurkan, S., Yumun, G. & Turker, P. (2017). Comparison of the effects of nebivolol and metoprolol on erectile dysfunction in myocardial revascularization surgery. Annals of Thoracic and Cardiovascular Surgery. 23(2), 91-95. retrieved fromhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5422634/
- Coco, G. (2009). Erectile dysfunction after metoprolol therapy: the Hawthorne effect. Cardiology. 112(3), 174-7. retrieved fromhttps://www.researchgate.net/publication/51427477_Erectile_Dysfunction_after_Therapy_with_Metoprolol_The_Hawthorne_Effect
- Silvestri, A., et al. (2003, November 1). The report of erectile dysfunction after beta-blocker therapy is related to the patient's knowledge of side effects and is reversed by placebo. European Journal of the Heart. 24 (21), 1928-1932. retrieved fromhttps://academic.oup.com/eurheartj/article/24/21/1928/450074
- Erectile dysfunction definition and facts. (2017, July). retrieved fromhttps://www.niddk.nih.gov/health-information/urological-diseases/erectile-dysfunction/definition-facts
- VIAGRA® (Sildenafil Citrate) oral tablets. (2014, March). retrieved fromhttps://www.accessdata.fda.gov/drugsatfda_docs/label/2014/20895s039s042lbl.pdf
- Skrypnik, D., Bogdanski, P. & Musialik, K. (2014, Fieber).Obesity - a major risk factor for erectile dysfunction in men. Merkuriusz Polish doctor. 36(212), 137-41. retrieved fromhttps://pubmed.ncbi.nlm.nih.gov/24720114/
- assessment of your weight. (2020, September 17). retrieved fromhttps://www.cdc.gov/healthyweight/assessing/index.html
- Esposito K, Giugliano F, Maiorino MI. & Giugliano, D. (2010, July). Dietary factors, Mediterranean diet and erectile dysfunction. The Journal of Sexual Medicine. 7(7), 2338-45. retrieved fromhttps://pubmed.ncbi.nlm.nih.gov/20487239/
- Harte, C.B. & Meston, C.M. (2008, January). Acute effects of nicotine on physiological and subjective sexual arousal in nonsmoking men: a randomized, double-blind, placebo-controlled study. Journal of Sexual Medicine. 5(1), 110-121. retrieved fromhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2864030/
This article is for informational purposes only and does not constitute medical advice. The information contained in this document is not a substitute for, and should never be relied on, professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standardson here.
Interactions between your drugs
Sildenafil can add to the blood pressure-lowering effect of metoprolol. Contact your doctor if you experience signs and symptoms of low blood pressure such as dizziness, lightheadedness, fainting, flushing, headache, or a rapid pulse or heart rate.
Epinephrine constricts your blood vessels and causes blood to pump more forcefully. It's thought that by blocking these receptors, beta-blockers may interfere with the part of your nervous system responsible for causing an erection.What heart medications cause erectile dysfunction? ›
Heart medications such as digoxin, beta-blockers, diuretics and spironolactone can cause erectile dysfunction. Erectile dysfunction medications sildenafil (Viagra), vardenafil (Levitra, Staxyn), tadalafil (Cialis) and avanafil (Stendra) relax blood vessel muscles in the heart, lungs and penis.Are there any beta-blockers that don't cause erectile dysfunction? ›
Beta blockers that are called 'cardio-selective' are those that only block the beta-1 receptors and do not tend to cause ED. Examples of cardio-selective beta blockers are metoprolol, acebutalol, esmolol, and atenolol. Some beta blockers also block certain alpha receptors as well, which can cause ED.What are the dangers of taking metoprolol? ›
Metoprolol may worsen the symptoms of heart failure in some patients. Check with your doctor right away if you are having chest pain or discomfort, dilated neck veins, extreme fatigue, irregular breathing or heartbeat, swelling of the face, fingers, feet, or lower legs, trouble breathing, or weight gain.How long can you stay on metoprolol? ›
Treatment with metoprolol is usually long term, possibly even for the rest of your life. Stopping metoprolol suddenly can make your condition worse, so talk to your doctor first. If you're bothered by any side effects, your doctor may be able to prescribe a different medicine for your heart problems.What is the best beta blocker to avoid erectile dysfunction? ›
Conclusions: Nebivolol is a beta-blocker option recommended to avoid ED because of its lower risk of ED compared with other beta-blockers. Bisoprolol was found to be associated with a higher risk of ED, followed by atenolol, metoprolol, and carvedilol, respectively.Do beta-blockers cause permanent erectile dysfunction? ›
ED is an occasional side effect of BP drugs like thiazide diuretics, loop diuretics, and beta-blockers, all of which can decrease blood flow to the penis and make it difficult to get an erection. However, other BP drugs, such as alpha-blockers, ACE inhibitors, and angioten-sin-receptor blockers, rarely cause ED.What is the best blood pressure medication for ED? ›
Studies have suggested that losartan, a type of high blood pressure medication, may improve ED by preventing the constriction (narrowing) of blood vessels and increasing blood flow into the penis during sexual arousal.What is the fastest way to cure ED? ›
Using oral medication
You can get quick results through oral medications such as Viagra, Cialis, Levitra, Staxyn, or Stendra. These pills boost blood flow to the penis during sexual arousal, making it possible to achieve an erection that is firm enough for satisfactory sexual intercourse.
Pills that are safe for ED after a heart attack
- sildenafil (Viagra)
- vardenafil (Levitra)
- tadalafil (Cialis)
- VED (Vacuum Erection Device) Often called a penile pump, a VED works by manually pulling blood into your penis using suction. ...
- Testosterone replacement. ...
- Urethral suppository. ...
- Penile injections. ...
- Penile implant.
People with erectile dysfunction can still get hard and experience orgasm. However, it may not be as frequent as a person previously experienced. Underlying conditions, such as diabetes or cardiovascular disease, can contribute to a person's ED.Does metoprolol affect testosterone? ›
Metoprolol affects both total and free testosterone levels (Rosen et al., 1988; el Sayed et al., 1998).Which of the following is a common side effect of metoprolol? ›
The most common (>2%) adverse reactions are tiredness, dizziness, depression, diarrhea, shortness of breath, bradycardia, and rash.Is 25mg of metoprolol a lot? ›
Typical dosing for metoprolol succinate (Toprol XL)
Adults: The typical dose is 25 mg to 100 mg by mouth once a day. Children 6 years and older: The dose is based on your child's weight. The typical starting dose is 1 mg/kg of body weight by mouth once a day.
Cardiac index (CI) and motor function had improved along with better QoL after metoprolol treatment in both the genders. In both age groups (<60 and ≥60 years), improvement in cardiac function, motor function, and QoL was observed; however, there was a difference in mental status.Is 200 mg of metoprolol a lot? ›
The recommended dose range for metoprolol [succinate] for treating chest pain is 100 to 400 mg once a day. The recommended dose range for metoprolol [succinate] for treating heart failure is 12.5 to 200 mg once a day.What drugs should not be taken with metoprolol? ›
Conclusion: Metoprolol should not be used concomitantly with paroxetine, fluoxetine or bupropion due to extensive interactions and the risk of serious adverse effects.What is metoprolol mainly used for? ›
Metoprolol: medicine for high blood pressure (hypertension) - NHS.
Erectile dysfunction can result from high blood pressure. While treating high blood pressure with medication and lifestyle changes may improve erectile dysfunction, some damage from chronic hypertension may be irreversible.Does erectile dysfunction from medication go away? ›
In many cases, yes, erectile dysfunction can be reversed. A study published in the Journal of Sexual Medicine found a remission rate of 29 percent after 5 years. It is important to note that even when ED cannot be cured, the right treatment can reduce or eliminate symptoms.Does erectile dysfunction go away after stopping medication? ›
For most people, erectile dysfunction from antidepressants is not permanent. Many people see a gradual return of their libido and sexual function after they stop taking SSRIs. 3 However, some people may experience post-SSRI sexual dysfunction syndrome, in which sexual side effects persist for months or even years.What do doctors recommend for erectile dysfunction? ›
- Sildenafil (Viagra)
- Tadalafil (Adcirca, Cialis)
- Vardenafil (Levitra, Staxyn)
- Avanafil (Stendra)
A penile erection can normally last anywhere from a few minutes to about half an hour. On average, men have five erections a night while they're sleeping, each lasting about 25 to 35 minutes (Youn, 2017).Which blood pressure medication is least likely to cause erectile dysfunction? ›
Drugs known as ARBs (angiotensin II receptor blockers, like losartan (Cozaar) are not only unlikely to cause erection problems, but they may improve sexual function in men with high blood pressure.Why do I keep losing my erection? ›
Erectile dysfunction is common, and there are many things you can do to manage it. A variety of factors may be causing your ED. These include your lifestyle, alcohol intake, some medications, diseases, disorders, and psychological stress. Depending on the cause, several effective strategies and treatments exist.Can a cardiologist treat erectile dysfunction? ›
Erectile dysfunction (ED) is the medical term for trouble getting or maintaining an erection that is satisfying for sexual activities. Doctors for ED include urologists, endocrinologists, cardiologists, and mental health professionals.Is erectile dysfunction a symptom of heart failure? ›
Erectile dysfunction — the inability to get and keep an erection firm enough for sex — can be an early warning sign of current or future heart problems. Likewise, if you have heart disease, getting the right treatment might help with erectile dysfunction.Does morning wood stop when you get older? ›
It's an indication of typical blood and nerve supply to the penis. Most young men will experience morning wood several times per week. As men grow older, they begin experiencing it less frequently. If you stop experiencing NPT, this may be an early sign of an underlying medical problem.
- Tobacco use.
- Peyronie's disease — development of scar tissue inside the penis.
- Alcoholism and other forms of substance abuse.
- Sleep disorders.
- Treatments for prostate cancer or enlarged prostate.
- Surgeries or injuries that affect the pelvic area or spinal cord.
- Low testosterone.
Many cases of it respond well to lifestyle changes, medications, surgery, or other treatments. Even if your efforts to treat ED are unsuccessful, you and your partner can still enjoy physical intimacy and a satisfying sexual life.How can I test myself for erectile dysfunction? ›
Another test called a penile plethysmograph can be performed by individuals themselves at home. This test uses a device to distinguish between physical and psychological ED as a man watches or listens to sexual material.How common is erectile dysfunction with beta-blockers? ›
The incidence of erectile dysfunction was 3.1% (only 1 patient) in the group not knowing which drug they were taking, 15.6% (5 patients) in the group knowing that they were receiving a beta-blocker and 31.2% (10 patients) in the group also knowing the side effects of the drug (P<0.01) (Fig. 2).Does high blood pressure cause erectile dysfunction? ›
Men with hypertension are almost twice as likely to have impaired penile blood flow and erectile dysfunction compared to men with normal blood pressure, increasing their risk of heart disease and death. High blood pressure damages artery walls, causing them to harden and narrow, and reducing blood flow to the penis.What blood pressure medicine should not be taken with Viagra? ›
Another type of drug that lowers blood pressure is a nitrate drug. Nitrate drugs are used in people with heart disease to relieve chest pain called angina. You should not use Viagra if you use a nitrate drug. This can also lead to a dangerous drop in blood pressure.Can I take Viagra while on blood pressure medicine? ›
Can I take Viagra if I have high blood pressure? For many patients with hypertension, taking Viagra and other ED medication – such as Stendra, Cialis, and Levitra – is safe, effective, and appropriate.Can you take Viagra if you are on heart medication? ›
Can you take Viagra and PDE5 inhibitors if you are taking heart medications? They can be taken with most medicines for your heart, but not nitrates (GTN) or nicorandil, which are used to treat angina.Can a person on high blood pressure medication take Viagra? ›
Erectile dysfunction medicines and high blood pressure
These medicines include sildenafil (Revatio, Viagra), vardenafil, avanafil (Stendra) and tadalafil (Adcirca, Cialis, others). The pill forms generally are thought to be safe for men with high blood pressure who are otherwise in good health.
ED is an occasional side effect of BP drugs like thiazide diuretics, loop diuretics, and beta-blockers, all of which can decrease blood flow to the penis and make it difficult to get an erection. However, other BP drugs, such as alpha-blockers, ACE inhibitors, and angioten-sin-receptor blockers, rarely cause ED.
If your erectile dysfunction is caused by high blood pressure, then lowering your blood pressure with healthy changes to your lifestyle, could be enough to improve your erections without any other treatments.Can ED from high blood pressure be reversed? ›
ED from high blood pressure can be reversed, especially if you are generally healthy and high blood pressure is the sole culprit.