Does duloxetine cause impotence by affecting serotonin and dopamine? Not every man experiences this side effect. Learn more about the sexual side effects of duloxetine.
Duloxetine may cause impotence in some men by raising serotonin and norepinephrine levels in the brain. Although it helps fight depression and pain, high serotonin can affect sexuality. Find out how.
What is duloxetine and how does it work?
Duloxetine, also known as duloxetine hydrochloride, is a medication for depression, generalized anxiety disorder, fibromyalgia, chronic low-back pain, osteoarthritis and diabetic peripheral neuropathic pain.
It belongs to the class of serotonin-norepinephrine reuptake inhibitors (SNRIs). These neurotransmitters help regulate mood and pain perception.
After doing their job, serotonin and norepinephrine are re-absorbed by neurons. Duloxetine blocks that reuptake, keeping the neurotransmitters active longer, which may improve communication between nerve cells and contribute to therapeutic effects.
Why does duloxetine affect sexual function?
The sexual side effects of duloxetine stem from an imbalance between serotonin and dopamine.
Dopamine yields reward feelings and regulates sexual desire and pleasure. Serotonin stabilizes mood and brings calm, but in excess it dampens sexual response.
Because duloxetine boosts serotonin to lift mood and ease pain, dopamine activity is reduced or even blocked. This neurotransmitter shift may be linked to lower libido and erection difficulties in some patients.
What other sexual symptoms can occur?
Duloxetine may be associated with erectile dysfunction and other sexual function changes, such as:
- Ejaculation difficulties (delayed or absent);
- Reduced genital sensitivity;
- Orgasm problems, such as anorgasmia (complete absence of orgasm).
What to do if you notice impotence linked to duloxetine?
Seek medical advice as soon as you notice impotence or any other sexual dysfunction while on antidepressants.
Your psychiatrist—the prescriber—should be consulted first to adjust the dose, switch or add another drug.
The psychiatrist may refer you to a urologist to rule out other causes of impotence.
Do not stop the treatment on your own
Stopping duloxetine abruptly can trigger withdrawal and worsen depression.
The drug alters brain chemistry and your body needs time to adapt. Stopping suddenly may lead to:
- Sleep disturbances;
- Irritability, anxiety or agitation;
- Nausea, dizziness, headache;
- Electric-shock sensations (“brain zaps”).
Talk to your doctor
Medical follow-up is essential to treat duloxetine-induced sexual dysfunction and to check for other health issues. Discussing the condition also prevents isolation and encourages pursuit of quality of life.
Erectile dysfunction can have other causes
ED may arise from psychological and physical factors, including:
- Psychological: performance anxiety, stress, relationship problems, low self-esteem;
- Physical: diabetes, cardiovascular disease, obesity, hormonal disorders, neurologic problems, kidney disease;
- Substance abuse: smoking, vaping, alcohol, illicit drugs.
Duloxetine can cause sexual side effects, but medical guidance is crucial to identify the origin of symptoms and choose the right treatment.
If you want updates on male sexual health, check Dr. Paulo’s official channels.
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