Which medication classes, in addition to antidepressants, may contribute to erectile dysfunction?

• A. Diuretics
• B. Proton pump inhibitors
• C. Antihistamines
• D. Statins

Answer: (A)

Erectile function depends on adequate penile blood flow, neural signaling, and hormonal balance, and many medications can disrupt one or more of these pathways. Diuretics are known to contribute to erectile dysfunction because they lower intravascular volume and blood pressure and can disturb electrolyte balance, which can blunt the vascular relaxation and blood inflow needed for an erection. Some potassium-sparing diuretics like spironolactone also have antiandrogen effects that can further reduce erectile function. Proton pump inhibitors don’t have a strong, consistent link to ED. Antihistamines can have anticholinergic effects that might affect erections in some individuals, but this is not a robust or common cause. Statins generally improve endothelial function and lipid profiles, and they are not considered contributors to ED; they may even help in some cases. So, diuretics are the medication class most likely to contribute to erectile dysfunction in addition to antidepressants.