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A commonly prescribed drug used to relieve nerve pain and seizures, gabapentin, has been linked to sexual side effects that can significantly affect quality of life. It affects all of us to different degrees, men and women alike. Not everyone experiences these issues but it’s helpful to know when they might appear so they can be managed.

Gabapentin And Its Uses

Gabapentin is a drug available by prescription. It was originally approved to help treat epilepsy and works by changing how nerves communicate with the brain [1]. Gabapentin helps quiet pain-inducing overactive nerve activity and is therefore effective at treating conditions like postherpetic neuralgia, diabetic neuropathy, and fibromyalgia. Its precise mechanism of action is unclear, although it does act to reduce the excitability of nerve cells by modulating calcium channels.

Besides its main uses, gabapentin is sometimes prescribed off-label for migraines hot flashes, and anxiety. While it is an effective remedy for illnesses involving nerves, gabapentin causes various side effects that can either seriously affect your day-to-day activities or impact your quality of life.

Gabapentin Side Effects From Long-Term Use

As with any medicine, gabapentin has its side effects. Common physical side effects include problems with coordination, dizziness, and fatigue. Gastrointestinal discomfort (nausea and diarrhea) may also occur in some users. Weight gain and swelling of the extremities (edema) have been reported.

Read Also : Dangers Of Mixing Gabapentin And Alcohol

Gabapentin could also make you feel confused, and irritable, or have psychological effects like feeling low in general. Some people on the drug might feel overly sedated or ‘foggy’. But one issue that is sometimes overlooked, and is important, is the ability of gabapentin to interfere with sexual health. To understand how gabapentin can affect sexual function, it’s important to also understand its broader side effects.

Understanding Sexual Side Effects

Sexual side effects can occur with many medications like gabapentin and are an often-underreported reason for stopping a medication. You may notice these effects as differences in your libido, trouble getting aroused, or trouble getting to climax (orgasm). Sexual health can also be impacted by medications like gabapentin, which can affect neurotransmitter levels in the brain — something that is important to sexual desire and performance.

Gabapentin is sedating or calming to the nervous system, and helpful in conditions such as nerve pain, but as it sedates the nervous system, it can reduce the ‘stimulation’ required for sexual arousal [2]. Even this can lead to a decreased interest in sexual activity or a lack of capacity to keep physical responses ready for intimacy.

Frequency Of Sexual Side Effects

Gabapentin’s sexual side effects are not as well studied as other effects of the drug. An estimated 1-5% of gabapentin users may have some sexual side effects and the true frequency may be limited due to underreporting. Reduced libido and erectile dysfunction (ED) are the most commonly reported issues.

Understanding the rate of occurrence of sexual side effects can help in making an informed decision regarding the use of gabapentin as a neuropathic pain reliever. Discussing these concerns openly with healthcare professionals allows patients to explore alternative treatments or solutions for their specific needs.

Gabapentin And Reduced Libido

Perhaps the most commonly reported sexual side effect of gabapentin is a decrease in libido or sexual desire. Users of the medication, men, and women, may find themselves with a decreased interest in having sex, which may be a result of the drug-altering neurotransmitters, such as gamma‑aminobutyric acid (GABA) [2]. Gabapentin suppresses the brain’s GABA level; which is important to regulate activity, and its suppression inadvertently dampens sexuality.

Moreover, gabapentin’s tendency to make people sleepy means that they’re also often fatigued, which can only decrease the desire for intimacy even more. Physical and emotional distancing can make it hard for users to initiate, or enjoy sexual experiences. As a result, people are left wondering: Does gabapentin suppress the sex drive? The answer lies in the drug’s dual role: it alleviates nerve pain, while simultaneously shutting down some of the neural pathways necessary for desire and arousal.

Arousal And Intimacy Challenges

Gabapentin may lead also to problems with achieving and maintaining an arousal physically. Lubrication might decrease in women and blood flow in men to the genitals, making intimacy uncomfortable. Gabapentin properties of sedation exacerbate these issues by blunting the sensory stimuli that are required for arousal.

Those who use gabapentin may experience emotional difficulties including feeling disconnection from a partner. The drug may impair mood and mental clarity enough to make intimacy difficult to maintain, straining relationships further. These effects are especially troublesome for those with already chronic conditions for whom intimacy may be a key cornerstone of emotional support.

Erectile Dysfunction In Men

Gabapentin tends to lead to erectile dysfunction (ED) for men, which is one of the more troubling sexual adverse effects of the drug. Gabapentin may affect blood flow or nerve signaling and lead to a man’s inability to get or keep an erection. 

Does gabapentin and ED play together? This phenomenon will not affect all users, nevertheless, the fact that studies and user testimonials indicate the occurrence of ED — especially with long-term use — is worrying [3].

We know that Gabapentin has a multifactorial effect on ED. Its sedative properties plus its effect on the central nervous system reduce physical response during sexual activity. This can be an issue that is frustrating and distressing for a younger guy or even if you are married, it is going to be difficult once it affects your confidence and satisfaction generally.

Delayed Orgasm Or Anorgasmia

Delayed orgasm or anorgasmia where pleasures aren’t experienced enough or experienced at all are equally concerning. In both men and women, gabapentin can affect nerve sensitivity in some way. His drug can make it hard for people to satisfy themselves in the way they’ve become used to because it suppresses the body’s natural response to sexual stimulation.

With these challenges comes questions: “How does gabapentin affect libido?” How does gabapentin change physical sexual responses? Exactly how no one knows, but we do know that the calming effect it has on the nervous system shuts down the natural processes involved with sexual performance and satisfaction.

Sexual Effects In Women

Because of the women’s unique sexual health, common complaints include vaginal dryness and sexual satisfaction. Sex is supposed to be fun, right? Vaginal dryness makes sexual activity uncomfortable, even painful, and that naturally leads to a decrease in the enjoyment of and frequency of intimacy. Gabapentin may distort the neurotransmitters and hormonal balances that control physical response and this may be the reason for this effect [4].

Moreover, women may have problems reaching orgasm, or lack sexual excitement altogether, even when they want to be sexually intimate. Gabapentin can cause a feeling of calm and/or fatigue or change of mood, and this ‘indirectly’ affects sexual health. Women who take gabapentin for chronic disease are often faced with the double whammy of having to live with the condition on top of these intimate side effects.

Sexual Effects In Men

Many men report sexual problems using gabapentin like erectile dysfunction (ED), delayed ejaculation, or sexual dissatisfaction. Beyond its physical challenges, gabapentin is one of the reasons when it comes to reducing testosterone levels [4]. The question, like many others, is, “Does gabapentin increase testosterone?” is common among users. “Gabapentin horniness” is a famous concept among habitual gabapentin users. Gabapentin research shows that while it doesn’t directly affect your testosterone levels, it affects your nervous system, and as a result could affect hormone regulation.

Another of gabapentin’s sedative properties can make men less energetic, less focused, and further detached from even attempting to perform sexually. On some occasions, these side effects can carry on after stopping the medication, and it’s crucial to keep an eye out for and tackle any of these effects with a healthcare provider.

The Role Of Mental Health

The sexual side effects of gabapentin will be amplified by its effect on mental health. According to many people on the drug who visit the clinic, they get depressed, anxious, or moody. But these mental health challenges can have a toll on individuals’ self-esteem, and can also make the interest of sex lower. Gabapentin may prove taxing to the psychological state as well if not as much as for the individual already faced with chronic pain or seizure problems.

Reduced sexual satisfaction can also create a vicious cycle like this: If you have mood disorders, you may feel inadequate or frustrated which makes you less interested and less able to perform. Addressing the mental health component of gabapentin’s side effects is highly significant to overall health, even more than the sexual health component.

Relationship Challenges

Since these side effects are sexual, this can hurt a romantic or marital relationship, if not appropriately addressed. Such medications that alter sexual behavior can confuse partners or they may feel ‘neglected’ without realizing it is the medication causing the changes in intimacy. Continuing with that unresolved over time can erode communications and lead to emotional distance.

It’s very hard to go through such phases in intimate relationships and having open conversations and professional counseling help couples get through them. Getting a deeper understanding of the root causes for the issues, like the side effects of gabapentin, can make partners find constructive solutions, no matter if that means medication change, lifestyle change, or therapy solutions.

Talking To Your Doctor

Before gabapentin’s sexual side effects are addressed, however, an open conversation with your healthcare provider needs to take place. Many people are afraid to talk about their intimate life, but they can be and usually are common matters. Gabapentin can cause problems, but doctors can tell if it’s the main cause or if something else, like something you already have or another drug, is contributing to the problem.

Your doctor may change the dosage or switch you to another drug to help you manage sexual side effects. Other nerve pain or seizure treatments that are less likely to cause sexual side effects may also be the best choice, for example. Sometimes doctors will prescribe another medication to deal with specific problems, like erectile dysfunction or low libido.

You are likely reading this article because you want to know whether gabapentin decreases your libido. Is gabapentin directly linked to ED in your case? The first step to solving these is to discuss them with a healthcare professional.

Lifestyle And Therapeutic Interventions Are Essential

Gabapentin’s sexual side effects can be mitigated with nonmedication-based strategies. For instance, regular exercise can help improve mood, boost circulation, and enhance your sexual health. Exercises (especially strength training and aerobic exercise) are especially helpful to promote blood flow and energy flow improving some of the physical side effects of gabapentin.

These side effects can be addressed by therapy or counseling. In particular, cognitive behavioral therapy (CBT) is one of the best ways to treat the stress, anxiety, or relationship anxieties associated with sexual dysfunction.

As couples, however, you can seek relationship counseling as an area to explore and resolve the emotional strain gabapentin’s side effects put on the intimacy in the relationships. Even when there are physical challenges present, open communication keeps the lines of communication open so that communication of needs and concerns, frustration, etc. leads to understanding and lends strength to the partnership.

1. Cleveland Clinic. Gabapentin. https://my.clevelandclinic.org/health/drugs/21561-gabapentin

2. Web MD. Gabapentin – Uses, Side Effects, and More. https://www.webmd.com/drugs/2/drug-14208-8217/gabapentin-oral/gabapentin-oral/details

3. Science Direct. Epilepsy And Behavior. Gabapentin-induced sexual dysfunction. https://www.sciencedirect.com/science/article/abs/pii/S1525505011002289

4. Medical News Today. What are the side effects of gabapentin? https://www.medicalnewstoday.com/articles/323753#gender-differences

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