Does Metformin Cause Erectile Dysfunction?

Does metformin cause erectile dysfunction? We'll discuss the effects of this medication and what you can do if it's causing you to experience ED.

Dr. Kelly Walker
By The Promescent Team Medically reviewed by Dr. Kelly Walker Last updated 12/11/2023

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can taking metformin cause erectile dysfunction

Unfortunately for some men, one of the complications with Type 2 diabetes is experiencing erectile dysfunction. The disease is known for negatively impacting nerves and blood vessels that lead to an erection.

Metformin is a common drug that’s prescribed to treat the condition. But since medication is the cause of 25% of ED cases, it’s important to ask the following question.

Quick FAQs

Metformin is a medication that's mainly prescribed to treat Type-2 diabetes.

While metformin can lower testosterone and potentially cause ED in some patients, because it treats diabetes, which is also a cause of ED, it may improve erectile function.

A doctor may recommend solutions such as trying an alternative medication, making lifestyle changes, or using a PDE5 inhibitor such as Viagra or Cialis.

Does Metformin cause erectile dysfunction? We’ll discuss how diabetes causes ED, what metformin is, and its potential side effects.

How diabetes causes ED

Diabetes is a condition where the body is unable to maintain healthy levels of blood sugar. In most cases, it’s the result of a lack of insulin, which is responsible for regulating blood sugar.

Type 2 diabetes is the most common form of diabetes. It can lead to issues such as nerve damage and heart disease, which can both affect erectile function.

Other health issues that are common with diabetes that can affect erectile dysfunction include:

What is Metformin?

Metformin is a widely prescribed medication primarily used to manage type 2 diabetes. It belongs to the class of drugs known as biguanides.

Metformin helps regulate blood sugar levels by reducing glucose production in the liver and increasing insulin sensitivity.

Does Metformin Cause Erectile Dysfunction?

While metformin is an effective medication for managing diabetes, there have been some concerns about the potential link between metformin usage and erectile dysfunction.

When we asked Dr. Kelly Walker of Posterity Health, she stated, “While metformin is generally not known to cause erectile dysfunction as a direct side effect, there is some research that suggests that it may indirectly contribute to sexual issues in some individuals.”

One theory of why metformin may lead to ED is its hormonal effects. The drug can cause a reduction in testosterone. As a result of the reduced testosterone, men may experience low sex-drive and erectile dysfunction.

As Dr. Walker states, “Yes, metformin has been found to potentially reduce testosterone levels in some studies. This reduction in testosterone may contribute to sexual dysfunction, including erectile dysfunction.”

Though with that said, it’s also possible that metformin may help with ED. Given that the drug treats diabetes, it’s likely erectile function would improve.

One study on rats found that metformin enhanced nitric oxide production. Nitric oxide has been proven to help men have erections by relaxing the vascular muscle that supplies blood to the penis when sexual arousal occurs.

Pro Tip: VitaFLUX Nitric Oxide Booster can help to relax blood vessels and allow more blood flow through increased nitric oxide production.

In the journal, Translational Andrology and Urology, researchers concluded that metformin can help improve ED. They noted the following three factors that led to this conclusion:

  • Metformin was found to have increased transcription of nitric oxide synthase in erectile issues.
  • Metformin regulated sympathetic tone. When sympathetic tone is elevated, it can potentially cause ED.
  • Men treated with metformin reported higher IIEF-5 scores. IIEF, or international index of erectile function, is a multidimensional scale that assesses erectile dysfunction.

How to Treat ED Caused by Metformin

As a male fertility specialist, Dr. Walker primarily helps men overcome common infertility issues like low sperm counts or conditions like oligospermia, and many of those treatment strategies may be applied to improve sexual function in others. These include:

  • Modifying medications
  • Employing combination therapies
  • Eliminating bad habits
  • Exercising regularly
  • Visiting a psychologist

If you are experiencing erectile dysfunction while taking metformin or have concerns about its impact on your sexual health, it is essential to consult with your healthcare provider. 

They can provide personalized advice based on your specific medical history and help explore potential solutions. Here are a few potential solutions that may be recommended

Alternative Medications

Depending on your individual circumstances, your healthcare provider might explore alternative diabetes medications that have a lesser known impact on sexual function.

One possibility is a diabetes medication that’s a part of the class of drugs known as sulfonylurea. A study found that sulfonylurea can help increase testosterone, which may improve erectile function.

Lifestyle Modifications

Certain lifestyle changes may contribute to better erections. Some of those changes include:

  • Regular exercise
  • A balanced diet
  • Weight management
  • Avoiding smoking
  • Avoiding excessive alcohol consumption

It’s important to also address any potential psychological causes of ED such as stress, anxiety, depression, relationship concerns, or low self-esteem.

Pharmacological Interventions

In some cases, healthcare providers may consider additional treatments for erectile dysfunction alongside metformin usage. These may include PDE5 inhibitors like sildenafil (Viagra), tadalafil (Cialis), or other options based on individual needs.

Can you take testosterone while on metformin?

According to Dr. Walker, it is possible to take testosterone while on metformin. The impact of metformin on testosterone levels may vary depending on individual factors such as age, baseline testosterone levels, and overall health. 

She also states, “If a patient taking metformin experiences symptoms of low testosterone, they should consult with their doctor. The doctor can evaluate the individual's specific situation and determine the best course of action, which may involve adjusting the medication or considering testosterone replacement therapy.”


In summary, the potential connection between metformin and erectile dysfunction remains an area of ongoing research and discussion. 

There’s evidence that metformin could negatively impact erectile function, and there’s evidence it could possibly impact erectile function. 

It is crucial to consult with your healthcare provider if you have concerns about erectile dysfunction or any potential side effects of metformin.

Remember, the management of both diabetes and erectile dysfunction should be personalized and tailored to your individual needs. 

Open communication with your healthcare provider, adherence to medication and lifestyle recommendations, and exploring potential alternative treatments are key factors in addressing these concerns effectively.

By staying informed and working closely with your healthcare team, you can make informed decisions and take proactive steps to optimize your overall health and well-being.

Dr. Kelly Walker

Dr. Kelly Walker

Kelly Walker, MD, is a reproductive urologist and graduated from medical school at Northwestern University’s Feinberg School of Medicine. She completed her urology residency at the University of California San Francisco and a fellowship in male fertility and microsurgery at the Medical College of Wisconsin. She also holds an MBA from Northwestern’s Kellogg School of Management and focuses her research on quality improvement and telehealth to deliver exceptional male fertility care. She is focused on creating a differentiated patient experience through the use of innovative technology and male fertility educational content.

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