Sexual Health: What Medications Can Do to Your Sex Life

Ever noticed a change in libido, arousal, or satisfaction after starting a new drug? Medications can change sexual function in clear ways — sometimes for the better, sometimes for the worse. This page walks through practical facts about two drugs we cover on the site (Bethanechol and Pramipexole), common patterns to watch for, and steps you can take if your sex life shifts after starting treatment.

How certain meds affect sexual function

Bethanechol is mainly used for urinary retention. Some people report improved arousal or genital blood flow while on it, likely because it stimulates certain nerve pathways. That said, effects vary a lot: some see small gains in sensation, others notice no change. Side effects like sweating, diarrhea, or low blood pressure can still dampen libido indirectly.

Pramipexole is a dopamine agonist used in Parkinson’s and restless legs. Dopamine boosts desire for many people, so pramipexole can raise libido and sexual enjoyment. But there’s a flip side: it can also trigger compulsive sexual behaviors or interfere with erection in some men. If you or a partner notice sudden urges that feel out of character, that’s a red flag to discuss with your prescriber.

Beyond these two, many common drug classes affect sex: SSRIs often lower desire or delay orgasm; blood pressure meds and opioids can reduce arousal; hormonal treatments change libido depending on their action. The timing helps pinpoint the cause — if changes began after a new prescription, the medication is a likely suspect.

Practical steps if you notice changes

Track what’s happening for two to four weeks. Note timing, specific symptoms (low desire, trouble with erection, delayed orgasm, new compulsive urges), and any side effects that could affect mood or stamina. That makes conversations with your clinician much quicker and more useful.

Don’t stop or change doses on your own. Instead, call your prescriber and share your notes. Options often include switching drugs, lowering dose, adding a counteracting med, or trying non-drug solutions first. For example, if an antidepressant lowers libido, a brief switch to a different antidepressant or an add-on medication often helps.

Try simple, evidence-based supports too: regular exercise, good sleep, reducing alcohol, and stress management can restore desire and performance. Couples therapy or sex therapy helps when communication or relationship factors interact with medication effects. If compulsive sexual behavior appears, ask for urgent review — that can be managed but should be addressed quickly.

Finally, be open with partners. A short, honest conversation about changes and steps you’re taking prevents blame and keeps intimacy alive while you sort things with your clinician.

If you want specifics on Bethanechol or Pramipexole, check our posts on each drug for study findings, typical timelines, and patient reports. I keep those pages updated as new research appears, so you’ll find practical, up-to-date info there.