Does spironolactone cause erectile dysfunction?
Apparently sometimes! A PubMed search of "spironolactone erectile dysfunction" only revealed only 17 articles. I'm attaching a very old (older than me ๐) JAMA case report that notes the association, and this abstract which speculates the mechanism is the suppression of inflammation that aldosterone usually induces in penile tissue. In my now eighth year of attending (four of them at the VA!), I cannot recall a single patient in whom I thought their spironolactone was contributing to their erectile dysfunction. I also texted a heart failure friend to check, will let you know if I hear something interesting back.
Ding Q, Wu F, Xiong ZQ, et al. Aldosterone induces inflammatory cytokines in penile corpus cavernosum by activating the NF-ฮบB pathway. Asian Journal of Andrology. 2018;20(1):24-24. doi:https://doi.org/10.4103/aja.aja_8_17
โGreenblatt DJ. Gynecomastia and Impotence Complications of Spironolactone Therapy. JAMA. 1973;223(1):82-82. doi:https://doi.org/10.1001/jama.1973.03220010068036
