Medically reviewed by Katelyn Hagerty, FNP
Written by Our Editorial Team
Last updated 2/26/2021
If you’ve been diagnosed with high blood pressure, angina, or if you’ve recently experienced a heart attack, your healthcare provider may prescribe you a medication called metoprolol.
Metoprolol is a beta-blocker. It works by relaxing blood vessels and slowing down your heart, reducing your blood pressure and improving your blood flow.
Although metoprolol is generally safe and effective, it may cause certain side effects, including erectile dysfunction.
Below, we’ve provided more information about metoprolol and how it works as a treatment for high blood pressure and cardiovascular disease, as well as its risk of causing side effects such as ED.
We’ve also explained what you can do to treat ED and improve your sexual performance if you are prescribed beta-blocker medications such as metoprolol.
Metoprolol is a type of beta-blocker medication. It’s marketed under a variety of brand names, including Lopressor®.
Currently, metoprolol is used to treat high blood pressure (hypertension) and angina, a type of chest pain caused by a poor supply of oxygen-rich blood to your heart.
It’s also prescribed after myocardial infarction, or heart attack, to improve survival and reduce the risk of complications. Metoprolol is often used alongside other medications to treat other cardiovascular health issues, including heart failure.
As a cardioselective beta-blocker, metoprolol works by latching onto the beta-1 receptors that are found in your heart cells. This helps block the effects of hormones such as adrenaline, which typically cause your heart to beat faster and harder.
After you take a beta-blocker such as metoprolol, your heart will typically beat slower and with better electrical conduction. Beta-blockers like metoprolol also help to relax your blood vessels and reduce blood pressure throughout your body.
Used as prescribed, medications like metoprolol can improve your general health and quality of life if you have a cardiovascular health issue.
Beta-blockers like metoprolol are safe and effective for most people. However, like many other medications, they can cause side effects. Common side effects of metoprolol include:
Dizziness or lightheadedness
Rash or itching
Gas or bloating
Cold hands and/or feet
Because beta-blockers such as metoprolol affect your blood pressure, they may cause erectile dysfunction.
Several studies have found that men who use metoprolol may experience difficulties related to getting and maintaining an erection.
For example, one study published in Clinical and Experimental Pharmacology and Physiology found that men with high blood pressure who used metoprolol had lower average scores on an erectile function survey than men who used other treatments.
A different study published in the Annals of Thoracic and Cardiovascular Surgery concluded that use of beta-blockers, including metoprolol, increases the risk of erectile dysfunction in men with ischemic heart disease.
While these might suggest that there’s a clear link between metoprolol and ED, other research has found that the connection might be more psychological than physical.
For example, one study of men with arterial hypertension found that their reaction to metoprolol differed based on whether or not they were told that the medication could cause ED before they started treatment.
In the study, 114 men were prescribed metoprolol to treat hypertension. The men were divided into three groups.
The first group was told that they were being treated with metoprolol and that metoprolol could potentially cause erectile dysfunction. The second group was partially informed, meaning they were told that they would receive metoprolol but weren’t informed about any ED risk.
The men in the third group weren’t informed about the medication they were given or about any of its side effects.
After 60 days of treatment, 32 percent of the men in the first group (fully informed) reported ED as a side effect of metoprolol. In comparison, only 13 percent of the men in the second group (partially informed) and eight percent of the men in the third group (uninformed) reported ED.
Interestingly, the men who reported ED were treated using either tadalafil (the active ingredient in the ED medication Cialis®) or a non-therapeutic placebo. The researchers found that both of the treatments were equally effective at treating ED.
A similar study of atenolol, another beta-blocker used to treat heart disease, produced a similar outcome.
The outcome of these studies suggests that the erectile dysfunction experienced by some men who usemetoprolol and other beta-blockers may be at least partly psychological in nature.
Erectile dysfunction is a common problem, both for men prescribed beta-blockers and for men in general. According to the National Institutes of Health, around 30 million men in the United States are affected by some degree of ED.
ED can vary in severity. You may be able to get an erection sometimes, but not on a consistent enough basis to always have sex when you want to. Alternatively, you may find it difficult to stay hard for long enough to have satisfying penetrative sex with your partner.
If you’re prescribed metoprolol or another beta-blocker and notice that it’s more difficult for you to get or maintain an erection, it’s best to talk to your healthcare provider. Based on your needs and general health, they may suggest one of the following treatment options.
In some cases, you may be able to treat ED and improve your sexual performance by switching from metoprolol to a different medication.
You should never switch medications or stop taking metoprolol on your own. Instead, reach out to your healthcare provider to tell them that you’re experiencing ED after starting treatment with metoprolol.
Based on your cardiovascular health and specific needs, your healthcare provider may suggest switching from metoprolol to a different medication that’s less likely to affect your erectile health and sexual performance.
Erectile dysfunction is usually treatable with prescription medication. These medications work by improving blood flow to your penis, making it easier for you to develop and maintain an erection when you feel sexually aroused.
Currently, several medications are available specifically to treat ED:
Sildenafil. The active ingredient in Viagra®, sildenafil (generic for Viagra) works quickly and provides relief from ED for approximately four hours per dose.
Tadalafil. The active ingredient in Cialis, tadalafil is a long-lasting medication that can provide relief from ED for up to 36 hours per dose.
Vardenafil. The active ingredient in Levitra®, vardenafil treats ED for slightly longer per dose than sildenafil.
Avanafil. Sold under the brand name Stendra®, avanafil is a newer ED medication that starts working rapidly and is less likely to cause certain side effects.
We offer several different ED meds, following a consultation with a physician who will determine if a prescription is appropriate.
Although ED medications are safe for most men, they can interact with some medications used to treat hypertension and other cardiovascular health issues.
For example, using ED medications like sildenafil and others with nitrates may cause a sudden drop in blood pressure. We’ve discussed these safety issues in more detail in our guide to ED treatments for men with heart disease.
Make sure that you inform your healthcare provider about all of the medications you currently use while discussing sildenafil, tadalafil and other treatments.
Although ED is most usually treated with medication, making certain changes to your habits and lifestyle can improve your erectile health and may make it easier for you to consistently develop and maintain an erection.
Many of the same habits and lifestyle changes that may improve your erectile health also offer benefits for your cardiovascular health. Try to:
Exercise frequently. Regular exercise can improve blood flow throughout your body, making it easier to get and maintain an erection.
If you’re prescribed metoprolol to treat a cardiovascular health issue, make sure to talk to your healthcare provider before you start exercising. They’ll be able to let you know how to exercise safely.
Eat a balanced diet. Try to eat a balanced diet that’s built around nutrient-rich foods like fruits, vegetables, whole grains, fish and lean sources of protein. Research suggests that the Mediterranean diet may help to improve erectile health in men.
Quit smoking. Smoking can damage your blood vessels, making it more difficult for blood to flow to your penis when you’re sexually aroused. Similarly, the nicotine in tobacco may have a negative effect on your sexual arousal and erectile health.
If you’re a smoker, try to quit. You can learn more about the most effective ways to give up smoking in our guide to quitting.
Our guide to naturally protecting your erection goes into more detail about lifestyle changes and habits that you can use to improve your erectile health.
Studies suggest that beta-blockers such as metoprolol can cause erectile dysfunction. However, we don’t yet know whether this is a physical side effect of metoprolol and other beta-blockers or a psychological one.
If you’re prescribed metoprolol and notice that it’s difficult for you to get or maintain an erection, talk to your healthcare provider.
Based on their advice, you may be able to treat your ED and improve your sexual performance by changing to a different beta-blocker, adjusting your dosage or using ED medication.