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Metformin and Erectile Dysfunction


Metformin is an oral antidiabetic drug that helps regulate blood sugar levels in individuals with type 2 diabetes. It works by reducing glucose production in the liver and improving insulin sensitivity. Metformin is often considered a first-line treatment for diabetes due to its effectiveness and relatively low risk of side effects.

While metformin is generally well-tolerated, some studies have suggested a possible association between metformin use and the development of erectile dysfunction.

A 2016 study concluded that “Metformin in type 2 DM leads to significant reduction in testosterone levels, sex drive and induction of low testosterone-induced erectile dysfunction.” 1

A 2022 observational study of metformin patients found a significantly higher risk of sexual dysfunctions of ED and infertility.2

A 2023 case study concluded, “Metformin is a potential cause of impotence in our patient. The mechanism of metformin- induced sexual dysfunction is unclear.” 3 

However, metformin may actually improve erectile dysfunction, by treating the underlying diabetes. A 2017 study concluded that “Given the encouraging data found in both animal and clinical studies, we advocate for further studies on metformin use in ED.” 4


The relationship between metformin and erectile dysfunction remains an area of ongoing research. While some studies have suggested a potential association, the evidence is not yet conclusive. Other studies have found potential benefits from metformin in the treatment of erectile dysfunction. It is important to consider individual factors such as diabetes control, overall health status, and other potential contributing factors when assessing the impact of metformin on sexual function.


  1. Al-Kuraishy. Hayder M; Al-Gareeb. Ali I. “Erectile Dysfunction and Low Sex Drive in Men with Type 2 DM: The Potential Role of Diabetic Pharmacotherapy.” Journal of Clinical and Diagnostic Research. 2016; 10(12):FC21-FC26. <>
  2. Tseng, Chin-Hsiao. “Metformin’s effects on varicocele, erectile dysfunction, infertility and prostate-related diseases: A retrospective cohort study.” Frontiers in Pharmacology. July 2022.
  3. Ngu, Min Huang; Zakaria, Rosnani; Zulkifli, Maryam Mohd; Rahman, Rahiza Ab. “Erectile dysfunction as a possible important side effect of metformin: A case report.” Malaysian Family Physician. 2023; 18: 20.
  4. Patel, Jay Pravin; Lee, Eric Hweegeun; Mena, Carlos Ignacio; Walker, Charles N. “Effects of metformin on endothelial health and erectile dysfunction.” Translational Andrology and Urology. 2017 Jun;6(3):556-565.

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