Xarelto and erectile dysfunction

Xarelto and Erectile Dysfunction: Personal Story

I was prescribed Xarelto (rivaroxaban) for deep vein thrombosis (DVT) following a treatment with heparin injections.

About two weeks after switching to Xarelto I noticed loss of libido, severe erectile dysfunction (very weak erections even after prolonged stimulation that almost immediately recede when stimulation ceases), reduced genital sensation, no response to sexual stimuli, premature ejaculation and sexual anhedonia (pleasureless orgasm) when an orgasm was achieved. It was like I had become completely asexual. Even nocturnal/morning erections had become extremely sparse and feeble, which was another way for me to confirm that there was something wrong on a physical rather than psychological level. To be more precise, the problem was not simply erectile dysfunction, but a sexual dysfunction with multiple manifestations.

The above dramatic changes took place in about 2 weeks after starting Xarelto (20 mg once per day), at a time when I was taking no other drug or supplement, and have persisted since discontinuing the drug (March 2017). Subtler issues also became more apparent, for example a sensation as if a low-intensity electric current was running through the penis, which was especially noticeably when lying down. Moreover, following an orgasm there would be a feeling of discomfort in the genital area, bordering on mild pain.

The host of sexuality-related side-effects I experienced can be aptly summed up in two words: chemical castration. Such was the extent and depth of change in such a short period of time. A severe “punishment” for an (intentionally?) misinformed medication user when in most countries even child molesters are exempt from such a “treatment“.

Surprisingly, such adverse effects were not listed on the a Xarelto patient information leaflet. But this should not come as much of a surprise, as it is alleged that Bayer Health Group and Johnson and Johnson (the pharmaceutical companies which developed the drug) were well aware of studies showing Xarelto had higher rates of serious side effects but failed to provide adequate warnings about the known side effects both to doctors and to patients [1]. And the side effects referred to here are the ones that quite often lead to death, i.e. internal bleeding. If they were reticent about such… lethal side effects, would they be eloquent about sexuality-related side effects? I very much doubt it… In fact, a Google search for Xarelto lawsuits gives plenty of results.  On March 25th, 2019, they settled for $775 million to get paid out to victims. [1]

Xarelto’s serious side effects have a long range, if one takes into account post-marketing reports: internal bleeding, wound infections, thrombocytopenia (platelet deficiency), hepatitisStevens-Johnson syndrome (severe skin reaction which can lead, among others, to multiple organ failure with a mortality rate of 7.5) [2]. In 2015, rivaroxaban accounted for the highest number of reported cases of serious injury among regularly monitored medications to the FDA’s Adverse Events Reporting System.

Summary of Xarelto Warning Label Updates
  • August 2013: Black-box warning added on the increased risk of spinal bleeds
  • January 2014: Warnings about the lack of an antidote and that the drug should not to be used by patients with prosthetic heart valves
  • March 2014: Additional information added for healthcare professionals on limiting spinal bleeds
  • December 2014: Addition of new adverse reactions, thrombocytopenia and hepatitis
  • May 2016: Warning of an increased bleeding risk with SSRI and SNRI antidepressants

The vascular specialists I asked had no clue about such an adverse effect. I thought that this reaction would probably resolve when I stop the drug. The medication was discontinued on March 2017 and the condition has not resolved at all (last update: 5 April 2019). In effect, it has remained exactly as it was when it first appeared.

Following visits to urologists/andrologists, I was asked to check hormone levels for testosterone, prolactin, estradiol, follicle-stimulating hormone (FSH), luteinizing hormone (LH), sex hormone-binding globulin (SHBG) and albumin.

There was nothing in the results that indicated why this problem had presented itself. In fact, my testosterone was 981 ng/dl, putting me at the top 2,5% of men.

The doctors said that the medical knowledge on these physiological mechanisms is limited; there are plenty of unknown chemical paths where this could go wrong. They don’t even know which are the chemical triggers of libido, apparently, this is not testosterone.

When I searched on EudraVigilance and FDA’s Adverse Event Reporting System (FAERS) I found that there was a number of Individual Case Safety Reports with same adverse reactions (one even included penile size reduced).

Currently, I am at a loss as what I should do to resolve the situation, or as to how the drug affected my organism and whether this can be remedied.

You have similar issues? What YOU can do to help yourself

I would encourage anyone to submit side effects directly or via one’s healthcare professional to the FDA (for people from the USA), RxISK (for people from all over the world; this is a very important resource as David Healy who founded it has undertaken research on similar conditions caused by other medications), EudraVigilance (for people from Europe), YellowCard (for people from the UK) and Kitrini Karta (for people from Greece) .

Why is this important? Because many side effects go under-reported, something which applies even more strongly to side effects relating to sexuality and the taboo and embarrassment that goes with it. The only way to raise awareness and find a possible cure is by having people who experienced the side effects report them.

Read also an article posted on RXisk about  Xarelto and sex.

Alternatives to Xarelto

If you are still taking Xarelto, or any other anticoagulant, including novel oral anticoagulants (NOACs) and you feel it is impacting your health negatively, then you can consult your doctor in order to switch medication. NOACs are the new kids on the block and their side-effects have not been fully documented yet. For decades the drugs available for anticoagulation were heparin and coumarins (warfarin—brand name Coumadin—mainly in the US and acenocoumarol—brand name Sintrom—in Europe).

If your physician is unsure regarding the way to switch medication, you can direct them to the leaflet switching between anticoagulants.

Bear in mind that switching medication for a particular side effect, for example erectile dysfunction or loss of libido, does not automatically guarantee that you will be rid of that side effect.
Firstly, you should have the relevant hormone and blood tests to exclude any other factors. Secondly, it appears that other anticoagulants may have similar side-effects—for example have a look at one of the comments below for Eliquis (apixaban).

Chinese Traditional Medicine formula

If you want to endeavour beyond Western medicine, traditional Chinese medicine (TCM) has a formula for anticoagulation called Bu Yang Huang Wu Tang (补阳还五汤) which can be taken in pill format or you can boil the herbs. This formula contains Angelica sinensis (dong quai, 当归) which contains coumarins. It should be noted that you cannot take this formula when you are taking any other form of anticoagulation as it can and will increase the risk of bleeding. Useful reference:  Traditional Chinese medicine formula activates blood circulation and prevents DVT (deep venous thrombosis).

Hirudotherapy (leeches)

The Chinese and the Greeks—among others—have used leeches as a therapy for thrombosis. Leeches contain a powerful anticoagulant named hirudin and hirudotherapy (leech therapy) is akin to taking heparin injections.

Other symptoms

Another symptom that started after taking Xarelto and persisted since, was a kind of skin rash that appeared in my forehead, more pronounced on the right side. I never had such a skin rash on my forehead or any other place of my body. A dermatologist I consulted had no idea what it was or what it was.

Drugs with similar side-effects

Interestingly, there are other medications that recently proved to have similar effects, like finasteride, causing post-finasteride syndrome (more about it by the Post-Finasteride Syndrome Foundation) and isotretinoin (Accutane, an acne medicine), causing post-retinoid sexual dysfunction (PRSD). And there are some papers on Endocrine Journal and International Journal of Risk & Safety in Medicine making the connection: 

Dr David Healy who wrote the book Pharmageddon and created the RxISK website makes a suggestion of nerve damage, and specifically of c-fibers in a presentation regarding sexual problems caused by post-SSRI sexual dysfunction. I was particularly touched by a comment to that video: 

…not only do they destroy ability to experience physical affection. They also stop ability to feel love, empathy, compassion, regret, human connection. They make you a shell of a human being. In fact they take away the essential essence of being human. Beyond unconscionable.

If one were to coin a term for this issue, since it is a kind of drug-induced erectile dysfunction /  medication-induced erectile dysfunction or more aptly drug-induced sexual dysfunction / medication-induced sexual dysfunction, it would be rivoraxaban-induced sexual dysfunction (RISD) / rivoraxaban-induced erectile dysfunction (RIED) or post-rivoraxaban sexual dysfunction (PRSD) / post-Xarelto sexual dysfunction (PXSD).

Another potential avenue of investigation has to do with ion channels (thanks to Heather for the clue) as they affect erection in a number of ways.

To put all this into context, such sexuality-related issues affect the individual on a scale that goes far beyond the sexual plane [4]:

Brain mechanisms involved in fundamental pleasures (food and sexual pleasures) overlap with those for higher-order pleasures (for example, monetary, artistic, musical, altruistic, and transcendent pleasures).

Which is hardly an original concept and has very aptly been described by Nietzsche, in the Twilight of the Idols (Raids of an Untimely Man, §8):

For there to be art, for there to be any aesthetic activity and observation, one psychological prerequisite is indispensable: intoxication. Intoxication must have already heightened the sensitivity of the whole machine: otherwise, no art will be forthcoming. All kinds of intoxication, as different as their causes may be, have this power: above all, the intoxication of sexual excitement, that oldest and most primordial form of intoxication.

Even if we see sexual energy from a spiritual point, its existence is the actual rocket fuel for spirituality (Swami Kriyananda, The New Path):

If the sex drive were taken away from you, you would see that you had lost your greatest friend. You would lose all interest in life. Sex was given to make you strong. If a boxer were to fight only weaklings, he too would grow weak in time. It is by fighting strong men that he develops strength. The same is true in your struggle with the sex instinct. The more you master it, the more you will find yourself becoming a lion of happiness.

Would Gods live a life deprived of pleasure? Not even them, according to Simonides (from Fragments, 71):

What human life is desirable without pleasure, or what lordly power? Without it not even the life of the gods is enviable.

(Τίς γὰρ ἁδονᾶς ἄτερ θνατῶν βίος ποθεινὸς ἢ ποία τυραννίς; τᾶς ἄτερ οὐδὲ θεῶν ζηλωτὸς αἰών.)

No wonder that many lesser mortals suffering from iatrogenic sexual dysfunction syndromes (like Oly) choose to take their own lives.

The words of yet another PSSD sufferer perfectly echo my feelings:

The effect of living with PSSD is devastating. It has destroyed two relationships. Relationships with women end up being like an asexual friendship, with sex being like a pleasure-less boring chore, with no emotional connection or lust whatsoever.

To wrap it up, I wonder whether there is any way to find out what is the status of the other people who reported the same issue; so if you are facing a similar situation, kindly get in touch.

You can see screenshots of the Individual Case Safety Reports at the end of this post.

Xarelto and Erectile Dysfunction: FDA reports

Erectile dysfunction is found among people who take Xarelto, especially for people who are 60+ old , have been taking the drug for 1 – 6 months, also take medication Amlodipine, and have Stroke. This study is created by eHealthMe based on reports of 119,666 people who have side effects when taking Xarelto from FDA, and is updated regularly (from ehlealthme.com).

Blood thinners and Erectile Dysfunction

There is not much data available on blood thinners in general, (including novel oral anticoagulants – NOACs) and erectile dysfunction or sexual dysfunction.  Some blood thinners may even have the opposite effect of priapism (this applies to any varieties of heparin like  low-molecular-weight heparin or unfractioned heparin which are administered with an injection). From a paper:

Treatment with the coumarin derivative, warfarin, was suggested to be associated with an increased risk of ED in elderly men, but in this study only a few patients were actually treated with warfarin. Therefore, although information regarding anticoagulants and erectile function is lacking. […] Evidence regarding effect on erectile function of lipid-lowering drugs, anticoagulants, antithrombotics, and antiarrhythmic therapy is sparse and not conclusive.

It is no surprising if such issues are under-reported given the novelty of some of these drugs and the taboo associated with it or the tendency of physicians to attribute them to a pre-existing condition or “psychological” reasons. You can see in the comments below a mention from a visitor who sent an e-mail regarding another NOAC, Eliquis (apixaban).

Possible treatments for Xarelto-induced erectile dysfunction

Since the issues that arise from the use of Xarelto are much more complex than erectile dysfunctionPDE5 inhibitors like sildenafil (Viagra), tadalafil (Cialis) and the like are not likely to give anything more than an artificial erection which would not improve the quality of sensation.

If we accept the conjecture that anhedonic symptoms are due to some sort of nerve damage (as posited by David Healy above regarding PSSD) then there is nothing available on the market. In a trial stem cells were used for erectile dysfunction which was the result of radical prostatectomy (interestingly, exclusion criteria for this study was treatment with anticoagulants and lack of sexual interest). Another new option is the intracavernosal injection of platelet-rich plasma, as illustrated in a review of currently available modalities for erectile dysfunction.

Drugs that may cause erectile dysfunction /sexual dysfunction

Here is a list of drugs [3] (which will be edited here by me to update with new data) that may cause impotence/erectile dysfunction/sexual dysfunction:

Antidepressants and other psychiatric medicines

Amitriptyline (Elavil)
Amoxapine (Asendin)
Buspirone (Buspar)
Chlordiazepoxide (Librium)
Chlorpromazine (Thorazine)
Clomipramine (Anafranil)
Clorazepate (Tranxene)
Desipramine (Norpramin)
Diazepam (Valium)
Doxepin (Sinequan)
Fluoxetine (Prozac)
Fluphenazine (Prolixin)
Imipramine (Tofranil)
Isocarboxazid (Marplan)
Lorazepam (Ativan)
Meprobamate (Equanil)
Mesoridazine (Serentil)
Nortriptyline (Pamelor)
Oxazepam (Serax)
Paroxetine (Paxil, Seroxat)
Phenelzine (Nardil)
Phenytoin (Dilantin)
Sertraline (Zoloft)
Thioridazine (Mellaril)
Thiothixene (Navane)
Tranylcypromine (Parnate)
Trifluoperazine (Stelazine)

Antihistamine medicines

(certain classes of antihistamines are also used to treat heartburn)

Cimetidine (Tagamet)
Dimenhydrinate (Dramamine)
Diphenhydramine (Benadryl)
Hydroxyzine (Vistaril)
Meclizine (Antivert)
Nizatidine (Axid)
Promethazine (Phenergan)
Ranitidine (Zantac)

High blood pressure medicines and diuretics (water pills)

Atenolol (Tenormin)
Bethanidine
Bumetanide (Bumex)
Captopril (Capoten)
Chlorothiazide (Diuril)
Chlorthalidone (Hygroton)
Clonidine (Catapres)
Enalapril (Vasotec)
Furosemide (Lasix)
Guanabenz (Wytensin)
Guanethidine (Ismelin)
Guanfacine (Tenex)
Haloperidol (Haldol)
Hydralazine (Apresoline)
Hydrochlorothiazide (Esidrix)
Labetalol (Normodyne)
Methyldopa (Aldomet)
Metoprolol (Lopressor)
Nifedipine (Adalat, Procardia)
Phenoxybenzamine (Dibenzyline)
Phentolamine (Regitine)
Prazosin (Minipress)
Propranolol (Inderal)
Reserpine (Serpasil)
Spironolactone (Aldactone)
Triamterene (Maxzide)
Verapamil (Calan)
Thiazides are the most common cause of impotence among the high blood pressure medicines. The next most common cause is beta blockers. Alpha blockers tend to be less likely to cause this problem.

Parkinson disease medicines

Benztropine (Cogentin)
Biperiden (Akineton)
Bromocriptine (Parlodel)
Levodopa (Sinemet)
Procyclidine (Kemadrin)
Trihexyphenidyl (Artane)

Chemotherapy and hormonal medicines

Antiandrogens (Casodex, Flutamide, Nilutamide)
Busulfan (Myleran)
Cyclophosphamide (Cytoxan)
Ketoconazole
LHRH agonists (Lupron, Zoladex)

Other medicines

Aminocaproic acid (Amicar)
Atropine
Clofibrate (Atromid-S)
Cyclobenzaprine (Flexeril)
Cyproterone
Digoxin (Lanoxin)
Disopyramide (Norpace)
Estrogen
Finasteride (Propecia, Proscar, Avodart)
Furazolidone (Furoxone)
H2 blockers (Tagamet, Zantac, Pepcid)
Indomethacin (Indocin)
Isotretinoin (Accutane, Roaccutane)
Lipid-lowering agents
Licorice
Metoclopramide (Reglan)
NSAIDs (ibuprofen, etc.)
Orphenadrine (Norflex)
Prochlorperazine (Compazine)
Pseudoephedrine (Sudafed)
Sumatriptan (Imitrex)

Opiate analgesics (painkillers)

Codeine
Fentanyl (Innovar)
Hydromorphone (Dilaudid)
Meperidine (Demerol)
Methadone
Morphine
Oxycodone (Oxycontin, Percodan)

Recreational drugs

Alcohol
Amphetamines
Barbiturates
Cocaine
Marijuana
Heroin
Nicotine

Alternative Names

Impotence caused by medications; drug-induced erectile dysfunction; drug-induced sexual dysfunction; prescription medicines and impotence; prescription medicines and sexual dysfunction

Screens from Pharmacovigilance databases

Xarelto and erectile dysfunction
FDA’s Adverse Event Reporting System (FAERS) reports for erectile dysfunction and Xarelto
Xarelto erectile dysfunction
EudraVigilance results for erectile dysfunction side effects following use of Xarelto
Xarelto libido side effect
FDA’s Adverse Event Reporting System (FAERS) reports for erectile dysfunction and Xarelto
FDA's Adverse Event Reporting System (FAERS) reports for erectile dysfunction and Xarelto
FDA’s Adverse Event Reporting System (FAERS) reports for erectile dysfunction and Xarelto
Xarelto's side effects
FDA’s Adverse Event Reporting System (FAERS) – Xarelto’s side effects
[1] WJB Associates – side effects of Xarelto – see also NYTIMES article

[2] Xarelto Serious Side Effects

[3] Drugs that may cause impotence

[4] Kringelbach ML. The hedonic brain: a functional neuroanatomy of human pleasure. In: Kringelbach ML, Berridge KC, editors. Pleasures of the Brain. Oxford, UK: Oxford University Press; 2010. See also: Neurobiology of sexual desire

47 Comments for “Xarelto and erectile dysfunction”

Dmitry

says:

Thank you for this information. I also took Xarelto for DVT and have the same symptoms that you described about erectile dysfunction.
Now I stopped taking the drug, but my sexual health did not improve at all.

says:

Hi Dmitry,

I am sad to hear that. Sounds like there are quite a few people out there with the same Xarelto side-effect.
For how long did you take Xarelto?

Katrina

says:

Hi I’m Kat my husband has had abnormal clotting DVT in his arms and lungs it came out of nowhere. They put him on eliquis. This is when my life changed. No matter what I do or say or wear or not wear my husband basically treats me as if I am a roommate. He will maybe once a week when we used to have sex 2-4 times a week we even had three and four ways. But he’s lost all life for any of it. I’m very sexual and not to bad looking and I am happy that I can say that maybe it’s not me that is causing this. The problem with this entire situation is my husband is at peace with having no desire for anything. I’m starting to feel like he doesn’t care about me even. It’s like someone turned his passion switch off. He cringes at kissing me. This is the hardest thing in our 18 years of marriage we’ve dealt with. I can’t handle it. He says you promised You’d stick to your word. But this has been going on a year and he makes no effort to have four play or anything. And he has no issue getting hard and staying hard it’s just he has no passion or desire. I don’t now what to do. I love him more than anything but to behave like my needs are not important at all. And that I should be okay with a sexless marriage to a man that treats me like a dude. He didn’t even get me flowers on Mother’s Day. Now last year when he wasnt sick he did. It’s like he’s not him. And he refuses to get help.

Katrina

says:

Hi I’m Kat my husband has had abnormal clotting DVT in his arms and lungs it came out of nowhere. They put him on eliquis. This is when my life changed. No matter what I do or say or wear or not wear my husband basically treats me as if I am a roommate. He will maybe once a week when we used to have sex 2-4 times a week we even had three and four ways. But he’s lost all life for any of it. I’m very sexual and not to bad looking and I am happy that I can say that maybe it’s not me that is causing this. The problem with this entire situation is my husband is at peace with having no desire for anything. I’m starting to feel like he doesn’t care about me even. It’s like someone turned his passion switch off. He cringes at kissing me. This is the hardest thing in our 18 years of marriage we’ve dealt with. I can’t handle it. He says you promised You’d stick to your word. But this has been going on a year and he makes no effort to have four play or anything. And he has no issue getting hard and staying hard it’s just he has no passion or desire. I don’t now what to do. I love him more than anything but to behave like my needs are not important at all. And that I should be okay with a sexless marriage to a man that treats me like a dude. He didn’t even get me flowers on Mother’s Day, last year when he wasnt sick he did. It’s like he’s not him.

Mark

says:

Iv been on Xarelto for a few years after multiple DVTs and have experienced the same side effects. If I did get an erection as soon as I stood up it would go and it was no where near as hard as it used to be. Morning erections stopped occurring which was very strange as I always used to wake up erect. It never even occurred to me that Xarelto could have been the reason for this. I have tried Viagra and Cialis but they did not work at all. However I found an injection that you inject directly onto the penis called Caverject I am glad to say that this has worked wonders, my erections on this are incredibly strong and last a long time. If you do try it start at a low dose I started with 20mcg and had an erection for over 12 hours. I now use 7.5mcg with great results

Jesse

says:

I was prescribed xarelto due to dvt as well. About 2 weeks after beginning the medication I suffered a severe drop in libido accompanied by ED. I was on it for about a month and after doing some research came on your article and decided to stop taking it. Luckily within a few days I was back to normal and am not suffering from any issues anymore.

J

says:

I am in tears right now I’m freaking out so bad. I was prescribed elequis on November 30th and I really loved the meds at first because I realized that I no longer got any headaches or migraines so I thought this was a miracle. Now I’ve been on this drug for two months and I’m feeling everything your describing with the ED. My libido is gone and I’ve gone from having erections multiple times a day to only one a week! I figured it was stress but now I know, and they didn’t give me any freakin warning.
Well tonight I’m stopping this drug and praying to god I return back to normal.

says:

Jesse, I am glad that my misfortune resulted in saving at least one other person. Thank you for sharing; it makes a difference to me.

Mark, injectable medications like the one you mentioned (containing the active substance alprostadil) have been around long before oral medications and they are still used as second-line treatment. (One can read this article about available modalities in 2019 for erectile dysfunction) But they hardly sound as the most appetizing way to have a sex life and they do not address issues regarding loss of libido and sensation.

Have you guys submitted a report in any of the databases mentioned in the article? This can be very important in assuring that more people get to know about such side effects.

Moe

says:

I feel cheated. I got into a bike accident in September. Weeks later I went to the hospital because of the pain. They found a dvt blood clot in my right leg and put me on xaretlo 20mg. They had 2 surgeries on my leg still taking the blood thinners. Over 3 weeks ago, I found out I couldn’t hold a erection and sex drive dropped. It is frustrating because my significant other thinks I’m not attracted to them anymore and couldn’t get a sexual release either. Is there any way I get back to normal? Thinking of throwing away the rest..

says:

It is been 2 years since I discontinued Xarelto and the issue persists. The only thing you can do is to help raise awareness. Big Pharma commonly avoid to alert about some side effects in order to boost sales (read “Pharmageddon”). Submit a report in any of the databases mentioned in the article like RXisk and the FDA.

As far as I can see, people who discontinued Xarelto in the first 2-3 weeks (after the first symptoms) had the issue resolved.

Let me assure your significant other that this has nothing to do with her.

Heather R

says:

Spiros, I just wanted to congratulate you on your well written articles and research on all this. My son Olly died after ending his life, because if initial terrible side effects on RoAccutane/Accutane/isotretinoin which led to a loss of pleasure in everything in life. We never discussed loss of libido but I expect he had this too. I broke my neck as passenger in a car crash in 2001, the same year as he got prescribed his first course of the acne drug (which is also a chemo drug but they don’t tell you that) and I was given heparin injections every day whilst I lay paralysed from the neck down, for some time. The heparin didn’t seem to affect me adversely but lying down I was light headed anyway from the neck injury and surgery so I don’t know for certain. I was lucky not to be given Xarelto, but maybe it didn’t exist then. My son presented symptoms of low mood literally 3 weeks after starting RoAccutabe but I was in hospital just after the accident so tragically I mistook his sadness for shock about me. I made a full recovery, miraculously, but it took a few years to get all feeling back. Now I’m trying to find a cure for PSSD and to understand the awful side effects of drugs like Escilatopram and other neuroleptic which helped to drive my son out of his mind I feel. I am very interested in ion channels and how they work, between the electrical signals all through cells in the body. Apparently there are some herbs like oregano and camphor to name just two, that can affect these channels, which can be blocked by many drugs including ADs and even things like lidocaine. Well worth looking into maybe in your research. Good luck with it all and please keep in touch if you wish. You are doing a wonderful job!

says:

Hi Heather,

Good to hear from you! I understand that your research on PSSD is a kind of tribute to your son? A way to make his suffering meaningful? I have added the links on the article you mention and ollysfriendshipfoundation so that other people may benefit from the material.

Heather R

says:

Thanks Spiros. Yes, what I do is mostly for Olly, inspired by him, but I’ve always had terrible reactions to prescribed medications myself so I’m very interested in discovering why. I thought it was partly being deficient in cyp450 enzymes and others but doctors don’t seem keen on this idea. I’m very interested in how the body’s own electricity between cells operates, and how things like Bio Energy healing works. This is not about mysticism, but about gaining understanding into the wonderful complexity of our nerve system and whether it can even be jumpstarted in some way. I guess most doctors would dismiss this out of hand, but I still think everything is worth exploring, there is so much as stake for so many, like Olly was and you are, who are struggling with prescribed drug side effects and not being taken seriously. I will let you know how I get on. Thanks for passing on details of http://www.ollysfriendshipfoundation.org.uk and the linked Facebook site.

says:

This is from an e-mail I got:

I was reading your blog in internet and your information about xarelto, sadly I am suffering similar side effects taking Eliquis (apixaban), a medicament similar to Xarelto.

I could not find any information online about Eliquis but reading about Xarelto open my eyes understanding the problem of the medicament.

The situation is pretty delicate for me. Doctors tell me that if I do not take this drug my life is at risk, but I am 50 years old with the wish to someday find love, and it is breaking any possibility of a sex life.

Seems that there are no options out there, and doctors do not even listen to your symptoms.

Any help about more information, possible treatment options against deep vein thrombosis would be really appreciated.

My reply to this was to report the side-effects as described further up this post and to ask the doctor to switch medication; warfarin (and coumarins) being the most tested one(s).

Gb

says:

Hello man. I have only 18 years and Xarelto was prescribed to me for DVP. I will take it for 6 months. I started feeling this issues but i still can hold a little bit into an erection. Any chance that i can recover my fully libido on the end of the treatment ?

says:

As you can see above, people who have not stopped immediately when symptoms started did not have the symptoms resolved, even years after stopping the drug. I encourage you to submit a report to Rxisk as well as the other databases mentioned in order to raise awareness for the issue.

JB

says:

Hi Spiros,
Thanks for sharing. I’ve got exactly the same symptoms from 11 days on Gabapentin (Antiepilecptic drug) for anxiety.
I’ve noticed GBP is not in your list maybe you could check and add it.
Also, my ED apperead during the withdrawal. When I was taking the drug everything was perfectly normal.
Thanks!

says:

Yes, some drugs cause dysfunction after withdrawal. For example read here:

Sexual side effects can sometimes persist for years or indefinitely after discontinuation of the drug; they can emerge on treatment and remain afterwards, or emerge or worsen when the drug is stopped.

I would recommend submitting your case to Rxisk, much more important that mentioning the drug here.

JB

says:

Yes I did that too. I think too that it’s a nerve issue… Therefore something like that could be a solution : https://www.comphya.com/

says:

Nobody knows for sure as different drugs could affect different pathways. What you refer to is presumably something that works for spinal injury victims.

Jb

says:

I think once you solve the erection issue, even if it’s mechanic, improvements will follow.
Also I have noticed that on a lot of forum of PSSD the only successes stories mentionned meditation and “rewiring” you brain to tell it that this lack of sensation / mild pain sensation that you are feeling is actually pleasure. It’s as difficult as it sounds, but in the short – mid term it sounds like the only solution…
Good luck!

Kyle

says:

Hi Spiros, I left a message to you on another page that sent me here. I have experienced your story to an exact letter. It’s quite concerning to know these drugs are out there and can ruin a perfectly good, if not electric sex life. It has really put my mind in a spin, being an age in which I shouldn’t have these issues. I have to get off this medication asap. Thank you for your research and articles in relation to this medication.

says:

Which page? Beware though, it may not be the only blood thinner causing these issues.

Kyle

says:

Hi Spiros, I’m sorry I don’t recall which page I saw your original article about this issue, but it linked me to your thrombosis page. Just another night where my sexual organ has stopped working regardless of how I want it to perform. Humiliating and demoralizing. Do you know of any reports from Coumadin? My dr won’t pull me off blood thinners just yet and I’m worried I will never perform the same again.

says:

Please read the sections “Alternatives to Xarelto” and “You have similar issues? What YOU can do to help yourself”.

Why do you take blood thinners? Coumarin-like anticoagulants like warfarin are the oldest kids in the block and, although not side-effect free, with good regulation and INR monitoring they have some of the safest records.
Personally, if I were to switch, it would be a coumarin or heparin.

Kyle

says:

Same reason you were on them- dvt. Mine was unprovoked(probably from dehydration) and it was found out during the process I’ve got factor V Leiden.
Thank you for pointing me to those sections. I was asking you directly, because as we both know, the side effects we are/have experienced from xarelto are not listed on the side effects list. I figured the same would be true for any other blood thinning medication. My plan is to speak to my Dr again regarding this issue and most likely will make the switch to Coumadin, although I have read reports of causing the same issues.

Thanks.

Dale

says:

I have been taking Xarelto for about 5 yrs. after having open heart surgery, a triple bypass with atrial fibrillation while in the hospital. I have exactly the same sexual problems, erectile dysfunction, low libido, dulled sensations, very difficult to get an erection and it goes down almost immediately. I did not suspect xarelto being the cause, since most websites does not list this as a side effect. I am at a loss as to what to do about it.

says:

You do not mention your age, but doctors are very quick to justify sexual dysfunction symptoms as due to your underlying condition(s) and/or psychology. All that can be done about it is listed in the article, as well as previous replies -:)

Shannon

says:

I am a 36 year old female that has been taking xarelto for 2 and a half years after a thrombosis, PE and DVT. I am experiencing sexual problems. Lack of desire, unable to be aroused, low sensitivity to vaginal stimulation. Unable to feel love or lack of romantic feelings. This is causing major issues in my relationship.

Jonas

says:

Hi Spiros, I just read your article, and now make more sense to me. I have the same side effects you have, I been Taking Xarelto for almost 4 years, but before that I was under warfarin for 12 years. 2 dvt both arms. I notice everything you said, exactly the same symptoms. Now I will like to try “bu yang huan wu tang” I read about it, sounds like more healthy and no side effects. I’m 39 years old good shape but I’m tired to feel like this. I don’t think doctor will pull me out of my medicine cause they told me I have to take it for the rest of my life. Thanks

says:

Hi Jonas,

I would advise against improvising. At the very least consult a specialist in Traditional Chinese Medicine.
Taking anticoagulants for such a long time and then stopping them suddenly poses a risk for rebound hypercoagulation, meaning your blood will tend to clot like crazy once you stop it.

I had been taking Xarelto for much less than you and its side effects persist unchanged 3 years after discontinuation.

Chris

says:

Hi Guys/Girls,

I’m on my second DVT and been prescribed Xarelto on a long term basis. Since taking the medication I constantly feel sick, look drained, and with no explanation woke up one day with a bad pain in my knee. After months of trying to figure it out it turned out two ligaments were torn in the knee. I still don’t know how I done this (the injury is similar to a person who’s been in a car crash) and pretty sure its attributed to the medicine. My errections are not as large as they are but managing the situation with mind power (the more you worry the worse it gets). I have told the Doctors time and time again but they insist its my age (39 and had no issues before taking the medication). Even when I have explained the side effects they have often “missed” this on follow up letters in which I have several open complaints.The hospitals believe that this is a wonder drug (it stops regular check ups and therefore saves money). This week after 1 year of fighting they have finally agreed to discuss changing the medication. Something is not right. Please email me on lovellsinternational@hotmail.co.uk. We need to talk, and may take some action against Bayer. Enough is enough.

says:

Yes, a wonder drug, it appears to do wonders if you have any problems with a strong libido or deep romantic feelings: it simply banishes them to extinction. As for its popularity, they have a very aggressive marketing campaign.

Chris

says:

Yes.And there still is not an antidote in the UK yet if you have a major bleed. When I’ve questioned this they have not given me a straight answer. St Guys and Thomas’ hospital (leading hospital in regards to DVT etc) in the UK tends to stay away from Xarelto and uses other modern blood thinners. I am wondering why?

Did I also mention that I have had an outbreak in the groin area and was sent to hospital for a suspected heart attack when I was on the higher dose of Xarelto (30mg).

If you are on blood thinners please do not stop them. But ask your Doctor for alternatives. Apixaban – I know somebody who is taking this and has reported no major side effects.

Michael

says:

9 years ago after my fiance passed away hi double pneumonia and my heart stopped 25 minutes I want a life support for 2 weeks set up alarm clock go to my loan third blood clot in my life no I am on blood thinners for the rest of my life and antidepressants because of the fiance passing away and I could not figure out for the longest time what happened to my penis that used to be beautiful nice big now it’s a very small flaccid thing it is super embarrassing I will not even look for female companionship don’t know what to do I’m still on the antidepressant they do health and I will be on blood thinners the rest of my life

says:

I am so sorry to hear about your predicament. Have you tried psychotherapy? It has been proven to be much more successful than antidepressants, not to mention side-effect free.

Paul

says:

My husband paul had a blood clot on his lung in 2016, he was on warfarin to start with. We started to see each other.
Paul was always tired so we thought riveroxoban would be a better option.
Long story short we married in 2018. Had a great sex life ti start with however later 2017vit all sort of stopped
Leaking from the penis, small, no erection no feelings everything just gone. Mem , new relationship pride apparently my fault. Transpires everything on your page is what Paul feels.
Like being castrated in his sleep.
We have been to the doctor seen a urologist had tests…. nothing. There is no way this is right normal acceptable in any way.
They knew it could cause erectile dysfunction, take away the ability to feel, empathise love and cuddle. Yes his this from there list of risks and side effects.
Why is this still being used. Why have they not been sued. To make people feel like this is wrong on every level.

Frannie and paul b

Ernie McCausland

says:

Dear sir
I read your story and I can feel your pain I’m now 65 years old and haven’t had a sex life in 25 years struck down in the prime of life It cursed me through everything same symtoms as you no attraction for the opposite sex and when I tried to go out there and meet someone when the hour of truth came that was it you can’t perform bye So I’ve lived a shell of a life not truely a man or a woman my mother used to say the girl would have to be understanding but none so far I’m on all kinds of meds that will kill your sex life Xarelto Lopressor and beta blockers those are the killers but all meds have risks and I have a fib which causes strokes so it’s a trade off try and live a half of a life without having a stroke or death or have a dead penis better than being in a wheelchair a wise old man told me something many years ago there are some things worst than death and this is my cross to bare because I know there are a lot of people worst off than me take care and think about it

Jude

says:

Your article was nothing short of
Excellent, accurate and frightening!! I’m only 1 month in, and everything is as you described. I call it not having a penis. I never realized how much a part of my existence it was, until it stopped working. It’s dead from this drug, and life will never be the same.

GB

says:

Spiros, I am mid 50’s and just had a second DVT. I wasn’t on thinners until I got second DVT and they put me on Xeralto. I was on Xeralto after first DVT and bilateral PE’s until they cleared up. And I think because it is my second, doctors will want me on thinners for the rest of my life. If you were me, would you switch to Coumadin now? Appreciate the help, Thanks, G

says:

GB, every organism is different, if you did not have sexual side effects with Xarelto so far, then you may not have them in the future or you may do, who knows? This is pretty much trial and error given the absence of data and trials that focus on such side effects. If your previous clots cleared up, and then you had another episode, is it perhaps something in your lifestyle that you could have changed? Doctors focus on medications, that is how the whole system makes money, true health begins with diet and lifestyle. I recommend this book: Michael Greger, How Not to Die: Discover the Foods Scientifically Proven to Prevent and Reverse Disease

GB

says:

Spiros, Thank you for this book recommendation. I will read it and see if I can come up with a lifestyle plan. I got the Pfizer vaccination about a month prior and I think it caused herpes virus to spike in me. Do you know if any of this could also be related to blood clots? Anyway, appreciate you, GB

Jay

says:

Wow you hit the nail on the head. Been taking xarelto for about six yrs and I’m definitely detached from emotions and suffer from Ed. Until today it didn’t add up. Thank you for the eye opener

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