How Corticosteroids Might Affect Your Sex Drive

Corticosteroids are a class of drugs that are widely used due to their anti-inflammatory and immunosuppressive effects, says the Cleveland Clinic. They are synthetic versions of the hormone cortisol, which is produced naturally by the adrenal glands. There are two main types of corticosteroids: glucocorticoids and mineralocorticoids. Glucocorticoids are the most commonly used and are primarily prescribed to reduce inflammation and suppress the immune system, per a 2016 study published in the journal Rheumatic Disease Clinics of North America. Corticosteroids like glucocorticoids bind to specific receptors in cells throughout the body, which triggers a series of biological processes that decrease inflammation and immune system activity, per the study. Examples of glucocorticoids include prednisone, prednisolone, dexamethasone, and hydrocortisone. 

Mineralocorticoids, on the other hand, regulate the balance of water and electrolytes in the body and are primarily used to treat conditions such as adrenal insufficiency (Addison's disease), according to Colorado State University. Examples of mineralocorticoids include desoxycorticosterone. While corticosteroids can be highly effective at managing various conditions, they can also have various side effects, including changes in libido and sexual function.

One 2019 study published in the journal Endocrine Connections found that long-term treatment with corticosteroids, specifically prednisone, was associated with decreased testosterone levels in men. This decrease in testosterone levels was consistent with a single dose as used in the study. This means that higher doses of prednisone may result in a greater decrease in testosterone levels. Men treated with corticosteroids may also experience erectile dysfunction. Erectile dysfunction is listed as a side effect of prednisone on Drugwatch and refers to the inability to get or keep an erection, according to the National Health Service.

Another 2013 study published in the journal Australian Prescriber reiterates this claim. In addition to erectile dysfunction, the study notes that men treated with corticosteroids like prednisone were found to have lower testosterone levels resulting in reduced sexual desire. Interestingly, another 2018 study published in the journal Neurology Neuroimmunology & Neuroinflammation reported that a higher percentage of women than men reported loss of interest in sex as a side effect of taking prednisone.

Mood changes, such as depression and anxiety, have been reported in people taking corticosteroids. A 2019 study published in the European Archives of Psychiatry and Clinical Neuroscience notes that depression is associated with the long-term use of corticosteroids. And in turn, WebMD notes that depression and sexual dysfunction have been linked. According to the source, men and women with depression are more likely to experience a decline in sexuality due to the malfunctioning of certain chemicals in the brain known as neurotransmitters. To make things worse, some medications like selective serotonin reuptake inhibitors (SSRIs) that treat depression may have side effects that may also impact sexual desire and function.

If you are experiencing changes in your sex drive while taking corticosteroids, talking to your doctor helps. They may be able to adjust your medication or provide other treatments to help manage any sexual problems you are experiencing. Talking to a therapist or counselor about any mood changes or body image issues you are experiencing may also be helpful.