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The greater the number of medications a man takes, the greater his risk of erectile dysfunction, according to a Kaiser Permanente study published online today in the British Journal of Urology International. In the study of more than 37,000 men ages 46 to 69, the researchers found that 29 percent reported moderate to severe problems with maintaining erections. The incidence increased along with the number of medications men took.

While fewer than half of the study participants who took zero to two medications a day had erection difficulties, more than three-quarters of the men taking 10 or more medications a day did. Most of the study participants took at least three medications for various health conditions, including diabetes, hypertension, and depression.

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The most common offenders included: antihypertensives (beta blockers, thiazides, and clonidine) and antidepressants (selective serotonin reuptake inhibitors, tricyclics, MAO inhibitors). The researchers took into account conditions that cause sexual problems like hypertension, excess body weight, high cholesterol, diabetes, smoking, and depression and concluded that taking multiple drugs was an independent risk factor for erectile dysfunction.

A host of over-the-counter medications can also cause the condition and these weren’t evaluated in the study. These include the acid blockers Zantac and Tagamet, the antihistamine Benadryl, and the painkiller naproxen. The baldness drug Propecia has also been linked to erectile dysfunction as well as loss of libido, according to a recent study from Boston University School of Medicine.

Men experiencing erectile dysfunction may want to speak to their doctors about adjusting their medications before turning to drugs like Viagra or Cialis to treat the symptom.

“These data help emphasize the importance of assessing medication use” in men who suffer from sexual problems, wrote the authors of the Kaiser study. “Decreases or changes in the amount of or type of medication may significantly improve a man’s health-related quality of life.”

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Deborah Kotz can be reached at dkotz@globe.com. Follow her on Twitter @debkotz2.