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Clinical evidence

Benzodiazepines

GABA-A modulator·Medication side-effects

Effect across the cycle

DesireInhibitory: Reduced libido at typical doses; a minority report the opposite.
ArousalInhibitory: CNS depression blunts arousal.
PerformanceInhibitory: Impaired erection via enhanced GABA-A tone.
ClimaxInhibitory: Dose-dependent delayed orgasm or anorgasmia.
ExperienceMixed: Anxiety reduction can improve the experience for some.
MemoryInhibitory: Anterograde amnesia at higher doses.

Mechanism

Positive allosteric GABA-A modulators causing CNS depression. Reduce libido, impair arousal and erection, and delay or block orgasm; enhanced GABA-A function reduces penile erection. A minority report increased libido through anxiety reduction.

Pharmacokinetics
Dose-dependent; anorgasmia reported with alprazolam and others.
Reversibility
Generally reversible with dose reduction or discontinuation.

Sex differences & notes

Around 8% report increased libido via anxiolysis; the majority effect is suppressive.

Key sources

  • Rev Int Androl 2020 review