Pregabalin and sex: what does Lyrica do to desire and erection?

9Does pregabalin affect sex?

“Ever since I started the nerve pill, I feel like my desire for everything has shut down, even for my wife.” Some patients say this with embarrassment, often after weeks of silence, because they do not know that what is happening to them is a known side effect of a medication they are taking.

Pregabalin is a medication doctors prescribe for nerve pain, epilepsy and other conditions, and among its best-known brand names in Egypt are Lyrica and Lyrolin. The pregabalin page explains how it works and why it is misused. Here we answer one question: what does pregabalin do to sexual life, both for people taking it on prescription and for those using it outside medical care?

The short answer: yes, it may have an effect, and the effect is officially recorded. But it does not happen to everyone who takes it, and it often improves when the doctor adjusts the plan. The bigger problem begins when the drug itself is used without supervision to chase a “high” or to delay ejaculation.

10What does the official Lyrica leaflet say about sexual effects?

The approved US Lyrica leaflet groups side effects by how often they appeared in trials, and counts as “frequent” anything seen in at least 1 in 100 patients. The list includes the following:

The leaflet also lists “increased desire” among the less frequent effects, which explains why some people report contradictory experiences. Responses vary from person to person, and a friend's experience is no guide to what will happen to you.

11An Egyptian study: how many patients had their sex life affected?

In a case series from the neurology and psychiatry department at Assiut University Hospital, published in 2018, data were presented on 75 patients prescribed pregabalin for various reasons, including sciatica, chronic headache, fibromyalgia and generalized anxiety disorder. Sexual dysfunction appeared in 31 patients, about 41%: nearly half of the men and about 37% of the women.

The problems appeared within weeks of starting the drug, were not linked to a higher dose, and improved within weeks of stopping it. Because this is a case series from a single center with no comparison group, its percentages cannot be used to estimate the risk for all patients. But it confirms the researcher's message: the doctor should ask about sexual function, and patients should talk about it without embarrassment.

12Does pregabalin treat premature ejaculation?

There is a widespread idea among young men that “the nerve pill delays.” The source of the idea may be a real side effect, since the leaflet lists ejaculation disorder among the less frequent effects. A randomized trial from Al-Azhar University published in 2020 tested pregabalin before intercourse in 116 men who completed the study. Ejaculation time improved only in the group that received the highest dose, and did not change in the other two groups.

But the researchers themselves described the drug only as “promising for further evaluation,” noting that the numbers were small, that follow-up lasted no more than two weeks, and that the right dose, duration of use and safety still need study. In other words, pregabalin is not an approved treatment for premature ejaculation, and using it for that purpose combines an uncertain benefit with a known risk of dependence.

13Pregabalin misuse and sex: why is the picture different?

People who take pregabalin in larger amounts than prescribed are usually looking for a high or calm. The leaflet notes that a feeling of euphoria appeared in 4% of those who took it in trials versus 1% with placebo. A systematic review published in 2017 noted a growing number of people taking higher than recommended amounts to get this effect. With large amounts the effects pile up: drowsiness, unsteadiness and poor concentration, all of which affect the marital relationship before any hormonal effect does.

In Egypt, pregabalin was placed on the control schedules in August 2019. According to a study published in 2025 that analyzed drug sales data, pregabalin sales fell by about 99% after the decision, while gabapentin sales rose by about 198%, which suggests that some use shifted to a similar drug. The gabapentin guide explains why it is not a safe alternative.

More dangerous is combining it with tramadol in search of a stronger effect or “for sex.” The leaflet mentions reports of life-threatening or fatal respiratory depression in people who took pregabalin with opioids or other nervous system depressants. The harms of pregabalin page goes into this mixture in detail.

14Does pregabalin affect fertility and hormones?

The leaflet describes a randomized study in healthy men who took pregabalin or placebo for 13 weeks, the length of a full sperm-production cycle. Sperm concentration fell to half or less in about 9% of the drug group versus about 3% of the placebo group, and the difference was within the limit the researchers had set in advance. No effect was seen on sperm shape or movement, or on testosterone.

In those affected, concentration returned to normal 3 months after stopping, except for one man whose reduction continued in later tests, and the leaflet says the clinical significance of these findings is unknown. Effects on fertility were also seen in studies on male rats. For this reason the leaflet advises a man who is planning to have children to tell his doctor. Decisions about pregnancy and breastfeeding always rest with the doctor.

15If you notice a sexual effect while taking it on prescription

1. Do not stop the medication suddenly, because stopping suddenly can cause withdrawal symptoms, which the pregabalin withdrawal symptoms page explains.
2. Tell the doctor who prescribed it honestly. They need this information just as they need to know about any dizziness or drowsiness.
3. Review your other medications with them, because some antidepressants and blood pressure medications also have sexual effects.
4. Ask about other possible causes, such as diabetes, anxiety or the pain being treated.
5. Let the doctor decide: adjust the plan, choose a suitable alternative, or continue with follow-up.

16When do you need an addiction treatment assessment?

If you take pregabalin without a prescription, in larger amounts than prescribed, or together with tramadol, or you cannot stop despite trying, these signs deserve an assessment. Treatment usually relies on a safe medical taper followed by psychological therapy that addresses what led you to the drug, and its stages are in pregabalin addiction treatment. At Eradah the first step is a free, confidential consultation, and treatment can continue through outpatient treatment or residential care depending on the case.