Based on NIH | Does taking naproxen increase the risk of sexual side effects such as decreased libido or erectile dysfunction?

Naproxen and sexual side effects: what we know

• Current evidence suggests that sexual side effects with naproxen (an NSAID) are uncommon, but they may occur. Reports include decreased libido and erectile dysfunction, though these are not listed among the most frequent adverse effects in standard consumer-facing references. ^[1]
• Large observational data on NSAIDs as a class show an association between regular NSAID use and erectile dysfunction, but this does not prove causation. In a cohort of ~81,000 men, regular NSAID users had higher odds of erectile dysfunction even after adjusting for age and health conditions. ^[2]

What official information says

• Commonly described naproxen side effects include stomach upset, dizziness, drowsiness, ringing in the ears, and sleep difficulty; sexual effects are not highlighted among the common reactions in consumer summaries. This implies that if sexual side effects occur, they are likely infrequent. ^[1]
• General NSAID medication guides focus on heart, stomach, kidney, liver, skin, and allergic risks, and list common nonsexual side effects like stomach pain, constipation, diarrhea, heartburn, nausea, vomiting, and dizziness. Sexual side effects are not emphasized in these standard guides. ^{[3] [4] [5]}

Research on NSAIDs and erectile function

• A large prospective cohort (California Men’s Health Study) found that regular NSAID use was associated with higher odds of erectile dysfunction; the adjusted odds ratio was 1.38 after controlling for age, smoking, diabetes, hypertension, lipids, vascular disease, coronary disease, and BMI. This suggests a modest association but does not establish that NSAIDs directly cause ED. ^[2]
• Observational designs can be affected by “confounding by indication” (people taking NSAIDs often have pain, inflammation, or vascular conditions that themselves increase ED risk). Therefore, the link may reflect underlying health issues rather than a direct drug effect. ^[2]

Possible mechanisms and context

• There is no definitive mechanism proving naproxen directly causes decreased libido or ED. Potential hypotheses include effects on blood vessel signaling or indirect impacts such as pain, poor sleep, or mood changes affecting sexual function, but these remain speculative in the absence of causal trials. ^[1]
• For women, naproxen may delay ovulation and could affect fertility while taking it, which highlights that NSAIDs can influence reproductive physiology. However, this is a different pathway from libido or arousal and does not confirm sexual side effects. ^[6]

Practical guidance if you’re concerned

• Risk seems to be low but not zero. If you notice decreased libido or erectile difficulties after starting regular naproxen, consider whether symptoms improve when the dose is reduced, the dosing schedule is changed, or the medicine is paused under medical guidance. ^{[3] [4]}
• Review other common contributors: stress, sleep problems, alcohol, smoking, depression, anxiety, diabetes, high blood pressure, and other medications (e.g., certain antidepressants, blood pressure drugs). Addressing these often improves sexual function more than changing the NSAID alone. ^[2]
• Discuss alternatives for pain control if needed: topical NSAIDs, acetaminophen, intermittent rather than daily use, physical therapy, or targeted treatments. Any medication change should be made with your clinician, especially if you have heart, kidney, or gastrointestinal risks. ^{[3] [4]}

Bottom line

• Naproxen does not commonly list sexual side effects in standard consumer information, suggesting these events are uncommon, but they have been reported with NSAID use and large observational data show an association with erectile dysfunction. Overall, naproxen may be associated with sexual side effects in some people, but the absolute risk appears low and causation is not established. ^{[1] [3] [4] [2]}