Since silodosin is a highly selective inhibitor of the α_1A adrenergic receptor, it causes practically no orthostatic hypotension (in contrast to other α₁ blockers). On the other side, the high selectivity seems to cause more problems with ejaculation.^[4]

As α_1A adrenoceptor antagonists are being investigated as a means to male birth control due to their ability to inhibit ejaculation but not orgasm, a trial with 15 male volunteers was conducted. While silodosin was completely efficacious in preventing the release of semen in all subjects, 12 out of the 15 patients reported mild discomfort upon orgasm. The men also reported the psychosexual side effect of being strongly dissatisfied by their lack of ejaculation