text: by taking tramadol as pain killer, will it cause e.d. or effact libido?   absolutely any derivative of the codeine molecule can make you have a limp stick just like any derivative of the morphine molecule can cause the same thing.  tramadol which is generic ultram is similar to dextromethorphan. it is the codeine molecule with a twist here and there of the chain, making is less addictive, longer acting, etc.  you can actually take those two together and get a synergistic response (1+1=3)