It goes without saying that high blood pressure (also known as hypertension) is a serious medical condition that can cause damage to blood vessels and increase risk of heart disease and stroke. What is not as well-known is how hypertension can affect male sexual performance. In fact, ED is one of the most important secondary conditions to cardiovascular ailments; thirty percent of hypertensive patients complain of erectile dysfunction. It is vital for men to pay attention to this matter as it can seriously hinder sexual functions, not to mention hypertension’s life-threatening situations mentioned earlier. In fact, men with ED are about 38% more likely to have high blood pressure than those without. In this article, we will take a closer look at high blood pressure and its relationship to ED.
Are High Blood Pressure and ED related?
Unsurprisingly, high blood pressure is a major cause of erection problems. A study in the Journal of the American Geriatrics Society found that about half of men ages 40 to 79 with high blood pressure had erectile dysfunction. In order to understand the relationship between high blood pressure and ED, we should understand the anatomy of an erection. With sufficient neural stimulation, the brain signals the smooth muscle chambers to relax and arteries to dilate, which allows blood to fill the empty spaces. The flow of blood vessels causes the sheath of tissue around the chambers to exert pressure on veins that retain blood and prevent blood back flow away from the penis. As the blood flow increases, the penis expands and stiffens. High blood pressure hinders an erection by preventing the arteries from functioning the way they should.
How Hypertension Affects Sex
High Blood Pressure and Blood Flow
Just to be clear, high blood pressure can damage your arteries by making them narrow and less flexible. If left untreated it can decrease the blood flow to the penile area. Poor circulation and weak blood flow to the penile area means that there will be no sign of a healthy and functioning erection. This is why studies target the underlying conditions such as hypertension – as well as diabetes – to be the leading reasons why men struggle with Erectile Dysfunction.
High Blood Pressure Drugs and Erectile Dysfunction
According to Harvard Special Health Report, one study in the European Heart Journal looked at men newly diagnosed with heart disease (but without ED) who started treatment with the beta-blocker Atenolol (Tenormin). Some of the participants were told about the sexual side effect of the blood pressure drug, and ED was reported by almost one-third of the participants. In contrast, among those who were not told the drug’s name or its side effects, only 3% said they experienced ED.
Can you Take Drugs for ED When You Have High Blood Pressure?
Given that ED is mainly a matter of blood flow, it can be said that the usual ED drugs (the pills) can complicate (or be complicated by) the effects of other medications. Men who are experiencing uncontrolled hypertension or are currently taking alpha-blockers (examples listed below) for that or for prostate issues, should avoid the typical pills (Viagra, Levitra, Cialis) or Staxyn. It is also not a good idea to take any of the ED pills when going through conditions such as:
• Taking nitrite drugs, such as for chest pain
• Had a heart attack/stroke less than 6 months previous
• Currently dealing with kidney or liver disease
• Currently dealing with the eye disease known as retinitis pigmentosa
While the use of Viagra – the brand name of sildenafil as 25mg, 50mg, and 100 mg tablets – is discouraged under these circumstances, Revatio – the brand name of the 20mg sildenafil tablet – is used to reduce high blood pressure specifically in relation to Pulmonary Arterial Hypertension (PAH). However, sildenafil can still be problematic at any amount when taken with a nitrate as the combination can result in blood pressure dropping too low. Understand that Revatio is only prescribed to treat PAH, not ED, and should not be considered a “lighter alternative” to Viagra, nor should they be taken with each other.
What Hypertension Drugs Cause Erectile Dysfunction?
Beta blockers and diuretics are two types of blood pressure medication known to be associated with side-effects which include ED.
Beta blockers target the same regions of the nervous system in charge of regulating erections. Such class of drugs prevents erections by restricting blood flow to the penile area, very similar to the effects of alcohol on erections. A few examples of beta-blockers include:
• Metoprolol (Lopressor, Toprol-XL)
• Atenolol (Tenormin)
• Propranolol (Inderal)
• Carvedilol (Coreg)
Diuretics (also known as “water pills”) reduce the intensity of blood flow to the penis; this is a major factor in causing men to not achieve an erection, especially for the elderly. This class of medication is also responsible for decreasing the zinc levels present in the body, which subsequently leads to a decrease in the testosterone levels.3 Lowered testosterone levels mean less sex-drive and desire for sexual activities, possibly leading to psychological ED.
Addictive substances can have a massive impact on your blood pressure and overall health. Smoking, alcohol consumption, caffeine, and drug use can directly damage blood vessels and the heart, as well as cause various non-reversible complications more severe than hypertension. Addictive substances exert an unusual amount of pressure on the heart and cause blood pressure readings to fluctuate greatly. This can impact not only the sex drive of individuals, but also their well-being in general. The best advice to correct this is to limit the intake of alcohol and caffeine, and avoid nicotine and other addictive drugs entirely.
Are there Blood Pressure Drugs that do NOT Cause Erectile Dysfunction?
While still carrying the risk of hampering blood flow to the penile region, there are alternative hypertension medications that are less likely to do so. As a result, the following drugs have seen far fewer (but are not free of) incidents of ED:
ACE (angiotensin-converting enzyme) inhibitors
reduce sodium levels in the kidneys and lower levels of angiotensin II, a hormone that causes blood vessels to constrict.
ARBs (Angiotensin II receptor blockers)
block angiotensin II from reaching receptors in the blood, heart, and kidneys
block the hormone catecholamine (another hormone that narrows blood vessels and makes the heart work harder) from reaching the body’s alpha receptors.
CCBs (calcium channel blockers)
rather than targeting the hormones, they target calcium levels in the blood, as excess calcium is also an element to the constricting of blood vessels.
ACE inhibitors, ARBs, and CCBs are also known to be helpful for those dealing with diabetes, another medical condition that often pairs with ED. While the use of any of these drugs is not a recommended (or guaranteed) way to fix Erectile Dysfunction, it is less likely to make an already awkward problem even worse.
Even in cases where hypertension did not cause ED, most of the medication for it can. Beyond the drugs, we are capable of controlling our blood pressure (to a certain extent) by eating healthy, maintaining a healthy weight, exercising regularly, and limiting the intake of addictive drugs such as alcohol, caffeine, and nicotine. Fixing high blood pressure is not a guaranteed way to cure ED, but it can help to overcome it. Erectile Dysfunction is a common experience, and could be due to various underlying conditions. That said, it can be improved with healthy behavior and especially with professional help. Boston Medical Group’s specialists offer professional advice in regards to treating ED, even when simultaneously dealing with High Blood Pressure. Feel free to contact us for more information.
THE CONTENT IS NOT INTENDED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE, DIAGNOSIS, OR TREATMENT. ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH PROVIDER WITH ANY QUESTIONS YOU MAY HAVE REGARDING A MEDICAL CONDITION.