Blood Pressure Medications & Erectile Dysfunction

Eli Ben-Yehuda

Written by Eli Ben-Yehuda

On September 10, 2019
What is Erectile Dysfunction (ED)?

Erectile dysfunction (ED) is the inability to get or keep an erection firm enough to have sexual intercourse. It’s also sometimes referred to as impotence.

Occasional ED isn’t uncommon. Many men experience it during times of stress. Frequent ED can be a sign of health problems that need treatment. It can also be a sign of emotional or relationship difficulties that may need to be addressed by a professional.

If you’re concerned about erectile dysfunction, talk to your doctor — even if you’re embarrassed. Sometimes, treating an underlying condition is enough to reverse erectile dysfunction. In other cases, medications or other direct treatments might be needed.

What Are The Causes of ED?

Male sexual arousal is a complex process that involves the brain, hormones, emotions, nerves, muscles and blood vessels. Erectile dysfunction can result from a problem with any of these. Likewise, stress and mental health concerns can cause or worsen erectile dysfunction.

Sometimes a combination of physical and psychological issues causes erectile dysfunction. For instance, a minor physical condition that slows your sexual response may cause anxiety about maintaining an erection. The resulting anxiety can lead to or worsen erectile dysfunction.

Also ED has been considered an early marker of cardiovascular disease. The connection between both conditions seems to be located in the endothelium, which may become unable to generate the necessary dilatation in penile vascular bed in response to sexual excitement, producing persistent impairment in erection.

On the other hand, the real influence of antihypertensive drugs in erectile function still deserves discussion. Therefore, regardless of ED mechanism in hypertension, early diagnosis and correct approach of sexual life represent an important step of cardiovascular evaluation which certainly contributes for a better choice of hypertension treatment, preventing some complications and restoring the quality of life.

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What Are The Risk Factors?

Common risk factor categories associated with sexual dysfunction exist for men and women including individual general health status, diabetes mellitus, cardiovascular disease, other genitourinary disease, psychiatric/psychological disorders, other chronic disease, and socio-demographic conditions.

Actually, vasculogenic ED is considered part of a systemic vasculopathy and has a known relation with cardiovascular risk factors such as hypertension, diabetes, dyslipidemia, and smoking. ED has been considered an early marker of cardiovascular risk that could precede traditional clinical manifestations of atherosclerosis, indicating the presence of vascular disease.

In addition, ED could alert clinicians to the presence of unknown risk factors and an increased cardiovascular risk. Thus, ED could offer the opportunity to implement adequate therapeutic efforts to minimize the burden of major cardiovascular disease such as myocardium infarction and stroke.

Can Certain Medication Cause ED?

Several drugs can produce erectile difficulties, but blood pressure drugs are near the top. ED is an occasional side effect of BP drugs like thiazide diuretics, loop diuretics, and beta-blockers, all of which can decrease blood flow to the penis and make it difficult to get an erection.

However, other BP drugs, such as alpha-blockers, ACE inhibitors, and angioten-sin-receptor blockers, rarely cause ED.

Some research even suggests the effect of blood pressure drugs may be more psychological than physical. When ED occurs after a man begins to take a new medication, it’s possible that anxiety about his health, rather than the medication, may trigger the problem. And being aware of possible side effects may make a man more likely to recognize them as abnormal.

Beta-Blockers and ED

Beta-blockers help lower blood pressure by blocking certain receptors in your nervous system. These are the receptors that are usually affected by chemicals such as epinephrine. Epinephrine constricts your blood vessels and causes blood to pump more forcefully. It’s thought that by blocking these receptors, beta-blockers may interfere with the part of your nervous system responsible for causing an erection.

However, according to the results reported in one study in the European Heart Journal, ED associated with beta-blocker use was not common. The reported cases of ED in men who took beta-blockers may have been a psychological reaction instead. These men had heard before the study that beta-blockers could cause ED. To learn more, read about psychological causes of ED

.

Diuretics and ED

Other common blood pressure-lowering medications that can contribute to erectile dysfunction are diuretics. Diuretics cause you to urinate more often. This leaves less fluid in your circulation, which leads to lower blood pressure. Diuretics may also relax muscles in your circulatory system. This may decrease the blood flow to your penis necessary for an erection.

How ED Can Be Treated

If your doctor thinks that your ED may be related to your beta-blocker and you can’t take other blood pressure drugs, you may still have options. In many cases, you can take drugs to treat erectile dysfunction. Your doctor must have a complete list of your current medications. This can help them know if the ED drugs could interact with drugs you already take.

Currently, there are six drugs on the market to treat erectile dysfunction:
  • Caverject
  • Edex
  • Viagra
  • Stendra
  • Cialis
  • Levitra

Of these, only Caverject and Edex are not oral pills. Instead, they’re injected into your penis.
None of these drugs are currently available as generic products. The side effects of these drugs are similar, and none of them interacts with beta-blockers.In an unfortunate twist, many drugs that are good for your heart can be hard on your sex life.

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Conclusion and Overview

Beta blockers and diuretics, two very popular classes of blood pressure medicine, can cause erectile problems in men. Though it’s usually safe to take erectile dysfunction drugs (Viagra, Levitra, Cialis) with high blood pressure medication, don’t take them with nitrates — this can cause a life-threatening drop in blood pressure. Also, a-adrenoceptor blockers such as doxazosin and tamsulosin should only be combined with these erectile dysfunction medications under close monitoring by your doctor.

If you develop any sexual difficulties after taking your medication, don’t suffer in silence. Your doctor can usually solve the problem by simply changing the prescription. ACE inhibitors, calcium channel blockers, and alpha blockers can lower blood pressure with fewer risks of sexual side effects.

In fact, some hypertension medicines may actually give a boost to a person’s sex life. A study of 82 men with sexual dysfunction, published in the May 2001 issue of the American Journal of Medicine and Science, found that patients had more reliable erections and more frequent sex after treatment with the drug losartan (Cozaar). Losartan belongs to a relatively new class of drugs known as angiotensin II receptor antagonists.

But whatever medicine your doctor prescribes, be sure to follow the instructions to the letter. Taking medicines properly is one of the surest ways to cut down on side effects, sexual or otherwise.

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