A frequent complaint of most men on high blood pressure medication is that, since they started taking these BP drugs, their sex life has gone down the drain. So Doc, what can be done about this? This is a legitimate concern; some blood pressure medications are notorious for causing erectile dysfunction (ED). High on the list is Beta blockers (Propranolol, Atenolol) and Diuretics (Moduretic, Thiazide diuretics, Frusemide). These drugs reduce blood flow to the penis which is needed to achieve an erection. Also diuretics remove vital elements like zinc from the body which is needed for the production of testosterone, male sex hormone.
High blood pressure itself can also lead to erectile dysfunction (ED). This is due to damage to the blood vessels that carry blood to the penis, which results in narrowing of the lumen of the vessels (atherosclerosis) hence to poor blood flow to the organ, thereby leading to poor erection.
However anxiety from being diagnosed of hypertension can also be a contributing factor, especially since some people believe hypertension is a form of heart disease, and that having sex with heart disease could lead to sudden death. Anxiety is a major factor that causes erectile dysfunction. Once a man has an episode of poor erection during sex, the fear tends to linger and may worsen. In such a situation counseling may be all that is needed. A clear explanation, that high blood pressure is not a death sentence to sex life, and that they should take their medication and ensure their blood pressure is controlled.
Recommendation, if the BP medication is responsible for the ED, other hypertensive drugs that are less likely to cause ED can be used, examples are calcium channel blockers (Amlodipine), angiotensin receptor blockers (Losartan), alpha blockers (Doxazosin). However, note that it takes a while, several days to weeks, before erection returns after stopping a drug that causes ED. Also note that if you have to use erectile dysfunction drugs like Viagra, Cialis, Levitra or Tadalafil, it is safe with most blood pressure medications with the exception of alpha blockers like Doxazosin (Cardura). However consult with a medical professional before using these drugs.