ERECTIONS ∙ 4 minutes read

Blood pressure medication and erectile dysfunction: everything you need to know

By Kirsty Mason | Medically reviewed by Prof. Sam Shah

Blood pressure medication is commonly prescribed when lifestyle changes, such as diet and exercise, aren’t enough to lower your high blood pressure. But as well as lowering your blood pressure, is the medication lowering your libido?

There are a number of different medications which treat high blood pressure. In some cases, erectile dysfunction (ED) has been reported as a side effect. Despite this, some blood pressure medications aren’t thought to contribute to ED.

Does high blood pressure cause erectile dysfunction?

Erectile dysfunction can sometimes be an indicator of underlying health issues and hypertension (abnormally high blood pressure) has been known to affect ED.

It’s thought that hypertension may affect ED for two main reasons:

  • Blood flow: High blood pressure can cause arteries to build up with fat and cholesterol, which restricts blood flow. Blood flow to the penis is necessary for getting an erection. When blood flow is obstructed, the ability to get an erection is compromised.
  • Testosterone: Low testosterone levels have been linked to high blood pressure. Testosterone is a key hormone when it comes to sexual function. This is because low levels of testosterone can lead to a reduced sex drive, inhibiting the ability to get an erection.

Aside from high blood pressure, there are a number of health issues which are linked to ED, such as diabetes and high cholesterol. To get to the root of what’s causing your ED, you can take a blood test, such as the At-Home Health MOT. This will measure important biomarkers such as cholesterol and testosterone.

Blood pressure medications which may be linked to ED:

If you have hypertension, it’s important to get it treated. Although not every individual has the same experience, sexual dysfunction is sometimes reported as a side effect when taking antihypertensive medication.

Antihypertensive medications which have been linked to ED include:

  • Thiazide diuretics: In a study on diuretic therapy, ED was reported at a significantly higher rate among men who were taking thiazide diuretics compared to those who weren’t. 

Some types of beta-blockers have also been associated with ED, including the following:

  • Propranolol: Sexual dysfunction has been linked to propranolol. This may be because it reduces levels of testosterone which is a key hormone when it comes to getting and maintaining an erection.
  • Pindolol: Pindolol has also been found to reduce testosterone and a study showed that sexual behaviour was inhibited in rats after administration of the drug.

A 2003 study investigated the effects of atenolol on ED and found that men who were informed that the drug might induce ED were much more likely to report experiencing ED. This suggests that ED may have occurred as a result of anxiety about the side effects of taking the drug, rather than from the drug itself. Similar results were found when men were given metoprolol.

Blood pressure medications which aren’t linked to ED:

Although it’s important to bear in mind that everyone reacts differently to medication, many antihypertensive drugs aren’t thought to negatively impact ED.

This includes:

  • Calcium antagonists (such as amlodipine, nifedipine, diltiazem and verapamil)
  • Angiotensin-converting enzyme (ACE) inhibitors (such as ramipril, captopril, cilazapril, enalapril, fosinopril, imidapril, lisinopril, moexipril, perindopril, quinapril and trandolapril)
  • Angiotensin receptor blockers (ARB) (such as valsartan, losartan, and candesartan)

If you think you’re experiencing ED as a side effect of the medication you’re taking, it’s worth discussing your options with your doctor or pharmacist. 

What’s the best erectile dysfunction medication for high blood pressure?

Just because you’re taking antihypertensive medication, it doesn’t necessarily mean you have to stop taking ED medication. Sildenafil (which is the generic version of Viagra), vardenafil and tadalafil are usually safe to take alongside antihypertensive medication, although you should always consult your doctor first.

The bottom line

Some antihypertensive medications have been linked to ED, particularly thiazide diuretics and certain types of beta-blockers. Levels of testosterone have been measured at a lower rate after taking propranolol and pindolol, which may explain the link between the medication and ED. When it comes to atenolol and metoprolol, studies suggest the association with ED may be psychological rather than physical.

There are a number of blood pressure medications which aren’t thought to contribute to ED, including calcium antagonists, angiotensin-converting enzyme (ACE) inhibitors, and angiotensin receptor blockers (ARB).

Erectile dysfunction can sometimes be an indicator of underlying health issues such as high blood pressure, high cholesterol and low testosterone. It’s important to take a blood test if you’re not sure what’s causing your ED.

Related articles:

What’s the link between statins and erectile dysfunction?

From penis pumps to shockwave therapy: 5 alternative treatments to erectile dysfunction

How too much porn can cause erectile dysfunction

Cholesterol and erectile dysfunction: the inconvenient truth

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