"Doctor, I seemed to have erectile dysfunction since I started hypertension treatment with antihypertensive drugs. Are they related?”
First of all, the answer may be yes or no.
Why is that?
First, we need to know some background knowledge.
“Erectile dysfunction is a precursor to circulatory (cardiovascular) problems!"
The caliber of the male genital arteries is the smallest in the entire body, even smaller than the coronary arteries that supply the heart!
Therefore, if the blood vessels begin to harden and narrow, “erectile dysfunction will occur earlier than myocardial infarction!"
So, men must not neglect erectile dysfunction. Your “buddy” may be your health sentinel and lifesaver!
In practice, urology clinics also often detect other systemic diseases through erectile dysfunction, such as hypertension, hyperlipidemia, diabetes, endocrine diseases, etc.
Therefore, "having hypertension itself means that there is a high possibility and risk of erectile dysfunction!"
Therefore, erectile dysfunction in hypertensive patients is likely to be a problem with the disease itself, rather than medication!
Furthermore, erectile dysfunction has many risk factors, including the three highs, endocrine problems mentioned earlier, as well as many other risk factors such as smoking, alcoholism, obesity, sedentary lifestyle, age, sleep disorders, neurological diseases, prostate diseases, liver and kidney dysfunction, the influence of other drugs, social and psychological problems, and partner relationship issues, etc.
In other words, "there are many other possible factors that cause sexual dysfunction!"
Finally, does antihypertensive medication itself affect sexual dysfunction?
The answer is: most of them won't, but some will!
For example, some diuretics and non-selective beta-blockers may indeed have an impact on sexual function.
(Special note: Medications that help with urination, smooth urine flow, and treat prostate enlargement are not diuretics! Many patients misunderstand this, so it is emphasized here!)
However, with the advancement of technology, the choice of antihypertensive drugs is increasing.
Even if a certain type of medication must be used, it may be possible to find a replacement drug in the same category.
For example, when a β-blocker is required due to the condition, Nebivolol (Nebilet®), a new generation selective β1-blocker, can be chosen.
Not only does it not cause erectile dysfunction, it may even be helpful!
Therefore, if you are worried that blood pressure medication may affect sexual function, you can discuss with your cardiologist.
More importantly, you must examine whether your chronic diseases, such as hypertension and diabetes, are well controlled and whether there are other risk factors causing sexual dysfunction.
Because these factors not only affect one’s sexual life, but also relate to one's health and even life safety!
Special thanks: I am grateful to my nice classmate, Dr. Cheng-Yen Chuang from the Cardiology Department at Shin Kong Wu Ho-Su Memorial Hospital, for providing hypertension treatment information!
Reference: https://www.mdpi.com/2227-9059/9/4/432
https://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/symptoms-causes/syc-20355776
https://pubmed.ncbi.nlm.nih.gov/16491268/
