Can blood pressure drugs cause erectile dysfunction?

Question

Hi doctor,

I am a doctor practicing in a rural area, and I am 55 years old. I have had high blood pressure for the last seven years. My blood pressure was 180/100 mmHg before treatment, and now I am on Telmisartan H 40 mg once daily. My BP fluctuates between 128 and 135 systolic to 85 and 90 diastolic. I do not have any symptoms of hypertension either before or after starting treatment. My only concern now is that I am having ED. Is it due to the drugs I am using, BP itself, or just an age factor? I have tried Sildenafil, but no effect. Can you suggest any solution either by changing the antihypertensive drug that is less likely to cause ED or any other medication? Or do you advise me to accept the situation? I can understand and follow your advice.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

Regarding your ED (erectile dysfunction), definitely your age can be a factor. But, if ED develops suddenly, then this could be caused by anxiety. It is one of the most important causes of ED. Yes, some ARBs (angiotensin receptor blockers) can cause ED as a side effect, and also Thiazide diuretics, which are present in your medication. I suggest you switch to ACE inhibitors such as Lisinopril with or without calcium channel blockers. If you are diabetic, then it is also a cause of ED.

Moreover, ED can be an indicator of future cardiovascular risk. I suggest you rule out vascular causes of ED. You can have a penile Doppler ultrasound with Alprostadil injection to rule out vascular elements. Do exercise yoga and remain happy. Sildenafil had no effect, which means it can be due to anxiety or depression. Have a lipid profile done and exercise tolerance test to rule out impending cardiovascular risk. Also, keep your BP well controlled.

I hope this helps.

Please revert so I can assist you further.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

I suggest Lisinopril 10 mg at night time. It may be combined with 5 mg of Amlodipine during the daytime. Monitor your blood pressure for about 15 days. Consult your specialist doctor, discuss with him or her, and take the medicine with consent.

Before penile Doppler US, do not forget to take an anxiolytic such as Alprazolam 1 mg or any other anxiolytic drug about two hours before the procedure.

I hope this helps.

Please revert so I can assist you further.

Thank you.