To treat erectile dysfunction (ED), you have to lower high blood pressure. Some people are able to do that through lifestyle changes alone. Others need help from prescription high blood pressure medication.
A problem for many men, though, is that some types of blood pressure drugs can cause erectile dysfunction. That may make it tough to stay on medication, especially if high blood pressure never caused any symptoms before. An estimated 70% of men who have side effects from high blood pressure medicine stop taking it.
While many drugs used to treat high blood pressure have been linked to erectile dysfunction, some are much less likely than others to cause problems. Certain high blood pressure drugs may even improve erectile dysfunction for some men.
It's known that diuretics (or water pills, like hydrochlorothiazide) and beta-blockers (like Atenolol) can also cause erection problems. These are also the first drugs that a doctor is likely to prescribe if you are not able to lower your high blood pressure through diet and exercise.
If you take a diuretic, you should stay on it until high blood pressure is under control. If erection problems persist, or blood pressure goes back up, then your doctor might switch to a drug that's less likely to cause erectile dysfunction. Or, a combination of medications might work better to control high blood pressure and lower the risk of erectile dysfunction.
High Blood Pressure Drugs Not Likely to Cause ED
Some families of high blood pressure drugs rarely cause ED as a side effect. They include:
ACE (angiotensin converting enzyme) inhibitors -- such as Capoten, Lotensin, Prinivil, and Zestril for example -- widen blood vessels and increase blood flow. Erectile dysfunction is rarely a side effect, occurring in less than 1% of patients. There are several different drugs in this category. This seems to be true of all of them.
There are also drugs known as calcium channel blockers, such as Amlodipine, Diltiazem, or Verapamil. As a group, they rarely cause erectile dysfunction. But erection problems may be less common with some individual drugs within that group than with others. Your doctor can tell you which.
In general, alpha-blockers do not often cause erection problems either. In one study, a small number of men actually had a 100% improvement in their erectile dysfunction after 2 years on the alpha-blocker Cardura.
Drugs known as ARBs (angiotensin II receptor blockers, like Losartan) are not only unlikely to cause erection problems, but they may improve sexual function in men with high blood pressure.
One study looked at the drug Cozaar, an ARB. At first, just 7% of men and women in the study said they felt sexually satisfied overall. After 12 weeks of Cozaar, about 58% said they were sexually satisfied. The percentage of men who reported having erectile dysfunction dropped from 75% to 12%.
The drugs controlled blood pressure equally well. But people who took the ARB reported having sex more often during the 16 weeks of treatment. They said they had sex about eight times a month before, and 10 times a month after. People taking the beta-blocker had sex much less often: eight times a month before, and four times a month after.
If Your Medicine Causes Erectile Dysfunction
Tell your doctor if you think blood pressure medicine may be causing erectile dysfunction.
If it is medication, and not just high blood pressure, switching to another prescription may solve the problem. Never stop taking medicine without your doctor's OK.
You should only take these drugs once your high blood pressure is under control. They are not safe for men with untreated high blood pressure. They are also not safe for men taking alpha-blockers, or men taking nitrate drugs for heart disease.