Cardiovascular Implications of Erectile Dysfunction

Some medicines may lead to life-threatening reactions if you do not take care when stopping or changing them. Among men, high blood pressure can cause erection problems by slowing the supply of blood to the penis. For example, if impotence is the result of a side effect of medicine or an underlying disease, the anxiety caused by lack of performance may perpetuate the erectile dysfunction even after the physical cause has been dealt with. However, sexual activity is also likely to be beneficial for your cardiovascular health. To help your doctor select the most appropriate medication for you, tell him or her all the other medications you're taking now — including herbal supplements and over-the-counter drugs.

Atherosclerosis affects not only the blood vessels supplying the heart (coronary arteries), but also blood vessels throughout the entire body. You think you'd like to also, but you have a problem getting an erection. This is used to measure the blood flow in the penis. Although levels peaks in midlife and then slowly declines with age, low testosterone does not appear to be a direct cause of erectile dysfunction, according to the latest research. The more your doctor knows about you, the better he or she can treat your high blood pressure — and help you maintain a satisfying sex life. Sildenafil citrate (Viagra). Vacuum devices.

Most men with penile implants and their partners say that they're satisfied with the results, and they return to more spontaneous intimacy.

Secondary sex characteristics, such as hair pattern, can point to hormonal problems, which involve the endocrine system. It's usually safe to combine the erectile dysfunction drugs sildenafil (Revatio, Viagra), vardenafil (Levitra, Staxyn) and tadalafil (Adcirca, Cialis) with high blood pressure medications. Here are 25 more heart-healthy secrets cardiologists want you to know. Erection problems (impotence) are very common, particularly in men over 40.

The adverse effects of clomipramine (Anafranil), for instance, include ejaculation failure (reported by more than 40 percent of men taking the drug), impotence (reported by at least 15 percent of patients) and decreased libido (reported by at least 18 percent of patients). July 20, 2020. Penile vascular surgery is not recommended for older men with hardened arteries. Several neurological problems can lead to ED. Sexual function in hypertensive patients receiving treatment. A new study also suggests that supplementation with amino acids called l-arginine and l-citrulline may also help to improve erectile function. Health care is a conversation, not a prescription.

Tests and diagnosis A doctor will often perform some of the following tests to diagnose ED: As ED is highly prevalent and deeply impacts overall health of sexually active men, sexual function should be part of anamneses in all hypertensive subjects, especially those over 50 years. Most people know that high blood pressure is not a good thing. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

Penile ultrasound.

When to see your GP

Burchardt M et al. In men in their 70s and 80s, the association all but disappeared, possibly because older men have different perceptions of masculinity. These drugs include: Because penile vascular surgery is not recommended for aging males who have failed oral PDE5 inhibitors, ICI or IU therapies, implants are the next step for these patients. Some authors state that ED symptoms in hypertensive patients would represent deterioration in endothelial dysfunction already present and should alert for a possible progression of a systemic vasculopathy [61]. ” An accompanying editorial urged healthcare professionals to use the information to reassure patients on cardiovascular-prevention drugs. Viagra (sildenafil), Cialis (tadalafil), or Levitra (vardenafil). To look for an underlying problem, such as:

Some blood pressure medications can cause eerectile dysfunction Hypertension - or high blood pressure - can damage arteries and make them less flexible. Getting an erection is really a complicated process. There are many causes of erectile dysfunction (ED) which can be physical, psychological, or both. Antiarrhythmics (medication for irregular heart action). Experts at Harvard Health point out that weaker erections are often the first sign of heart disease and should always be reported to a doctor. As more blood flows in, the level of pressure increases and the penis gets harder.

You can almost think of the process like water filling a balloon. You then place a rubber ring around the base of your penis to keep the blood in place, allowing you to maintain an erection for around 30 minutes. Erectile dysfunction is very common as men age. Alert about the necessity of sexual excitement to reach an erection under PDE5 inhibitor. Specifically relevant for sexy time, hypertension can restrict adequate flow to the pelvic region and affect the sex lives of both men and women.

Further Testing

The FDA has issued consumer warnings and alerts. Positive impact on patients and their partner quality of life. Psychotherapy. Here are seven other surprising factors that may raise your risk of developing ED. Two types of implants are used to treat ED, including: Male sexual function (published March 2020). Here's the good news: In well controlled hypertensive subjects who take one or two antihypertensive drugs and have no other risk factors, indicating low cardiovascular risk, PDE5 inhibitors could be tried.

Feeling embarrassed about being impotent may prevent many men from seeking the medical attention they need, which can delay diagnosis and treatment of more serious underlying conditions. Before we get into the ways hypertension can indirectly affect erections, let’s look at the direct effects that it has on ED. Learn, [32][33][34][35][36] The FDA has warned consumers that any sexual enhancement product that claims to work as well as prescription products is likely to contain such a contaminant. One of the signs that diabetes may be to blame for a man's ED experience is the age of onset. So with this physiological effect in mind, it stands to reason that if a man has an erectile issue, circulation or other blood flow problems could be to blame. If it happens more often, it may be caused by physical or emotional problems.

Anti-seizure medications. A single dose of alprostadil for urethral application is around $10. The symptom of ED is not being able to get or keep an erection firm enough for sex. In these cases, seeing a counsellor may help. Now, doctors know that many cases of impotence have a physical cause, which usually can be treated. Often they do not have any symptoms so it is a good idea to regularly check your blood pressure and keep it under control.

Can Cialis be taken with Carvedilol?

Getting (and maintaining) an erection requires a surprising amount of things to go right. This may seem like a lot to manage at a glance, however, just focus on one step at a time. Diuretics (pills that cause increase urine flow). Comparable results were obtained with newer PDE5 inhibitors vardenafil and tadalafil [80]. Men considering medications for erectile dysfunction should check with their doctor first. The treatment for ED starts with taking care of your heart and vascular health. When you’re stressed and focusing on other issues apart from sex, you might find that you don’t want to have sex as often and there might be a drop in your ability to perform when you do try.

We know why high blood pressure and some of the medications to treat it might affect men.

The end result is difficulty with maintain a firm erection (losing an erection too quickly) that is now believe to be an early manifestation of atherosclerosis and vascular disease. Finally, high blood pressure can have a negative effect on sexual performance because it can cause blood vessel walls to harden and make it difficult to get enough blood flow to the penis to maintain a strong erection. Meaning of ED as a cardiovascular risk marker. Some antidepressant medications cause erectile failure. Also, a-adrenoceptor blockers such as doxazosin and tamulosin should only be combined with these erectile dysfunction medications under close monitoring by your doctor. The general recommendation is 30 minutes a day 5 days a week.

Start by talking with your doctor. Experimental studies have demonstrated an enhancement of endothelial function in aorta and corpus cavernosum with a significant reduction in penile oxidative stress and collagen content [49], protected cavernosal tissue against structural changes, and increased expression of endothelial NO synthase (eNOS) [50]. Finding a medication that treats high blood pressure without causing ED is a goal of many men. It is now known that, for most men, erectile dysfunction is caused by physical problems, usually related to the blood supply of the penis. ED is an occasional side effect of BP drugs like thiazide diuretics, loop diuretics, and beta-blockers, all of which can decrease blood flow to the penis and make it difficult to get an erection. In atherosclerosis, the arteries are clogged and narrowed, resulting in reduced blood flow.


Erectile dysfunction (ED), sometimes called impotence, is the inability to get or keep an erection firm enough for sexual intercourse. Taking medicines properly is one of the surest ways to cut down on side effects, sexual or otherwise. Actually, vasculogenic ED is considered part of a systemic vasculopathy and has a known relation with cardiovascular risk factors such as hypertension, diabetes, dyslipidemia, and smoking. Some of the study participants were told about the sexual side effect of the blood pressure drug, and ED was reported by almost one-third of the participants.

This can be due to atherosclerosis, also known as hardening of the arteries.

That is because there is a risk of prostate enlargement and other side effects. Inform about the time interval to take drug before sexual intercourse. ” Not so fast!

There are many neurological (nerve problems) causes of impotence.

Venous Leakage

Accurate risk factor identification and characterization are essential for prevention or treatment of erectile dysfunction. You’re also more likely to have morning erections, and be able to have an erection when you masturbate, than men whose impotence has a physical cause. Like any learned behaviors, it can be unlearned.

What many may not know is how the penis achieves this state. One reason erectile dysfunction (ED) becomes more common with age is that older men are more likely to be on medication, and ED is often a side effect of many common drugs. It may also be considered in: Vision changes are the least common. It can also mean you are not happy with the size or hardness of erections, or how long erections last. Hormone-induced impotence. It is well known that the blood increment towards cavernous tissues necessary for a rigid erection is huge and even small hemodynamic disturbances could produce sexual dysfunction [22].

The regulation of blood vessel tone – how wide or narrow the blood vessels are – is a complicated process that employs many chemical and physical mediators.

Treatment For Erection Problems Depends On The Cause

If you develop any sexual difficulties after taking your medication, don't suffer in silence. Hormones regulate everything from weight gain, bone growth to sexual drive, and erectile response. Blood loss is typically small. Specific treatment for erectile dysfunction will be determined by your doctor based on: Or perhaps your erection isn't quite as firm as it once was, but it's still good enough.

9 million adult men in the U.

High blood pressure (hypertension) is the dirty, rotten scoundrel behind many health conditions, including erectile dysfunction (ED). Although PDE5 inhibitors have been extensively used for more than one decade, inadequate use is still one major cause of therapeutic failure. If erectile dysfunction is caused by high blood pressure, then lowering blood pressure through medicines and lifestyle changes should treat the problem effectively. What medications are you taking?

Depression is another cause of ED and is closely related to erectile dysfunction.

If your GP feels this type of exercise could be beneficial, then you may want to discuss it with a physiotherapist to learn it correctly. This creates a vacuum that causes the blood to fill your penis, making it erect. 9 million men. In men, it’s probably more obvious. Benzodiazepines may also interfere with the production of testosterone, a hormone important for sexual desire in women as well as men. Or, a combination of medications might work better to control high blood pressure and lower the risk of erectile dysfunction. It's usually nothing to worry about, but you should see a GP if it keeps happening.

What causes ED?

There is generally no change to a man's feeling or orgasm. Sildenafil works for 4-8 hours; vardenafil works for up to 8 hours; and tadalafil works for up to 36 hours. If you or a loved one has been prescribed one of these drugs for Alzheimer’s-related depression or agitation, talk to the doctor immediately.

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Losartan works by blocking angiotensin, a hormone that causes high blood pressure, and keeping it from binding to body tissues. For more information on preventing heart disease, diet, weight loss, exercise, quitting smoking, and ED, see the following: That’s why we call ED your body’s “check engine light. Sites, 8) compared with placebo-treated patients (3. In this way, search for new data on basic mechanism under ED development in hypertensive individuals is an actual need. This means less blood is able to flow to the penis.

If you have heart problems, tell your doctor before taking any ED medicines. Left untreated, high blood pressure can cause ED. The pump moves a saline solution into the cylinders to cause an erection. The drugs require normal nerve function to the penis. Ideally, such investigation could be held before starting therapeutic. Premature ejaculation is the inability to maintain an erection long enough for mutual satisfaction. Exercise, particularly cardiovascular exercise such as jogging and cycling, can naturally lower your blood pressure. If the results suggest an increased risk for cardiovascular disease, a referral to a cardiologist is reasonable for detailed diagnostic testing and initiation of therapy [73].

Occasional erection trouble isn’t necessarily a cause for concern. Talk to your doctor if you have any side effect that bothers you. Always speak to your GP before using any complementary therapies. To make sure your blood pressure remains within a safe range, you may need frequent blood pressure readings while you're not taking the blood pressure lowering medication that may be causing your sexual difficulties. Better lifestyle choices such as losing weight, avoiding tobacco and drinking in moderation, can lower blood pressure and make erections better. Implants are usually not considered until other methods of treatment have been tried but they have a very high patient satisfaction rate and are an excellent treatment choice in the appropriate patient. Improving arousal and lubrication can help. This can be very frustrating for you and your partner.

  • Prolonged erections (>1 hour) can be reversed by a second injection (antidote) in the office.
  • During COBRA (PolarCath Cryoplasty Versus Conventional Balloon Postdilation of Nitinol Stents for Peripheral Vascular Interventions) trial, Montorsi et al.
  • Erectile dysfunction (updated 25 May 2020).
  • So, when is it erectile dysfunction and when should you seek help?


One of the most common causes of ED is diabetes. They make a stiff penis that lets you have normal sex. Usually, a man takes 1 tablet 30 minutes to 1 hour before he plans to have sex. ACE inhibitors, calcium channel blockers, and alpha blockers can lower blood pressure with fewer risks of sexual side effects. An estimated 80% of erectile dysfunction is due to physical causes. Sex -- like any other form of exercise -- does get the heart pumping. New therapeutic strategies and molecular targets will help to improve quality of erections and sexual satisfaction.

In fact, a sexual issue may be the first symptom that raises the suspicion of underlying heart disease or peripheral artery disease.

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In clinical studies, Levitra has been shown to work quickly and improve sexual function in men the first time they take the medication. Other substances or drugs that can cause or lead to ED include these recreational and frequently abused drugs: Erectile dysfunction is frequently a sign of atherosclerosis, a clogging or narrowing of the blood vessels that causes heart attacks. When something’s off in one of those body systems, erectile dysfunction (ED) can result. According to a study published in the Journal of Sexual Medicine, men who were inactive or moderately active (30 to 149 minutes of physical activity a week) had 40–60% higher odds of ED compared with active men who got 150 or more minutes of physical activity weekly (Janiszewski, 2020).

How do couples cope with ED? In addition, detailed recommendations for cardiovascular patients, concerned about a potential risk of sexual intercourse in the light of their underlying cardiovascular condition, are available both for further diagnostic workup and therapeutic interventions according to the first and second Princeton Consensus Conference [74, 77]. These are placed within the erection chambers of the penis and can be inflated or deflated using a cable that passes through them. When simple honest communication fails to bring couples closer, professional counseling may be needed. Nonetheless, the incidence of sexual dysfunction associated with antipsychotic drugs ranges in different studies from 45 percent to as high as 90 percent. Some blood pressure medicines can also cause erectile dysfunction. Hypertension can lead to erectile dysfunction, lower libidos and less interest in sex for both men and women.

Poorly regulated blood sugar can damage the nerves and small blood vessels that control erections and allow blood flow to the penis, Kramer said. Erectile dysfunction due to diabetes is much better understood now. Parkinson's disease drugs. In the most severe cases of erectile dysfunction, a man isn't able to get even slightly erect. The types of implants used to treat ED include: Speak to your GP if you’re worried that medication could be causing erectile dysfunction, the Blood Pressure UK advised. At the end of TOMHS, ED was more frequent among those with more antihypertensive drugs or systolic pressure over 140 mm Hg. Secondary PE is due to physical causes, usually involving the penile arteries, veins, or both.

Oral Drugs (PDE5 inhibitors)

Using the drug this way means you don't have to give yourself a shot, unfortunately it may not work as well as ICI. Avoid alcohol and cigarettes. To understand how high blood pressure can lead to erectile dysfunction , you first have to understand how erections work. In fact, it’s estimated that more than 30 million American men have experienced erection problems at some point (Nunes, 2020). Semi-rigid Penile Prosthesis. Keep in mind that it can take anywhere from several days to several weeks after stopping a high blood pressure medication for erections to return.

Impotence, or erectile dysfunction, is the inability to achieve an erection, and/or dissatisfaction with the size, rigidity, and/or duration of erections. The relatively high probability of detecting potentially serious diseases warrants further investigations [75]. Infection is the most common cause of penile implant failure and is treatable with antibiotics. Diuretics are also referred to as water pills.

Lower High Blood Pressure for Better Overall Health

The treatment for erectile dysfunction depends on what is causing it. If conditions such as anxiety or depression are causing your erectile dysfunction, you may benefit from counselling (a talking therapy). The side effects of ED medications are mostly the same.

From the label of having an psychological illness to an exhaustive, invasive and mostly usefulness series of complementary exams, the evaluation post-PDE5 inhibitors turned to a simple identification of risk factors [10], their control whenever possible, and improvement of sexual performance through PDE5 inhibitors prescriptions [11] that quickly became one sales blockbuster. Alcoholism can cause permanent nerve damage, resulting in impotence. Although the condition is called venous leak, the real problem is not with the veins but malfunction of the smooth muscle that surrounds the veins.