and high blood pressure meds

[Guest guest]

, this is pretty good and gives examples of alternative

medications. I take Cozaar myself and it is very effective. It is

also very expensive. I would certainly talk to your doctor and see

about trying something else.

Laurel

High Blood Pressure and ED: When Medicine Is the Problem

WebMD Medical Reference

WebMD Medical Reference

Guide: High Blood Pressure and Sexual Problems

High Blood Pressure and ED: When Medicine Is a Problem

Reviewed by Brunilda Nazario, MD, November 2005

WebMD Guide Menu

• Erection Problems

• The Link to High Blood Pressure

• Medication Side Effects

• The " Better Sex " Lifestyle

• Treating Sexual Problems

• Working With Your Doctor

• The WebMD Hypertension Health Center

To treat erectile dysfunction (ED), you have to lower your blood

pressure first. Some people are able to do that through lifestyle

changes alone. Others need help from prescribed blood pressure

medication.

A problem for many men, however, is that some types of blood pressure

medicines can actually cause erectile dysfunction. That may make it

difficult to stay on your medication, especially if your high blood

pressure never caused any symptoms before. An estimated 70% of men

who have side effects from blood pressure medicine stop taking it.

Many drugs used to treat high blood pressure have been linked to

erectile dysfunction. But some are much less likely than others to

cause problems. Certain of the blood pressures 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 cause erection problems. These

are also the first drugs that a doctor is likely to prescribe if you

are not able to lower your blood pressure through diet and exercise.

If you're taking a diuretic, you should stay on your medicine until

your blood pressure is under control. If your erection problem

persists, or your blood pressure goes back up, then your doctor might

switch you to a drug that's less likely to cause erectile

dysfunction. Or, a combination of medications might work better to

control your blood pressure and reduce the risk of erectile

dysfunction.

If you take a beta blocker you may also want to ask your doctor if it

might cause erectile dysfunction. You might be better off on a

medication less likely to cause a problem.

Erection-Friendly High Blood Pressure Drugs

Some families of high blood pressure drugs rarely cause erectile

dysfunction as a side effect:

ACE inhibitors

Alpha-blockers

Calcium channel blockers

ARBs

ACE (angiotensin converting enzyme) inhibitors -- such as Lotensin,

Capoten, Zestril, Prinivil, etc. -- 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 medications

in the category. This seems to be true of all of them.

There are also medications known as calcium channel blockers, such as

Diltiazem, Verapamil, or Amlodipine. 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 published in the journal Hypertension in 1997, a

small number of men actually had a 100% improvement in their erectile

dysfunction after two years on the alpha-blocker Cardura.

Drugs known as ARBs (angiotensin II receptor blockers, like Losarten)

are not only unlikely to cause erection problems, but they may

actually improve sexual function in men with high blood pressure.

A 2001 study published in the American Journal of the Medical

Sciences 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%.

Another study compared the drug Diovan, an ARB, with Coreg, a beta-

blocker. The study, published in the American Journal of Hypertension

in 2001, compared the effect of the two drugs on blood pressure and

frequency of sexual intercourse.

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.

Steps to Take If Your Medicine Causes Erection Problems

Tell your doctor if you think your blood pressure medicine may be

causing problems with your erections.

If it is your medication, and not just your high blood pressure,

switching to another prescription may solve the problem. Never stop

taking your medicine without your doctor's OK.

But high blood pressure itself still could be to blame for your

erectile dysfunction. In that case, ask about trying an erectile

dysfunction drug like Viagra, Cialis, or Levitra.

You should only take these drugs once your 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.

Next: The " Better Sex " Lifestyle

SOURCES: American Urological Association, " AUA Guideline on the

Management of Erectile Dysfunction: Diagnosis and Treatment

Recommendations. " Barksdale, J. Pharmacotherapy, May 1999; vol 19: pp

573-581. Ferrario, C. Journal of Clinical Hypertension,

November/December 2002; vol 4: pp 424-432. Fogari, R. American

Journal of Hypertension, January 2001; vol. 14: pp 27-31. Grimm, R.

Hypertension, January 1997; vol 29: pp 8-14. Llisteri, J. American

Journal of the Medical Sciences, May 2001; vol. 321: pp 336-341.

WebMD Medical Reference provided in collaboration with The Cleveland

Clinic: " Hypertension: Treatment With ACE Inhibitors. "