Mr. Liu is 48 years old this year and usually in good health. Even if he has a headache or fever, he doesn’t need to take medication; he gets better on his own in a couple of days.
But in the past six months, he found that his ability in that aspect seemed to have problems. It started with a couple of times a week where he didn’t perform well. But later on, the situation became more frequent, and sometimes his wife also showed impatience. Helpless, Mr. Liu quickly went to the hospital for a check-up.
Upon examination, it was found that Mr. Liu’s blood pressure was as high as 180/110mmHg. The doctor said that his erectile dysfunction was due to high blood pressure. After receiving treatment to lower his blood pressure and it returned to normal range, his condition did improve.
This left Mr. Liu feeling very surprised. How could high blood pressure be related to sexual function? What is going on?
1. Is the decline in male function due to taking antihypertensive drugs?
High blood pressure is a common cardiovascular disease in clinical practice that, if not intervened in time, can lead to a series of complications, including erectile dysfunction. Clinical data shows that the probability of erectile dysfunction in men with high blood pressure is 40%.
Xie Hong, Deputy Chief Surgeon of the Urology Department at the Sixth People’s Hospital Affiliated with Shanghai Jiaotong University, explained that normal penile erection in men requires involvement of neural regulation, endocrine function, and vascular vasomotion. The main cause of organic erectile dysfunction is impaired vascular function. Once the endothelial cell function in the blood vessels is damaged, it disrupts the balance of vasomotor function in the vessel wall, affecting normal erection. High blood pressure is one of the main factors inducing endothelial cell damage.
In addition, there is a high degree of consistency in the etiology and risk factors of erectile dysfunction and high blood pressure. Factors such as long-term smoking and alcohol abuse, unhealthy diet, and mental stress can cause damage to blood vessels, with smaller blood vessels being more prone to injury. The penis has abundant small blood vessels, and once the endothelium of the blood vessels is damaged, the reproductive organs will be the first to show a reaction, leading to erectile dysfunction.
In addition to the mutual impact between high blood pressure and erectile dysfunction, many people think that long-term use of antihypertensive drugs can also affect male function. Regarding this, Chen Yuanyuan, Director of the Cardiovascular Department at Peking University People’s Hospital, stated that whether antihypertensive drugs will affect male function largely depends on individual sensitivity; the vast majority are not affected, so there is no need to be overly concerned.
Common antihypertensive drugs that affect male function mainly include the following:
1. Diuretics
Common ones include spironolactone, hydrochlorothiazide, etc. These drugs reduce blood volume to lower blood pressure, but at the same time may affect the engorgement of the corpus cavernosum, weakening erectile function.
2. β-blockers (“olol” antihypertensive drugs)
Common ones include atenolol, bisoprolol, etc. When β receptors are blocked while α receptors remain stimulated, it increases vascular resistance, impeding blood flow filling in the genitals and affecting normal erection.
Similarly, there are two types of antihypertensive drugs that can improve erectile dysfunction.
1. Angiotensin-converting enzyme inhibitors (“pril” antihypertensive drugs)
Such as enalapril, perindopril, etc., which do not have a negative impact on sexual function and can even improve symptoms to some extent.
2. Angiotensin receptor blockers (“sartan” antihypertensive drugs)
Such as valsartan, telmisartan, irbesartan, etc., these drugs can inhibit vasoconstriction to a certain degree, reduce the resistance of blood vessel filling and improve endothelial function, thereby improving erectile dysfunction.
2. Can hypertensive patients enjoy marital relations?
Many people know that hypertensive patients cannot engage in activities that would raise their blood pressure. The process of intimacy will certainly lead to excitement, tension, and increased blood pressure. Does this mean hypertensive patients cannot engage in marital relations?
Wang Chuanhang, Chief Physician of Traditional Chinese Medicine Andrology at China-Japan Friendship Hospital, stated in a published article that whether hypertensive patients can engage in sexual activity depends on their blood pressure condition, and adjustments should be made accordingly.
Mild hypertension: In these patients, the elevated blood pressure during intimacy can quickly return to normal after the activity, so it generally does not cause acute complications.
Moderate hypertension: Relatively stable blood pressure, but there may be complications involving the heart, brain, and kidneys. Intimacy should be conducted with controlled use of medication.
Severe hypertension: Patients may experience chest tightness, headache, discomfort in the precordial area, and impaired kidney function, indicating a high risk of cardiovascular accidents during intimacy. It is recommended for these patients to stabilize blood pressure first, consult with a doctor, and only then engage in sexual activity.
Additionally, when hypertensive patients engage in marital relations, doing these 5 things can help ensure safe enjoyment.
1. Pay attention to the frequency of sexual activity
Hypertensive patients are generally advised to engage in sexual activity once or twice a week; excessive activity is detrimental to blood pressure control.
2. Avoid sexual activity when blood pressure is elevated
For individuals with systolic pressure >160mmHg, it is advisable to first lower the blood pressure and then seek medical advice; otherwise, there is a high likelihood of accidents occurring.
3. Avoid sexual activity when having other illnesses
It is better to abstain from sexual activity when suffering from a cold, fever, or heart, brain, liver, or kidney diseases, as it could significantly raise blood pressure and lead to accidents.
4. Choose to engage in intimacy in the morning
Engaging in intimacy in the morning provides the body with sufficient rest time. Remember not to engage in intimacy when hungry, tired, after meals, or when intoxicated.
5. Supplement with “medications” moderately
Some patients with concurrent erectile dysfunction can take drugs such as sildenafil or tadalafil under medical guidance to improve erection. However, remember not to take these drugs along with nitrate medicines, as it could lead to low blood pressure and even life-threatening situations.
3. These 4 common drugs may easily affect male function
For men, it is crucial to pay attention to medications taken daily, as some common drugs may affect sexual function once consumed.
1. Anti-prostate hyperplasia drugs
Medications such as finasteride, dutasteride, and other 5α-reductase inhibitors inhibit the conversion of testosterone to the more active dihydrotestosterone, which, with long-term use, may cause erectile dysfunction and reduced libido.
2. Antipsychotic medications
Tricyclic drugs like clozapine, amitriptyline, block serotonin transporters, affecting sexual function and easily causing erectile dysfunction. Selective serotonin reuptake inhibitors like paroxetine, fluoxetine, can lead to genital anesthesia, decreased libido, and erectile dysfunction with long-term use.
3. Hormone medications
Corticosteroids, adrenocorticotropic hormones, estrogen, etc., all inhibit the hypothalamic-pituitary-gonadal axis function, reducing testosterone synthesis, leading to erectile dysfunction.
4. Anti-inflammatory/anti-rheumatic drugs
Such as cyclophosphamide, sulfasalazine, aspirin, cyclophosphamide can cause irreversible and long-term oligospermia, severely affecting male fertility; sulfasalazine can induce reversible oligospermia; aspirin can affect sperm vitality and quantity.
High blood pressure is a chronic disease that threatens overall health. Once detected, timely intervention and treatment are necessary. Do not ignore it simply because there are no symptoms. High blood pressure has long been dubbed the “silent killer,” and waiting until symptoms arise can be too late.
References:
[1] “Could That Issue Be Related to High Blood Pressure? Proportion Exceeds 40%.” Family Doctor Report 2022-10-29
[2] “Sexual Encounters for Hypertensive Patients: How to Safely Engage?” Qianhai Life Guangzhou General Hospital 2023-03-29
[3] “Double-Edged Sword – Comprehensive Evaluation of Common Drugs That Can Cause Erectile Dysfunction.” MaxMen 2022-10-14
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