Mr. Liu is 48 years old this year, and he is usually in good health. Even if he has a headache or fever, he doesn’t need to take medicine, and he’ll be fine in a couple of days.
However, in the past six months, he found that he seemed to have a problem in that aspect. Initially, there were one or two times a week when he didn’t perform well. But later, the situation became more frequent, and sometimes his wife also showed impatience. Helpless, Mr. Liu quickly went to the hospital for a check-up.
After the examination, it was found that Mr. Liu’s blood pressure was as high as 180/110mmHg, and the doctor said that his erectile dysfunction was due to his high blood pressure. After receiving treatment for lowering blood pressure and returning it to normal range, the situation did improve.
This made Mr. Liu feel very surprised. How could high blood pressure be related to sexual function? What’s going on?
1. Does high blood pressure cause male function decline due to taking antihypertensive drugs?
High blood pressure is a common cardiovascular disease in clinical practice. Failure to intervene in a timely manner can lead to a series of complications, including erectile dysfunction. Clinical data shows that the probability of erectile dysfunction in male patients with high blood pressure is 40%.
Xie Hong, Deputy Chief Physician of the Urology Department of the Sixth People’s Hospital affiliated with Shanghai Jiao Tong University, explained that normal penile erection in males requires the involvement of neural regulatory function, endocrine function, and vascular contractile function. The main cause of organic erectile dysfunction is vascular dysfunction. Once the function of vascular endothelial cells is damaged, the balance of vascular wall contractile function is disrupted, affecting normal erection. High blood pressure is one of the main causes of vascular endothelial cell lesions.
In addition, there is a high degree of consistency in the onset causes and risk factors of erectile dysfunction and high blood pressure. Factors such as long-term smoking, alcohol abuse, unhealthy diet, and mental stress can damage blood vessels, with small blood vessels being more vulnerable to injury. The penis has abundant small blood vessels, and once the endothelium of the blood vessels is damaged, the genital organ will be the first to react, leading to erectile dysfunction.
In addition to the certain mutual influence between high blood pressure and erectile dysfunction, many people think that long-term antihypertensive drug use will also affect male performance. Regarding this, Chen Yuanyuan, Chief Physician of the Department of Cardiovascular Internal Medicine at Peking University People’s Hospital, stated that whether antihypertensive drugs affect male function depends largely on individual sensitivity. The vast majority will not be affected, so there is no need to worry excessively.
The common antihypertensive drugs that affect male function mainly include:
1. Diuretics
Common ones include spironolactone, hydrochlorothiazide, etc. These drugs lower blood pressure by reducing blood volume. However, they also affect the filling of the corpus cavernosum, weakening erectile function.
2. Beta-blockers (“olol” antihypertensive drugs)
Common ones include atenolol, bisoprolol, etc. When β receptors are blocked and α receptors are still excited, the resistance of blood vessels increases, leading to obstruction of blood flow filling in the reproductive organ, 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 to some extent improve symptoms.
2. Angiotensin receptor blockers (“sartan” antihypertensive drugs)
Such as losartan, telmisartan, valsartan, etc., these drugs can inhibit vascular constriction to some extent, reduce the resistance of blood vessels, improve endothelial function, and thereby improve erectile dysfunction.
2. Can hypertensive patients enjoy marital relations?
Many people know that hypertensive patients should not engage in activities that can cause blood pressure to rise, and the process of intercourse will definitely cause excitement, tension, and an increase in blood pressure. Does this mean that hypertensive patients cannot engage in marital relations?
Dr. Wang Chuanhang, Chief Physician of Traditional Chinese Medicine Andrology at the China-Japan Friendship Hospital, pointed out that whether hypertensive patients can engage in sexual activity depends on their blood pressure status and requires corresponding adjustments.
Mild hypertension: The elevated blood pressure in these patients during intercourse can quickly return to normal after intercourse, so it generally does not cause acute complications.
Moderate hypertension: Relatively stable blood pressure, but there may be heart, brain, and kidney complications, intercourse should be carried out under drug protection with controlled measures.
Severe hypertension: Patients may experience chest tightness, headache, discomfort in the precordial region, and renal dysfunction, and the risk of cardiovascular accidents during intercourse is higher. It is recommended that such patients first stabilize their blood pressure and then consult a doctor about engaging in sexual activity.
In addition, hypertensive patients can enjoy marital relations by doing these 5 things securely.
1. Pay attention to the frequency of sexual activity
Hypertensive patients are generally advised to engage in marital relations 1-2 times a week, excessive intercourse is not conducive to blood pressure control.
2. Avoid having sexual intercourse when blood pressure is elevated
For individuals with a systolic blood pressure >160mmHg, it is recommended to first lower blood pressure and then consult a doctor before engaging in sexual activity, otherwise, there is a high possibility of accidents occurring.
3. Avoid sexual intercourse when having other illnesses
It is best not to engage in sexual activity when having a cold, fever, or suffering from heart, brain, liver, or kidney diseases, as it may lead to a sharp rise in blood pressure, triggering accidents.
4. Opt for intercourse in the morning
Having intercourse in the morning provides the body with sufficient resting time. Remember not to engage in sexual activity while hungry, fatigued, after meals, or after drinking alcohol.
5. Consider using “medication” appropriately
For patients with erectile dysfunction, under the guidance of a doctor, they can use medications such as sildenafil, tadalafil to improve erection. However, it is important to remember that these two types of medications should not be taken with nitrate drugs, as it may lead to hypotension, and in severe cases, it may even threaten life.
3. These 4 common medications may affect male function
For men, it is important to pay attention to daily medication, as some common medications may affect sexual function.
1. Prostate enlargement drugs
5α-reductase inhibitors such as finasteride, dutasteride, inhibit the conversion of testosterone to the more active dihydrotestosterone. Long-term use may cause erectile dysfunction and decreased libido.
2. Antipsychotic drugs
Tricyclic drugs such as chlorpromazine, amitriptyline, block the serotonin transporter, affecting sexual function and easily causing erectile dysfunction; selective serotonin reuptake inhibitors such as paroxetine, fluoxetine can cause reversible erectile dysfunction, genital numbness, decreased libido, etc., with long-term use.
3. Hormone drugs
Glucocorticoids, adrenocorticotropic hormones, estrogens, etc., inhibit the hypothalamic-pituitary-testicular axis, reducing the synthesis of testosterone, leading to erectile dysfunction.
4. Anti-inflammatory/anti-rheumatic drugs
Cyclophosphamide, sulfasalazine, acetylsalicylic acid, etc., cyclophosphamide can cause irreversible, long-term oligospermia, severely affecting male fertility; sulfasalazine can cause reversible oligospermia; acetylsalicylic acid 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 your body just because you have no symptoms. Hypertension is often referred to as the “silent killer.” Waiting until symptoms occur before intervening may be too late.
References:
[1] “Trouble Down There, Related to High Blood Pressure? Proportion Exceeds 40%.” Family Doctor Report 2022-10-29
[2] “Sex Education Class | How Can Hypertensive Patients Safely Engage in Sexual Activity?” Qianhai Life Guangzhou General Hospital 2023-03-29
[3] “Double-Edged Sword – A Comprehensive Inventory of Common Medications Leading to Erectile Dysfunction.” MaxMen 2022-10-14
Reproduction without author’s authorization is prohibited.
