How Hypertension Can Lead to Erectile Dysfunction

To address the widespread misinformation about sex, News18.com is running this weekly sex column, titled 'Let's Talk Sex'. We hope to initiate conversations about sex through this column and address sexual health issues with scientific insight and nuance.

The column is being written by Sexologist Prof (Dr) Saransh Jain. In today's column, Dr Jain discusses the connection between hypertension and erectile dysfunction.

Hypertension (High Blood Pressure) is a leading cause of erectile dysfunction; it puts people at higher risk of ED. When your blood flows naturally, you can have healthy erections. Natural arousal leads to increased blood flow to your penis causing an erection. This process becomes more difficult with hypertension. In this case, the blood vessels constrict, slowing the natural flow of blood. Not only does hypertension raise your risk of a stroke or heart attack, it also complicates erections. Men with high blood pressure are nearly twice as likely to have erectile dysfunction and impaired penile blood flow than those with normal blood pressure.

Why Hypertension is a Silent Killer

Hypertension develops for a variety of reasons, including medical conditions such as kidney disease and lifestyle choices such as smoking or a high sodium diet. Sometimes people develop high blood pressure without an identifiable cause.

Regardless of why you have hypertension, untreated chronic high blood pressure damages your heart and blood vessels and eventually leads to life-threatening medical conditions like heart disease and stroke. And because the condition doesn't come with noticeable symptoms, doctors call it "the silent killer."

Link between Erectile Dysfunction and Hypertension

To understand how hypertension can lead to erectile dysfunction, you first have to understand how erections work. Getting an erection is a complicated process.

In the shaft of the penis there are two side-by-side chambers of spongy tissue called corpora cavernosa. They're are made of small arteries and veins, smooth muscle fibre and empty spaces. The chambers are wrapped in a sheath of thin tissue.

This is how you get an erection: signals from the brain travel through the nerves to the penis and cause the smooth muscle of the chambers to relax and arteries to dilate, or open wider. This allows a rush of blood to fill the empty spaces. The pressure of blood flow causes the sheath of the tissue around the chambers to press on the veins that normally drain blood out of the penis. That traps blood in the penis. As more blood flows in, the penis expands and stiffens, and you have an erection.

Hypertension damages your blood vessels and arteries, making it impossible for the arteries that supply blood to your penis to function as they're supposed to. This also affects the muscle in the penis by creating an inability to relax. As a result, your penis doesn't get enough blood to make it erect or keep it erect. In addition, your risk of having low testosterone is nearly two times higher if you have hypertension. While the relationship between hypertension and low testosterone is still being investigated, having low testosterone can contribute to erectile problems and low libido.

Treatment Options for Men with Hypertension and Erectile Dysfunction

Keeping hypertension under control is imperative for your overall health. Every year, this silent killer kills or contributes to nearly half a million deaths, but only one in every four adults with hypertension has the condition under control.

It's important to take steps to lower your blood pressure, both through lifestyle changes and medications, if recommended by your doctor. Unfortunately, many medications prescribed to help lower blood pressure can make your erectile dysfunction worse since they impact blood flow. Sometimes, the choices that some men with high blood pressure make can add to the problem. Smoking, especially, is one of those. Smoking increases blood pressure, and damages blood vessels and reduces blood flow in the body.

By living a healthy lifestyle and working with your doctor, there's a chance that you will be able to have normal sexual function, again. You may have much more success treating erection problems if you incorporate these lifestyle changes to manage blood pressure:

• Eating well and exercising regularly will help prevent and manage high blood pressure.

If you experience erectile dysfunction shortly after starting treatment with any hypertension medication, speak with your doctor. They can work with you to recommend a substitute for the existing medication or troubleshoot your problem. Keep in mind that different drugs have different half-lives, which means it may take several days or several weeks for the drug to leave your body, therefore it may take some time for your erections to return after stopping a hypertension medication.

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