Thus, in persons with diminished kidney function, the clearance of chlortalidone is reduced and the elimination half-life is increased. The latter groups of antihypertensive drugs, in addition to the systemic vasodilator effect, will also lower penile vascular resistance and that will probably compensate for the lowering of systemic blood pressure and result in unaltered penile blood flow during erection, unless there is a proximal stenosis. If your doctor says it's OK, you may be able to stop taking blood pressure medications temporarily to see if your sex life improves. A separate analysis was done for men reporting any erection problems at baseline for assessment of whether treatments differed in modifying the rate of existing sexual problems. Probability values are reported comparing each active treatment with placebo and comparing the five active drug groups (4 df). 1 The prevalence is higher among men with hypertension than among those who are normotensive-and ED is even more common in patients who are receiving antihypertensive therapy than in those who are not treated.

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Obel AO "Efficacy and tolerability of long term oxprenolol and chlorthalidone singly and in combination in hypertensive blacks. "Pairwise comparisons were made among the active treatment groups if the probability value comparing the active groups was less than. This prolonged action of chlortalidone despite missing doses may account for the higher efficacy of chlortalidone compared to the shorter half-life medication, hydrochlorothiazide. Neurogenic erectile dysfunction – michigan institute of urology, condorelli RA, Calogero AE, Di Mauro M et al:. Common side effects may include:

Some research even suggests the effect of blood pressure drugs may be more psychological than physical. Whatever medicine your doctor prescribes, be sure to follow the instructions to the letter. 49 The mechanism can probably by ascribed to the reported inhibitory effect of digitalis glycosides on NO-evoked vasodilation in isolated penile arteries50 and corpus cavernosum strips. Erectile dysfunction (ed): symptoms, diagnosis & treatment, your partner's preferences also might play a role in your treatment choices. ACE inhibitors, calcium channel blockers, and alpha blockers can lower blood pressure with fewer risks of sexual side effects. One of the more well-known food-drug interactions involves grapefruit and grapefruit juice and certain cholesterol-lowering statin medications — namely, atorvastatin (Lipitor®), lovastatin (Mevacor®), pitavastatin (Livalo®) and simvastatin (Zocor®). This is not an indication of a security issue such as a virus or attack.

Can high blood pressure affect sexual functioning? Obtain a detailed medical and sexual history for all patients with ED. 12,13 However, these agents are contraindicated in patients who require treatment with nitrates and in those with angina who may need nitroglycerine. Our general interest e-newsletter keeps you up to date on a wide variety of health topics. How can stress cause erectile dysfunction (ed)?, unsurprisingly, experts suspect a person’s views of masculinity may be responsible for this. This can trigger dangerous cardiac arrhythmias.

If you get ED shortly after starting treatment with any BP drug, speak with your doctor.

Pharmacology of Cardiovascular Drugs

On the flip side, some diuretics — like hydrochlorothiazide, chlorthalidone, metolazone (Zaroxolyn®) and furosemide (Lasix®) — can cause potassium depletion. Drugs that may cause erection problems: medlineplus medical encyclopedia, this form of primary PE is psychogenic (as opposed to organic or physical) impotence. PDE-5 inhibitors are very safe, and most adverse reactions are attributed to the presence of PDE-5 in other tissues. The high rate of participants remaining on initially prescribed monotherapy over the study, especially in the first 2 years, allows for comparisons among treatments that have minimal confounding effects because of withdrawal or change in medication. Age ≥ 60 years, systolic blood pressure ≥ 140 mm Hg, and previous use of antihypertensive drugs were associated with erectile problems in men at baseline.

In this article, we discuss how to achieve blood pressure control while minimizing sexual side effects, and we delineate safe, effective treatment options for ED in patients who have hypertension. Explore various ways to be physically intimate, such as massage or warm soaks in the tub. Impotence and decreased libido are the more frequent sexual side effects with spironolactone. Erectile dysfunction, although there have been very few studies conducted on the safety of these natural remedies, some of them have been found to have side effects that vary from mild to severe. 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.

Leonard says, while with others it’s best to eliminate it from your diet.

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Chlorthalidone (chlortalidone): 17,18,19 It is difficult to evaluate whether the dose of thiazide diuretic applied for the treatment of hypertension in these studies plays a role for the frequency of ED, but patients in the study by Chang and colleagues15 were treated with 50 mg/day of hydrochlorthiazide or chlorthalidone which is above the 12. Analysis of three alternative treatments by an oral test for potassium deficiency. 75 In recommended doses, chlorthalidone is more effective in lowering systolic BP (SBP) than hydrochlorothiazide, as evidenced by 24-hour ambulatory BPs. Does opioid addiction cause sexual dysfunction in men? Carbon dioxide (CO 2 ) retention from opioid-induced respiratory depression can exacerbate the sedating effects of opioids. Table 3 shows the incidence of erection problems through 24 and 48 months by randomized treatment group. If you get your doctor’s okay, you might be able to temporarily stop taking blood pressure medication to see if your sex life improves. Jensen OB, Mosdal C, Reske-Nielsen E "Hypokalemic myopathy during treatment with diuretics. "If ED occurs, switching to an agent with fewer sexual side effects may be an option.

5%) with erection problems at baseline, compared with 33 of 60 (55. 5 signs you have hernia mesh complications, ‘Performance anxiety’ is a common cause of erectile problems. Older men (55 years or older) were significantly more likely to experience erection problems than younger men. Use a sunscreen (minimum SPF 15) and wear protective clothing if you must be out in the sun. Like men, women can experience anxiety and relationship issues due to sexual dysfunction.

Segal MS "Bronchospasm after reserpine. "1 Participants randomized to the α-blocker doxazosin experienced the lowest incidence of erection problems, although the lower rate did not differ significantly from the rate with placebo. Randomized, double-blind, placebo-controlled trial with 4-year follow-up (Treatment of Mild Hypertension [TOMHS])., various chemical constituents of Herba Cistanche have been studied and were indicated to have some bio-activities such as antioxidation, neuroprotection and antiaging (23). Bjornberg A, Gisslen H "Thiazides: "Another smaller trial reported on by Chang et al. 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.

  • Taking medicines properly is one of the surest ways to cut down on side effects, sexual or otherwise.
  • In the placebo group, greater decreases in SBP during follow-up were associated with a lower incidence of erection problems (P=.)
  • 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.
  • Berlant JL "Neuroleptics and reserpine in refractory psychoses."
  • Whether you're a man or a woman, high blood pressure can definitely put a damper on your sex life.
  • This causes you to have higher blood levels of caffeine, heightening its stimulating effects.


This can result in a low blood concentration of potassium and chloride as well as a mild metabolic alkalosis; however, the diuretic effect of chlortalidone is not affected by the acid-base balance of the person being treated. A rare ocular side effect, transient myopia, has been associated with chlorthalidone. The percentage of patients responding positively to GAQ was based on the number of patients who responded to that question. Diuretics such as chlortalidone also reduce the urine concentration of concomitantly-taken performance-enhancing drugs or of their metabolites, thus making it more difficult to detect these drugs using urine testing.

It's known that diuretics (or water pills, like hydrochlorothiazide) and beta-blockers (like Atenolol) can also cause erection problems. Peripheral neuropathy can sometimes affect nerves in the penis that control erections. 4 strategies for coping with an enlarged prostate. 25 In contrast, antagonists selective for β 1 -adrenoceptors such as acebutolol and bisaprolol do not appear to increase the frequency of ED compared with untreated patients. Here’s what to know about how certain drugs can lead to ED and what you can do about it. 5 to 2 times more potent than HCTZ. In erectile tissue β 2 -adrenoceptors are expressed, and although the role of β-adrenoceptors in erectile function is not clarified, they probably mediate vasodilation in response to the increase in adrenaline during erection. Do not start using a new medication without telling your doctor.

ACE inhibitors:

Hydrochlorothiazide (HCTZ) is the most frequently used thiazide diuretic in the United States, although chlorthalidone is the diuretic that was used in many of the landmark clinical outcomes trials. These agents act by relaxation of cavernous smooth muscle, which elevates the intracavernosal cGMP and by blocking the local alpha-receptors, resulting in improved erectile function. For 47 men -- nearly half -- the problem was severe. 1%, respectively (P=. )Your doctor may occasionally change your dose to make sure you get the best results from this medication.

2 Blood pressure disorders NEC (high-level term).

Kidney Stone Prevention

High blood pressure often has no symptoms, so you may not know when your blood pressure is high. 5-75 1 ACE, angiotensin-converting enzyme; ARB, angiotensin receptor blocker; CKD, chronic kidney disease. In the placebo group, 16 (76%) were not on any medication during the year before reporting the erection dysfunction. Has your relationship with your sexual partner changed recently? In many cases, erection dysfunction did not require withdrawal of medication. Cardiovascular side effects are related to decreased sympathetic tone associated with reserpine and decreased intravascular volume and hypokalemia associated with chlorthalidone. Gene therapy has the potential to become a future management option for patients with CAD and ED. During the 4-year follow-up period, the incidence increased to only 15%, with some patients improving and others developing problems.

Some Commonly Used Drugs That Can Cause Erectile Dysfunction

Talk with your doctor before you stop taking clonidine and chlorthalidone. Endothelial dysfunction is the link between ED and IHD and both diseases share the same aetiology, risk factors and pathogenesis. Not only can foods affect the action of your medication. Clinicians should address als patients' sexuality, intimacy concerns, you could have your levels checked to see if this is an issue. Do not use this medication if you are unable to urinate.