Which High Blood Pressure Medications
Affect Your Sex Drive --- and Which Ones
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February 4, 2017

By Susan Callahan, Contributing Columnist

Let's state the obvious --- if you have high blood pressure and your
doctor has prescribed medications, you need to stay on your meds until
you discuss it with him or her.

But one of the most bothersome problems that come along with simply
trying to control your high blood pressure with medications is little
discussed publicly.  Many of these medications destroy your sex drive.  

It's a terrible dilemma many of us, especially men, face. Either follow
your doctors orders and take the blood pressure medications to control
hypertension and lower your risk for a heart attack or stroke. Or, stop
taking the medications in order to have a full sexual life.

Let's put it another way. You can choose between dying from a heart
attack or dying from sexual starvation.  That's almost an inhumanely
cruel choice.

What we're going to do is to list the blood pressure medications
prescribed today tell you the effects they have on your sex drive, how
long these effects can be expected to last and which dosages are most
often correlated with a decreased sex drive.  This information you can
be prepared to discuss other options with your physician that are
easier on your sex life.

But before we get to the list, we want to give you a quick overview
with other strategies for lowering your blood pressure that may be
worth a try. Using these strategies in combination with your prescribed
medications ---again, after consultation with your doctor --- may
encourage your doctor to lower your dosage.  With a lower dosage of
the hypertension medications, you may  experience fewer sexual

44% of Men with High Blood Pressure  Experience Erectile Dysfunction

Taking hypertension medications may cause ED but it is also likely that
many of you eventually would develop ED even if you stop staking your
medications. The reason is that high blood pressure itself, when
untreated, is strongly connected with erectile dysfunction.  In fact,
many cases of erectile dysfunction are called "vascular" erectile
dysfunction because the underlying condition is endothelial dysfunction
---a dysfunction of the inner lining of your artery walls.

A 2002 study led by Dr. M.K. Walzak from the Center for Sexual
Function and Section of Endocrinology, Lahey Clinic Northshore in
Massachusetts found that 44% of all men with high blood pressure
experience erectile dysfunction.

The bottom line here is to find a way to treat the endothelial
dysfunction an d, in doing so, you will solve both the hypertension and
the erectile dysfunction.

Diuretics (Water Pills) Cause Erectile Dysfunction

One of the easiest ways to lower your blood pressure is to induce
dehydration.  That's the principle behind diuretics. These class of drugs
reduce the total amount of water and salt in your body. Lower water
volume equals lower blood pressure. Lower salt levels also mean lower
blood pressure.

Diuretics cause your kidneys to excrete more sodium (salt) into your
urine, which also lowers the amount of water in your blood stream.

But here's the catch. Blood is about 70% water.  And, since you need a
high enough water volume to produce an erection, decreasing the total
water volume below a critical  level will also eliminate the volume of
blood going to your groin. Hence, your erections disappear.

The Reason Your Doctor Prescribes Some Medications First and Not

There has been considerable disagreement over decades among
doctors as to the best way to treat hypertension, especially in people
over the age of 60.  

Motivated by a need to reconcile these conflicting positions for the
good of the nation's health, organizations banded together as a
committee to come up with national guidelines for treatment of

The committee, called the Joint National Committee on Prevention,
Detection, Evaluation, and Treatment of High Blood Pressure, has
issued recommendations over the years which establish the guidelines
that doctors in the US follow to treat hypertension.

One of the guidelines concerns the order in which medication should be
prescribed.  Doctors are recommended to first try thiazide diuretics to
lower your blood pressure to an acceptable target, typically under 140
for the systolic (top number) of your blood pressure. For
African-Americans, a group of doctors recommends a lower target of
135 as systolic blood pressure target.   Your doctor may aim fro an
even lower target if you have a family history of stroke, heart or other
organ failure.

If the diuretics do not do the trick, the next recommended approach is
to add a second medication, typically either angiotensin-converting
enzyme (ACE) inhibitors, calcium channel blockers, , angiotensin II
receptor blockers or beta blockers.

Here are the most commonly prescribed diuretics:

Bumetanide (Bumex)

Chlorothiazide (Diuril)



Ethacrynic acid (Edecrin)

Furosemide (Lasix)

Hydrochlorothiazide (Microzide)





Torsemide (Demadex)




Beta Blockers Can Cause Erectile Dysfunction

Beta blockers, technically called "beta-adrenergic blocking agents",
work by blocking the stress hormones.  They literally block off access
to receptors located on your heart for the stress hormones, adrenaline
and norepineophrine. As a result, you stay chill when you otherwise
would have blown your stack and perhaps your heart.

Beta blockers are effective at lowering blood pressure. But, here again,
this good result comes with the significant downside of also inducing
erectile dysfunction in many men.

The good news is that beta blockers have been shown to be not as
effective as other hypertension medications which do not trigger
erectile dysfunction. Read on.

Calcium Channel Blockers

These class of drugs interfere with the way that calcium moves through
your body.  Excess calcium can cause artery stiffness. Stiff, hard
arteries increase your blood pressure in the same reason that a stiff
water hose projects water at a higher pressure.

Calcium channel blockers have not been associated with an increased
risk for erectile dysfunction.

Here is the list of most commonly prescribed calcium channel blockers:

Amlodipine (Norvasc)

Aranidipine (Sapresta)

Azelnidipine (Calblock)

Barnidipine (HypoCa)

Benidipine (Coniel)

Clevidipine (Cleviprex)

Isradipine (DynaCirc, Prescal)

Efonidipine (Landel)

Felodipine (Plendil)

Lacidipine (Lacipil and Motens)

Lercanidipine (Zanidip)

Manidipine (Calslot, Madipine)

Nicardipine (Cardene, Carden SR)

Nifedipine (Procardia, Adalat)

Nilvadipine (Nivadil)

Nimodipine (Nimotop)

Nisoldipine (Baymycard, Sular, Syscor)

Nitrendipine (Baylotensin, Cardif and Nitrepin)

Pranidipine (Acalas)

Be aware that if you are on calcium channel blockers, you should talk to
your doctor before taking calcium supplements. There is a risk,
however small, that taking calcium supplements could decrease the
effectiveness of your calcium channel blocker medication.

Angiotensin II Receptor Blockers Do Not Cause ED

Angiotensin is a naturally-occurring hormone in your body which
makes your arteries constrict.  Angiotensin blockers lower your blood
pressure by blocking angiotensin, which makes your arteries relax.

Interestingly, certain foods also have the same effect. Garlic is a natural
angiotensin blocker, many scientists believe. A 2010 study from
Laboratory of Vascular Biology, IMBECU-CONICET, in Mendoza,
Argentina, found that two compounds in garlic block angiotensin.  

As the study noted "allyl methyl sulphide (AMS) and diallyl sulphide
(DAS) inhibited aortic smooth muscle cell angiotensin II-stimulated
cell-cycle progression and migration."

Angiotensin II receptor blocker medications have not been associated
with an increased risk for erectile dysfunction.

Here is a list of the most commonly prescribed angiotensin II receptor
blocker medications:

Azilsartan (Edarbi)

Candesartan (Atacand)


Irbesartan (Avapro)

Losartan (Cozaar)

Olmesartan (Benicar)

Telmisartan (Micardis)

Valsartan (Diovan)

ACE Inhibitors Do Not Cause Erectile Dysfunction

ACE inhibitors are also angiotensin blockers, excect they block the
enzyme that produces angiotensin.

Like angiotension II receptor blockers, ACE inhibitors have not been
associated with an increased risk for erectile dysfunction.

benazepril (Lotensin, Lotensin Hct)

captopril (Capoten)

enalapril (Vasotec)

fosinopril (Monopril)

lisinopril (Prinivil, Zestril)

moexipril (Univasc)

perindopril (Aceon)

quinapril (Accupril

The takeaway from all of this is that, if you are taking prescribed
hypertension medications that are affecting your sex drive, know that
there are alternative medications which may also work without the sex
drive side effects. Talk with your doctor.

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Certain high blood pressure medications
have no effect on your sex drive.