The Tribune

By GREGGORY PINTO

It is well-known that uncontrolled elevated blood pressure can lead to erectile dysfunction in men. It is relatively common for the first symptom of new onset or known poorly controlled hypertension to be poor quality erections.

Few people are aware of the fact that high blood pressure in women can lead to sexual dysfunction as well. Another surprising fact is that more women experience sexual dysfunction than men. It is estimated that 43 percent of women and 31 percent of men experience some form sexual dysfunction.

For women, sexual dysfunction is defined as recurrent or persistent reduction in sexual desire, decrease in sexual arousal, painful intercourse or inability or difficulty in achieving an orgasm. There are numerous possible causes of female sexual dysfunction. Elevated blood pressure in women can lead to a reduction in the body’s release of the chemical nitric oxide which negatively impacts a woman’s relaxation of smooth muscle, which can inhibit sexual arousal.

In a well-respected, peer-reviewed scientific study presented at the 21st Annual Scientific Meeting of the American Society of Hypertension, it was concluded that women with high blood pressure were twice as likely to experience sexual dysfunction when compared to women with normal blood pressure. The study included 417 sexually active women aged 31 to 60 years old.

In the United States there are 65 million people with hypertension and about half are women. The Bahamas has one of the highest per capita incidences of hypertension in the Caribbean and in the world. A blood pressure of 140/90 mmHg or above is considered high.

High blood pressure causing male ED

A scientific study published in the Journal of Urology determined that 68 percent of men with high blood pressure had some element of erectile dysfunction ED; 45 percent of these men had severe ED.

Elevated blood pressure can prevent blood vessels that supply the penis from fully expanding, as well as limiting the relaxation of the smooth muscle of the penis so that insufficient blood flows to the penis to make it erect.

Men with high blood pressure are also more likely to have low testosterone levels. Testosterone is a hormone that is important for normal erectile function in men.

Certain medications can cause ED

Erectile dysfunction ED can be caused by high blood pressure, diabetes, high cholesterol levels, artherosclerosis with plaques in blood vessels, low testosterone levels amongst many other causes. Managing ED necessitates treating the root causes and not just the symptoms. The little blue pill, Viagra, or other similar regulated sexual enhancing medications such as Cialis and Levitra, can in most cases initially improve erectile function in men who have elevated blood pressures or uncontrolled diabetes. However, these conditions will continue to damage blood vessels and nerves supplying the penis and enhancing erectile medications will stop being effective and irreversible erectile dysfunction may occur.

It is a recognised fact that many medications can lead to erectile dysfunction. Certain high blood pressure medications can potentially worsen or initiate ED in some men and women. Men and women should, however, never stop prescribed high blood pressure medication themselves but instead consult their physician and alert them to the negative ED side effects, so that another class of high blood pressure medications can be given. In this way men can have well controlled blood pressure and still maintain good erections.

There are several classes of high blood pressure medications such as ACE inhibitors, angiotensin 2 receptor blockers, alpha blockers beta blockers, combined alpha and beta blockers, calcium channel blockers, diuretics, vasodilators and others. Every man is different and a certain class of hypertension medication many cause erectile dysfunction in one man but not another.

It is more common for thiazide diuretics, loop diuretics and beta blocker high blood pressure medication to cause erectile dysfunction ED, as these medications can potentially reduce blood flow to the penis and make erections more difficult to achieve. Hypertension medication such as ACE inhibitors, alpha blockers and angiotensin receptor blockers rarely cause ED.

Other medications that commonly cause ED include antidepressants, antihistamines, muscle relaxants nonsteriodal anti-inflammatory drugs, tranquilizers, anti-seizure medications, hormones, anti-arrhythmics (for irregular heart beat), prostate cancer drugs, Parkinson’s disease drugs, chemotherapy agents and others. Never stop taking these essential medications yourself if you have erectile dysfunction side effects but seek the consult of a physician who will safely address the issue.

High blood pressure can kill your erections and you

High blood pressure is a silent killer leading to an estimated 7.6 million deaths worldwide, which represents 13.5 percent of all deaths, more than any other risk factor for death. High blood pressure is also a silent killer of erections, destroying the blood supply to the male sex organ as well as to other organs such as the kidneys, heart, brain and eyes.

Seeking medical attention for erectile dysfunction can not only have you regain your erections but also may lead to the new diagnosis and treatment of potentially devastating conditions such as high blood pressure, high cholesterol, diabetes, early heart disease and atherosclerosis. A reported 54 percent of strokes and 47 percent of coronary disease are related to high blood pressure. High blood pressure will negatively impact small blood vessels of the penis long before larger blood vessels that supply the kidneys, heart and brain. Erectile dysfunction can be an early warning sign of underlying conditions such as high blood pressure, that if treated early and effectively, could potentially prevent a heart attack or stroke or kidney failure in the future.

Seek confidential, compassionate and comprehensive care for erectile dysfunction.

• Dr Greggory Pinto is a board-certified Bahamian urologist and laparoscopic surgeon. He can be contacted at OakTree Medical Center #2 Fifth Terrace and Mount Royal Avenue, Nassau, Bahamas; Telephone – (242) 322-1145-7; email: welcome@urologycarebahamas.com or visit the website:www.urologycarebahamas.com