Harvard Men's Health Watch

On call: Blood pressure medication and erections

On call

Blood pressure medication and erections

Q. I am 47 years old and I've just been diagnosed with high blood pressure. My doctor wants to put me on medication, but I'm worried that it will make me impotent. If I decide to take a drug, which would be best?

A. Your question raises several important issues.

First, you certainly should bring your blood pressure down. If you are otherwise healthy, 140/90 is a reasonable target, but it would be even better to bring it lower if you can do so without significant side effects. Over the long run, untreated hypertension will increase your risk of stroke, heart attack, and kidney damage. And it will also increase your risk of erectile dysfunction since the arteries in your penis are as vulnerable as those in your heart and brain. In fact, some of the erectile dysfunction attributed to blood pressure medication is actually due to hypertension itself.

Second, unless your blood pressure is very high or you have other risk factors, you can try lifestyle treatment first. That means exercise, diet, and weight control. Try walking for 30 minutes a day, cut down on the amount of salt you eat, and eat lots of fruits, vegetables, whole grains, and nonfat dairy products. If you use alcohol, make two drinks a day your limit. If your blood pressure stays up, you'll need to add medication "" but you should continue to follow good health habits; among other benefits, they can reduce your risk of developing sexual dysfunction as you age.

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