How to manage erectile dysfunction(ED) in hypertensive patients?

Erectile dysfunction is one of the major sexual issues men face as they age. It is defined as the inability of a man to maintain or get an erection for satisfactory sexual intercourse. Indeed for many men & their partners, this can be a frustrating problem as the penis is unable to become sufficiently rigid and performing intercourse may seem impossible.

ED is being more common in younger men too due to their lifestyle choices. Many men have at some point been unable to get it up. Current estimates state that Chronic ED affects about 5% of men in their 40s and 15-25% of men by the age of 65. Transient ED and inadequate erection affect as many as 50% of men between the ages of 40 and 70. It is also estimated that by the year 2025, 322 million men will suffer from Erectile dysfunction.

Erectile dysfunction can be caused due to various conditions like Diabetes, Hypertension, Multiple Sclerosis. Psychological factors like stress, anxiety, depression, and low self-esteem can also contribute to ED.

Hypertension is considered one of the most hazardous cardiovascular risk factors and it is a frequent comorbidity of men with ED. A study in the Journal of the American Geriatrics Society found that about 49% of men ages 40 to 79 with high blood pressure had erectile dysfunction. So we are here to discuss how to manage ED in hypersensitive patients.

What is Hypertension and How it contributes to ED?

Hypertension which is also known as High blood pressure is a medical condition in which the blood pressure is persistently elevated. This can be quite dangerous as it can make the heart work harder to pump blood out of the body and can contribute to heart failure and stroke.

Men with hypertension are almost twice as likely to have impaired penile blood flow and erectile dysfunction compared to men with normal blood pressure, increasing their risk of heart disease and death. High blood pressure damages artery walls, causing them to harden and narrow, and reducing blood flow to the penis which will cause Erectile dysfunction.

The release of Nitric oxide is a major factor for erection but in Hypertension patients, the high blood pressure leads to premature aging which can result in decreased ability to release Nitric oxide and this can lead to ED.

AS we all know that Testosterone levels in the body are a major factor that affects healthy sex life in men. Hypertension is often linked to low levels of testosterone and so can lead to Erectile dysfunction in men.

Treatment of ED in Hypersensitive patients

Testosterone Replacement Therapy ( TRT ) :

Testosterone Replacement Therapy increases the testosterone level if you are suffering from low testosterone. Testosterone is the primary sex hormone that plays a major role in the male reproductive system. TRT helps you with increased stamina, energy, increased sexual performance, and muscle mass. TRT involves the injection of testosterone into the human body through different injection techniques.

  • In a recent study, it has been shown that TRT can be a safe treatment in patients with hypogonadism and an increased risk of cardiovascular diseases.

Alprostadil and Trimix:

Intracavernosal injection is a second-line therapy for ED that achieves a predictable and fast erection in less than 10 minutes. Alprostadil is the most frequently used drug and it is also available as an intraurethral pellet. The intracavernous injection can increase peripheral blood levels of alprostadil which can result in hypotension, so care should be taken when using it together with other hypotensive drugs.

PDE-5 Inhibitors:

Phosphodiesterase type 5 (PDE5) inhibitors are medications that are effectively used in treating ED in hypersensitive patients. The different PDE5 inhibitors are sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra), and avanafil (Stendra).

PDE5 inhibitors block an enzyme in the walls of blood vessels. Blocking PDE5 causes blood vessels to relax, increasing blood flow to certain areas of the body like into the penis. This process will pump blood into the penis which eventually causes an erection.

Lifestyle Changes:

Erectile dysfunction is not directly improved by lifestyle changes. Instead, lifestyle changes can treat the cause of ED. For example, if smoking is causing high blood pressure that in turn leads to ED, your symptoms may subside if you stop smoking.

  • Any kind of exercise, even just a 30-minute walk every day, can improve erectile dysfunction symptoms. In fact, a recent Harvard study found that 30 minutes of walking a day was linked with a 41% drop in risk for ED. Exercise can help with stress, anxiety, high blood pressure, high cholesterol, and other ED causes.
    A poor diet can affect your energy levels and may increase your chances of developing diabetes, cardiovascular disease, high blood pressure, and high cholesterol. Healthier consumption, and the weight loss that often comes with it, is linked to a decrease in ED.


Erectile dysfunction is present twice the percent in people with hypertension than normal individuals. Hypertension and antihypertensive drug therapy may contribute to the development of erectile dysfunction in patients with arterial hypertension. The management of erectile dysfunction in hypertensive patients is tricky and should take into account the different effects of antihypertensive drug categories on erectile function. Taking PDE-5 inhibitors and healthy lifestyle changes can significantly improve ED condition.

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