Blood flow to the penis, along with other components such as hormonal and nervous systems, plays a vital role in getting an erection. Unattended hypertension, or high blood pressure, may damage your blood vessels affecting blood flow to the penis.

Hypertension is a silent disease, and many people suffering from this condition do not have any symptoms. In some cases, it may be picked up accidentally, while in others, it is diagnosed in the presence of hypertension-related complications. One such complication is erectile dysfunction (ED).

But the good news is that even if you have ED due to hypertension, there are various proven treatments to help you get back your healthy sex life. If you have hypertension and have ED symptoms, consult your doctor, and they will help you with the best treatment for your case.

Overview and Facts

Numbers suggest that 50% of Canadian men have ED at some point in time. Hypertension is among one of the common factors that contribute to erectile dysfunction. Besides, certain medications used to treat high blood pressure may also cause ED. 

It is seen that about 30% of hypertensive men also have ED. So, a medicine that manages blood pressure without causing erectile dysfunction is the primary goal.


Symptoms of hypertension, if present, include:

  • Headache
  • Dizziness
  • Flushing of the face
  • Chest pain
  • Shortness of breath
  • Nose bleeds
  • Visual changes
  • Blood in the urine

Some common symptoms of ED are:

  • Difficulty in getting an erection
  • Difficulty in maintaining the erection
  • Loss of sexual desire

The Process of Erection

Before moving ahead, let us first understand the process of erection. There are two chambers besides the shaft of the penis, which are responsible for erections. The urethra, a tube that carries urine and semen, runs through the center of the penis. The surrounding tissues of the chambers include smooth muscle fiber, small blood vessels, and empty spaces. 

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For getting an erection, signals from the nerve endings in the penis or brain prompt the blood vessels to dilate and smooth muscles of the chambers to relax. This causes the empty spaces to fill with blood.

The pressure of blood flow causes the sheath to press on veins, which drain blood out of the penis. The pressure thus traps the blood inside the penis. With more flow of blood, the penis stiffens and expands, resulting in an erection. When arousal ends, smooth muscles contract, relieving pressure off the veins, and the penis returns to the original flaccid state.

Hypertension Types and Effects On ED

Two primary types of hypertension are:

  • Essential or primary hypertension: In this type, there is an identifiable cause for high blood pressure.
  • Secondary hypertension: This type of hypertension is secondary to an underlying health condition.

Long-term high blood pressure of either type may damage your blood vessels. Over a period of time, your arteries become narrow and less flexible, reducing blood flow. This not only increases the risk of stroke or heart attack but also limits blood supply to the penis. Inadequate blood flow is a significant risk factor for ED. So, unattended high blood pressure can result in ED.

Moreover, some medicines used to manage hypertension may also impair sexual functions and, ultimately, ED. While it may seem like a vicious cycle, but is not always the case.

Blood pressure medicines and ED

Some blood pressure medicines are more likely to cause ED, while others may be safe.

Hypertension drugs that may increase the risk of ED are:


These drugs influence the part of the nervous system responsible for causing an erection. They also curb blood flow to the penis, making it difficult for you to get an erection.

Some examples include:

  • Atenolol
  • Carvedilol
  • Metoprolol
  • Propranolol


Diuretics, or water pills, may reduce the intensity of blood flow to the penis. This may make it difficult for you to get an erection.

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Further, diuretics can also lower your zinc levels. Zinc plays an essential role in the production of testosterone. Low zinc levels reduce the production of testosterone by your body, which may decrease your sex drive. 

Hypertension drugs that are less like to cause ED are:

  • Angiotensin II receptor blockers
  • Angiotensin-converting enzyme inhibitors
  • Calcium channel blockers
  • Alpha-blockers


If you have hypertension and notice a change in the duration or frequency of erections, it is best to consult your doctor. Many men may find talking about this problem embarrassing, but not consulting will only keep you away from a treatment that may reverse your problem.

To confirm the diagnosis, your physician will ask your questions and run a physical check. They may also advise urine and blood tests to ensure the cause of ED, such as low testosterone levels and diabetes.

Once the ED diagnosis is confirmed, they may refer you to a sexual health expert or prescribe medicines to manage the same. If they feel that pills are not suitable, other treatment options may be recommended (more on this below).

Also, if you do not have any symptoms of erectile dysfunction or are diagnosed with hypertension or heart disease, you can discuss the probability of getting it in the future with your physician.

They can help you with lifestyle changes and other precautions you can take to prevent ED.

Living with Hypertension & Managing ED

In some cases, lifestyle choices a man with hypertension make may add to the problem, especially smoking. Smoking damages blood vessels and increases blood pressure, reducing blood flow to the body. 

You can also bring the following lifestyle modifications:

  • Having a healthy diet
  • Being active
  • Limiting the intake of alcohol
  • Maintaining a healthy weight
  • Manage your stress levels
  • Get adequate sleep

Ultimately, the power to control your sexual health and blood pressure is in your hands. Lead a healthy lifestyle and work with your doctor, and you may regain your sexual function.

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If you have hypertension, your doctor may change your medicine to prevent the risk of ED. This may include a change in dose for some men, while it may involve changing the medication type for others.

If you get ED, speak to your doctor openly. They will help you with various treatment options to get back your erection.

Prescription Medicines

Usually, the doctor’s first choice is oral pills called PDE5 inhibitors. All these medicines do not increase your sexual desire but increase blood flow to the penis and help get an erection when you are sexually aroused. 

Some common medicines used to manage ED are:

Learn more about these ED medicines here.

Men whose blood pressure levels are not under control and are on alpha-blockers should not take these medicines.

You should also avoid these medicines if you:

  • Take nitrate drugs
  • Have liver or kidney diseases
  • Have an eye disorder known as retinitis pigmentosa
  • Had a stroke or heart attack in the past six months

However, do not worry, even if pills are not an option for you. There are other treatment options, as well.

Other Treatment Options

Some other common treatment options include:

  • Penis suppository
  • Injections
  • Vacuum pump
  • Testosterone replacement
  • Penile implants
  • Vascular surgery

You can also read our previous blog on the treatment of ED here.

Final Thoughts

Hypertension is a long-term condition, and if left unattended, it may damage your blood vessels. This may affect blood flow through your body, including the penis, increasing the risk of ED. Certain medicines used to manage hypertension, such as diuretics, can also increase the risk of ED.

But you should know that changing the dose or type of medicine used to manage high blood pressure can help revert erectile dysfunction. Various treatment options are also available to manage ED and help you get back your healthy sex life. You can work with your physician and dietitian to manage blood pressure levels and prevent ED.

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