It can be both, so let’s explore it further.

High blood pressure, also known as hypertension, is a condition where the pressure of the blood pumped by the heart around the body is elevated.  Okay, but what is considered high or low blood pressure, and what exactly is blood pressure?

A quick lesson on blood pressure

The heart is responsible for pumping blood around the body.  The pressure rises as the heart contracts to push blood into the arteries.  As the heart relaxes, the pressure declines.  When a healthcare professional takes your blood pressure, they look at two readings.  The systolic and the diastolic pressure.

Systolic pressure is the pressure in the artery as the heart contracts.  Diastolic pressure is the pressure in the artery when the heart relaxes and fills with blood.

So, what is high or low pressure?

As a general rule of thumb, it is considered high blood pressure when the reading is higher than 140/90 mmHg.  So, if the systolic reading is above 140, the diastolic reading is above 90, or both are higher.   So why is blood pressure even significant?  Well, as it is a measurement of blood flow, when it is high, the blood flow to your organs is affected.  So the longer your body has to deal with high pressure, the greater your risk of heart disease, stroke, chronic kidney disease, eye disease, erectile dysfunction, and many other conditions increases.

So how do I prevent high blood pressure and reduce my risk of erectile dysfunction?

Typically the cause of hypertension remains relatively unknown.  However, certain factors dramatically increase the risk of you acquiring it:

• Sedentary lifestyle – minimal to no exercise
• Smoking
• Being overweight
• Excessive sodium intake
• High cholesterol
• Excessive alcohol consumption
• Diabetes
• Family history

I’m aware of how often the catchphrase of lifestyle changes, eating a healthy, balanced diet, and moving more is used for nearly all health conditions.  However, these recommendations are a preventative method for reducing the risk of many health conditions and are also the first line of defense treatment for the underlying causes.  Think of medical treatment as a top-down approach to health conditions and lifestyle changes as a bottom-up approach.

Okay, so how does high blood pressure exactly cause erectile dysfunction?

Well, to get an erection, we need blood flow.  Obtaining an erection is complex and requires the processing of messages via nerves to blood vessels in the penis to dilate, allowing increased blood flow.  Any change in blood flow will affect the ability to have an erection.  Hypertension causes damage to the blood vessels in the penis, just like it does to the kidney, heart, eyes, etc.  Over time, the blood vessels develop atherosclerosis, narrowing the blood vessels and potential plaque build-up, resulting in restricted blood flow.

Hypertension can independently cause erectile dysfunction or is associated with other causes such as diabetes, high cholesterol, etc.

Medical treatment for high blood pressure also contributes to erectile dysfunction

When you have been diagnosed with hypertension, it can feel like the focus of treatment is lowering the blood pressure at the expense of your sexual function.  However, many blood pressure medications can impact sexual function, and often it can feel that this is not as important as lowering your blood pressure. 

Research has found that particular blood pressure medication can further impact erectile function.  For example, thiazide diuretics, loop diuretics, and beta-blockers have the potential side effects of reducing blood flow to the penis, compounding erectile dysfunction.  On the other hand, other medications such as ACE inhibitors, angiotensin-receptor-blockers, and calcium channel blockers have no relevant impact on erectile function.

Discussing your sexual function with your healthcare professional when discussing BP medication is essential.  In addition, understanding your current erectile function before commencing any medication allows for discussions on whether any medication worsens the effects.  Also, suppose your healthcare professional knows you are already experiencing erectile dysfunction.  In that case, they are more likely to commence you on one of the alternative medications that don’t have side effects related to erectile function.

Titrating dosage and determining what medication will work for high blood pressure and your sexual function may take some time.  Still, it is achievable if you are willing to openly discuss it with your healthcare professional.  Your sexual function is as important as your overall health.  In fact, studies show good sexual function is beneficial to our overall health and well-being.