How does hypertension affect sexual function?

Diuretics (water pills), which are prescribed to treat high blood pressure (hypertension) can cause erectile dysfunction (ED). Diuretics, like spironolactone (Aldactone) and thiazides (Diuril and Naturetin), decrease blood flow to the penis, which makes it difficult to get or maintain an erection. Diuretics also lower levels of zinc in the body, a mineral that is needed to make the male hormone testosterone.

If you are experiencing problems getting or maintaining an erection while taking a diuretic, don’t stop taking it without talking to your doctor first. You may be given a different dose or switched to another medication.
Hypertension can cause erectile dysfunction (ED), as can the medications commonly used to treat high blood pressure. Some of the drugs for high blood pressure such as the thiazide diuretics and angiotensin converting enzyme (ACE) inhibitors have been found to cause problems with vasocongestion in the genitals. It's hard to get an erection if you have this problem.
Dr. Mehmet Oz, MD
Cardiology (Cardiovascular Disease)
Untreated hypertension can be a stealth cause of erectile dysfunction (ED). Chronically elevated blood pressure can damage the arteries that provide blood flow to the penis. Without sufficient circulation, the penis cannot fill with blood and become firm enough for sexual activity.

Ask your doctor how often you should have your blood pressure checked. If you have high blood pressure, take your medication as prescribed.
High blood pressure can lead to sexual function problems in men. High blood pressure can damage the arteries and veins in your body. A man needs these blood vessels to work well to get an erection. If they are damaged, erectile dysfunction can occur.
Jan L. Shifren, MD
Reproductive Endocrinology
Hypertension (high blood pressure), another form of vascular disease, contributes to sexual dysfunction. It changes circulatory patterns in the body and damages the inner lining of arteries (the endothelium), both of which may decrease blood flow to the penis and vagina. Moreover, many popular blood pressure medications can cause erectile difficulties. In fact, sexual problems are a main reason why people stop taking drugs that lower blood pressure. But doing so can be quite dangerous, given that high blood pressure is a leading cause of stroke and also plays an important role in the physiologic changes that underlie heart attacks and heart failure.

Sexual problems attributed to high blood pressure and the drugs used to treat it include impotence and ejaculation problems in men, painful or uncomfortable intercourse and difficulty having an orgasm in women, and lack of desire in both.

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