Can high blood pressure or BP tablets cause erectile dysfunction?
Yes, both can. But in one trial, men warned about the side effect were 10 times as likely to report it. So never stop your tablets on a hunch. Talk to your GP first.
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Can high blood pressure cause erectile dysfunction?
Yes. The NHS lists high blood pressure as a possible cause when erection problems happen often. They’re very common, particularly in men over 40.
High blood pressure can help cause a build-up of fatty material inside your arteries.
How high blood pressure can lead to erection problems
- 1
Extra strain
High pressure strains your blood vessels and heart.
- 2
Narrower arteries
Fatty material can build up, hardening and narrowing them.
- 3
Less blood flow
Less blood reaches the penis, so erections are harder to get or keep.
- 4
An early sign
Penis arteries are so narrow that problems can show there first.
The narrowest pipe in a house often shows a slow flow first. A slow tap doesn’t mean the whole house is blocked, but it’s a reason to check the pipes.
In 12 studies of 36,744 men, those with erection problems were 48% more likely to get heart or circulation disease later. That’s a link, not a forecast for you.
You’re usually considered to have high blood pressure at 140/90 or higher when checked by a healthcare professional, or 135/85 or higher at home.
So if erections keep failing, get your blood pressure checked. Many pharmacies do it free if you’re 40 or over. Here’s how to check it at home.
Can ramipril or other BP tablets cause erectile dysfunction?
Some can. The BHF says beta blockers and diuretics (water tablets) can make erection problems worse by cutting blood flow to the penis.
| Tablet type | Examples | What its NHS page or leaflet says |
|---|---|---|
| Beta blockers | Atenolol, bisoprolol, metoprolol | Erection problems are listed as a common side effect. |
| Thiazide diuretics (water tablets) | Bendroflumethiazide | Can cause it in rare cases. If it’s the cause, it usually gets better after stopping treatment. |
| ACE inhibitors | Ramipril | Uncommon: may affect up to 1 in 100 people. |
Sources: NHS: beta blockers; NHS: bendroflumethiazide; Ramipril leaflet
On ramipril? Its leaflet lists sexual problems in men as uncommon. The NHS ramipril page doesn’t list them among its common side effects.
Trials paint a calmer picture. A review of 25 studies found no BP tablet type clearly changed erections, compared with each other or with a dummy pill.
But most of those studies had weaknesses in how they were run, which could skew the results. So the question isn’t settled.
Think a tablet is to blame? Tell your GP when the problems began. The NHS says your doctor may switch you to a different medicine.
Never stop or change a prescribed medicine without your prescriber.
Do beta blockers cause erectile dysfunction?
They can. But in one trial, what men were told mattered too. Men with newly found heart or circulation disease took the beta blocker atenolol for 3 months.
| Group (32 men each) | What they were told | Reported erection problems |
|---|---|---|
| Group A | Not which pill they took | 3.1% |
| Group B | The drug’s name only | 15.6% |
| Group C | The drug and its effect on erections | 31.2% |
Being warned was enough. Men told about the side effect reported it 10 times as often as men who didn’t know their pill. The researchers think worry may have caused it.
Men who reported problems then tried sildenafil (Viagra) and a dummy pill. Both worked equally well for all but one of them.
It was one small trial of one drug. Still, it shows the tablet may not be the whole story.
If a beta blocker does seem to be the problem, ask about others. In 4 trials, men on nebivolol scored a little better on an erection questionnaire than men on metoprolol.
Can I take Viagra with blood pressure tablets?
Usually, but check with your doctor first. The BHF says these medicines, called PDE5 inhibitors, can be taken with most heart medicines. They can help two-thirds of men with erection problems.
| If you | What the NHS or BHF says |
|---|---|
| Use nitrates (GTN) or nicorandil for chest pain | Don’t take them together. Your blood pressure can drop dangerously low. |
| Have low blood pressure | Not recommended. It can push blood pressure lower. |
| Have uncontrolled high blood pressure | May not be suitable. |
| Recently had a heart attack or stroke | May not be suitable. The BHF says it can be prescribed from 6 months after a heart attack, if you’re stable. |
| Take other blood pressure medicines | Some may not mix well. Tell your doctor everything you take. |
Sources: NHS: sildenafil; BHF
The BHF also gives gaps for GTN. Leave at least 12 hours between a PDE5 inhibitor and GTN spray. For nitrate tablets, leave at least 24 hours, or 48 for Cialis (tadalafil, another PDE5 inhibitor).
Bought sildenafil from a pharmacy without a prescription? The NHS advises a check-up with your doctor within 6 months. Erection problems can be a sign of diabetes or heart problems.
What can I do about erectile dysfunction with high blood pressure?
The NHS gives almost the same list for both. Healthy changes can sometimes help erections and can help lower blood pressure.
Your blood pressure and erection checklist
- Lose weight if you’re overweight.
- Stop smoking.
- Exercise daily, building up to at least 150 minutes a week.
- Drink no more than 14 units of alcohol a week.
- Cut down on salt: avoid salty food and adding salt to meals.
- Write down when the problems started and which tablets you take, and show your GP.
Sources: NHS: erectile dysfunction; NHS: high blood pressure
Cycle more than 3 hours a week? The NHS suggests not cycling for a while. The NHS also suggests trying to reduce stress and anxiety.
Your doctor may also refer you for tests. See blood tests for erectile dysfunction and what causes high blood pressure.
When to speak to a GP
High blood pressure does not usually cause symptoms. See a GP or a sexual health clinic if:
- Erection problems keep happening. The NHS says it might be a sign of a health condition that can be treated.
- They started after a new blood pressure tablet. Your doctor may switch you to a different medicine.
- You bought sildenafil without a prescription and haven’t had a check-up within 6 months.
- You’re 40 or over and haven’t had your blood pressure checked for more than 5 years.
Call 999 if you get sudden chest pain or discomfort that doesn’t go away, which can feel like squeezing, pressure, burning or indigestion. Call too if pain spreads to your arm, neck, jaw, stomach or back. Or if chest pain comes with sweating, feeling sick, light-headed or short of breath.
On sildenafil, call 999 if you think you’re having a severe allergic reaction, a heart attack or a seizure (fit). Call 111 for a painful erection lasting longer than 4 hours.