EFFECTS OF HYPERTENSION, DIABETES, AND MEDICATIONS
// October 25th, 2010 // No Comments » // Impotence
High blood pressure (hypertension) by itself has a negative effect on male sexual activity. Untreated hypertensive men are three times more likely to experience potency problems than men of similar age with normal blood pressure. Unfortunately, antihypertensive medication can cause further deterioration in erectile or ejaculatory function.
To overcome problems caused by medications, the patient can describe the unpleasant and unwanted effects to his physician in detail (being forthright about potency problems) and the physician can adjust drug dosage or prescribe alternative medication to control high blood pressure without negative sexual (and other) side effects. The same approach holds true for many other medications routinely used to treat a spectrum of common problems such as peptic ulcer, gastrointestinal disturbances, depression, and a wide range of psychiatric conditions. Many of these can interfere with normal erections. (See Chapter 16 for a comprehensive list of prescription medications and chemicals that adversely affect male sexual function.)
Diabetes mellitus can have a devastating effect on a man’s sexual function. As many as 35 percent of diabetic men twenty to sixty years old experience impotence, whereas only 9 to 10 percent of nondiabetic age-matched controls (that is, men in the same age bracket who do not have diabetes) are similarly affected.
Diabetes is associated with an increased predisposition to two types of vascular disease. One affects the large blood vessels that supply blood to the pelvis. The other involves the smaller blood vessels in the penis that must dilate to become engorged with blood so that an erection can occur. If an impotent, diabetic man has evidence of either macro- or microvascular disease in body organs distant from the genital area (heart, eyes, kidney, and so on), he most likely has vasculogenic impotence. Effective treatment depends on pinpointing the specific defect responsible for the erectile failure; treatment for vasculogenic impotence differs from that for neurogenic impotence.
