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High Blood Pressure and ED: The Connection & What to Do

Mike Bohl, MD, MPH, ALM

Reviewed by Mike Bohl, MD, MPH, ALM

Written by Geoffrey C. Whittaker

Published 01/24/2018

Updated 04/04/2024

High blood pressure, or hypertension, is one of the most common medical conditions, affecting almost half of American adults. It’s also closely linked to erectile dysfunction (ED)

Blood flow plays a major role in helping you develop and maintain an erection. Over time, high blood pressure can impair blood flow, which is why bringing your blood pressure into the healthy, optimal range isn’t just good for your overall health — it’s also a good way to reduce the risk of experiencing erection problems and improve your sexual function and confidence.

Below, we’ll explain how blood pressure affects erectile dysfunction, as well as some tactics you can use to lower your blood pressure into a good range for your sexual health.

Can high blood pressure cause ED? Yes, over time. 

High blood pressure damages blood vessels and can impact the way blood flows through your body — including to your penis. Since healthy erections rely on healthy blood flow to the penis, high blood pressure can pose a big problem in the bedroom (and elsewhere).

Why exactly it hampers this process, however, is a bit more complicated — let’s explore why.

High blood pressure makes every aspect of erectile function more challenging for your body, since the arteries that are responsible for transporting blood into the penis can become damaged, reducing penile blood flow.

In total, according to an article published in the journal, Current Opinion in Nephrology and Hypertension, about 30 percent of men with hypertension also have some degree of erectile dysfunction.

Normal, unobstructed blood flow is the key to sexual health. When you feel aroused, your body increases the level of blood flow to tissues inside the penis, filling the corpora cavernosa and giving you an erection.

There are direct and indirect side effects of high blood pressure on erection quality and consistency

  • High blood pressure can make this more difficult by damaging blood vessels. Hypertension is closely linked to narrowed, ruptured or otherwise damaged blood vessels — an issue that can negatively affect blood flow and even potentially increase your risk of having a stroke or heart attack.

  • Damaged blood vessels possibly caused by hypertension result in weaker, less consistent blood flow throughout your body — a condition that makes developing an erection much more difficult.

  • When there isn’t enough blood flow to fill the corpora cavernosa and increase pressure in the penis, you might have trouble with getting and maintaining an erection. Sometimes, high blood pressure might not produce total ED. Instead, you might notice slightly weaker erections that are harder to maintain.

  • Also, high blood pressure can have a negative effect on sexual performance because it can cause blood vessel walls to harden and make it difficult to get enough blood flow to the penis to maintain a strong erection.

  • High blood pressure can also make physical exercise more of a challenge. This can lead to people exercising less and not being in the best physical condition for optimal sexual performance.

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High blood pressure may not only affect the “hardware” and mechanics of your sexual organs, but it may also be related to your libido itself. 

In middle-aged and elderly men, high blood pressure is closely linked to a decline in testosterone levels, the key hormone responsible for sex drive in men. Research from 2021 published by the Journal of the American Heart Association found that men with hypertension typically had lower levels of testosterone than men with normal or optimal blood pressure.

Choose your chew

If you have high blood pressure, the best thing you can do is talk to your healthcare provider about how you can safely and sustainably reduce it. Your healthcare provider might recommend making changes to your lifestyle, or they may recommend using high blood pressure medications. 

The best option is typically improvements to your diet and exercise habits, along with better care for sleep hygiene and, generally, your mental health. 

Often, high blood pressure is caused by several factors at once. Below, we’ve listed some of the most effective steps you can take to naturally lower your blood pressure and reduce your risk of experiencing blood pressure-induced ED:

  • If you have overweight or obesity, change your diet and lifestyle to help you lose weight and return to the healthy range. Weight, and fat around the waist in particular, are closely correlated with higher-than-normal blood pressure levels.

  • Exercise frequently. Exercise, particularly cardiovascular exercise such as jogging and cycling, can naturally lower your blood pressure. Often, as little as 30 minutes of steady exercise per day is enough to significantly reduce your average blood pressure level.

  • Reduce your sodium intake. If your diet is high in sodium, it can increase your average blood pressure level. One of the most effective ways to lower your blood pressure is to reduce your consumption of salty, sodium-heavy foods.  

  • Avoid alcohol and cigarettes. Drinking too much alcohol can raise your blood pressure. Cigarettes and cigars also increase your blood pressure, often by a significant amount.

  • Finally, diet is closely linked with blood pressure. By lowering your intake of saturated fat and increasing green vegetables, vitamin supplements and low fat foods, you may be able to produce a slight reduction in your blood pressure. A healthy lifestyle is key.

Some treatment options for high blood pressure are diuretics, beta-blockers, alpha-blockers and ACE inhibitors.

There’s also medication for erectile dysfunction to consider.

Modern erectile dysfunction medications and specifically PDE5 inhibitors work to relax smooth muscles in arteries in order to increase blood flow to your penis. PDE5 inhibitors like sildenafil (generic for Viagra), tadalafil (generic for Cialis) and Stendra (avanafil) are considered safe and effective when used as directed.

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High blood pressure is known as the “silent killer” for good reason — over time, it’s a serious risk factor for straining every organ in your body, from your heart (including cardiovascular disease or heart failure) to your kidneys, liver and brain. This means hypertension increases the risk of everything from a stroke to ischemic heart disease.

If you have high blood pressure, it’s important that you take action and make changes to your life. Seek medical advice from your cardiology healthcare professional to discuss options like blood pressure drugs and lifestyle changes. Doing so won’t only improve your sexual performance and help you reduce the effects of ED — it can also help you live longer and enjoy a higher general quality of life.

4 Sources

  1. Nunes, et al. (2012, March 21). New insights into hypertension-associated erectile dysfunction. Department of Physiology, Georgia Health Sciences University. Retrieved May 12, 2022, from https://www.ncbi.nlm.nih.gov/pubmed/22240443
  2. Mengyuan, et al. (2021, March 19). Association of Serum Testosterone and Luteinizing Hormone With Blood Pressure and Risk of Cardiovascular Disease in Middle‐Aged and Elderly Men. Journal of the American Heart Association. Retrieved May 12, 2022, from https://www.ahajournals.org/doi/10.1161/JAHA.120.019559
  3. Frappier, et al. (2013, October 23). Energy Expenditure during Sexual Activity in Young Healthy Couples. PLOS ONE. Retrieved April 12, 2022, from https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0079342
  4. American Heart Association. (2016, October 31). Smoking, High Blood Pressure and Your Health. American Heart Association. Retrieved May 12, 2022, from https://www.heart.org/en/health-topics/high-blood-pressure/changes-you-can-make-to-manage-high-blood-pressure/smoking-high-blood-pressure-and-your-health
Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Mike Bohl, MD, MPH, ALM

Dr. Mike Bohl is a licensed physician, a Medical Advisor at Hims & Hers, and the Director of Scientific & Medical Content at a stealth biotech startup, where he is involved in pharmaceutical drug development. Prior to joining Hims & Hers, Dr. Bohl spent several years working in digital health, focusing on patient education. He has also worked in medical journalism for The Dr. Oz Show (receiving recognition for contributions from the National Academy of Television Arts and Sciences when the show won Outstanding Informative Talk Show at the 2016–2017 Daytime Emmy® Awards) and at Sharecare. He is a Medical Expert Board Member at Eat This, Not That! and a Board Member at International Veterinary Outreach.

Dr. Bohl obtained his Bachelor of Arts and Doctor of Medicine from Brown University, his Master of Public Health from Columbia University, and his Master of Liberal Arts in Extension Studies—Journalism from Harvard University. He is currently pursuing a Master of Business Administration and Master of Science in Healthcare Leadership at Cornell University. Dr. Bohl trained in internal medicine with a focus on community health at NYU Langone Health.

Dr. Bohl is Certified in Public Health by the National Board of Public Health Examiners, Medical Writer Certified by the American Medical Writers Association, a certified Editor in the Life Sciences by the Board of Editors in the Life Sciences, a Certified Personal Trainer and Certified Nutrition Coach by the National Academy of Sports Medicine, and a Board Certified Medical Affairs Specialist by the Accreditation Council for Medical Affairs. He has graduate certificates in Digital Storytelling and Marketing Management & Digital Strategy from Harvard Extension School and certificates in Business Law and Corporate Governance from Cornell Law School.

In addition to his written work, Dr. Bohl has experience creating medical segments for radio and producing patient education videos. He has also spent time conducting orthopedic and biomaterial research at Case Western Reserve University and University Hospitals of Cleveland and practicing clinically as a general practitioner on international medical aid projects with Medical Ministry International.

Dr. Bohl lives in Manhattan and enjoys biking, resistance training, sailing, scuba diving, skiing, tennis, and traveling. You can find Dr. Bohl on LinkedIn for more information.

Publications

  • Younesi, M., Knapik, D. M., Cumsky, J., Donmez, B. O., He, P., Islam, A., Learn, G., McClellan, P., Bohl, M., Gillespie, R. J., & Akkus, O. (2017). Effects of PDGF-BB delivery from heparinized collagen sutures on the healing of lacerated chicken flexor tendon in vivo. Acta biomaterialia, 63, 200–209. https://www.sciencedirect.com/science/article/abs/pii/S1742706117305652?via%3Dihub

  • Gebhart, J. J., Weinberg, D. S., Bohl, M. S., & Liu, R. W. (2016). Relationship between pelvic incidence and osteoarthritis of the hip. Bone & joint research, 5(2), 66–72. https://boneandjoint.org.uk/Article/10.1302/2046-3758.52.2000552

  • Gebhart, J. J., Bohl, M. S., Weinberg, D. S., Cooperman, D. R., & Liu, R. W. (2015). Pelvic Incidence and Acetabular Version in Slipped Capital Femoral Epiphysis. Journal of pediatric orthopedics, 35(6), 565–570. https://journals.lww.com/pedorthopaedics/abstract/2015/09000/pelvic_incidence_and_acetabular_version_in_slipped.5.aspx

  • Islam, A., Bohl, M. S., Tsai, A. G., Younesi, M., Gillespie, R., & Akkus, O. (2015). Biomechanical evaluation of a novel suturing scheme for grafting load-bearing collagen scaffolds for rotator cuff repair. Clinical biomechanics (Bristol, Avon), 30(7), 669–675. https://www.clinbiomech.com/article/S0268-0033(15)00143-6/fulltext

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