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Last updated May 4, 2020. 3 minute read

Erectile dysfunction and high blood pressure

High blood pressure can also make arteries more vulnerable to atherosclerosis. Atherosclerosis means that fatty plaque has built up on the walls of blood vessels. This can reduce blood flow to the heart or brain. Or the penis—leading to ED.

Self Written by Michael Martin
Reviewed by Mike Bohl, MD, MPH

ED can have a number of causes, some more serious than others. On the “more serious” end of the spectrum is high blood pressure. Read on to see why and how ED can be one of the earliest signs of the conditions.


  • One potential cause of ED is high blood pressure (hypertension).
  • In some men, ED is an early sign of the condition.
  • High blood pressure can damage blood vessels and raise your risk of serious health problems like heart disease and stroke.
  • If you’ve developed ED, it’s a good idea to talk with a healthcare provider to rule out any serious health problems.

What is ED?

Erectile dysfunction, or ED (the malady formerly known as impotence), is when you can’t get or maintain an erection strong enough for satisfying sex. That can include erections that don’t last as long as you want or aren’t as firm as you’d like. ED is the most common sexual dysfunction: Experts believe more than 30 million American men have experienced it (Nunes, 2012).

ED and high blood pressure

High blood pressure (hypertension) is a condition in which the pressure of blood inside the arteries is too high. Over time, this can damage blood vessels, leading to health problems such as heart disease.


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High blood pressure can also make arteries more vulnerable to atherosclerosis. Atherosclerosis means that fatty plaque has built up on the walls of blood vessels. This can reduce blood flow to the heart or brain. Or the penis—leading to ED.

Hypertension can also cause ED even in the absence of atherosclerosis. It can prevent the arteries from dilating properly, and prevent smooth muscle tissue from relaxing—two key factors in the development of an erection. According to a study published in the Journal of Andrology, 35% of men with hypertension had some level of ED, compared to 14% of men with normal blood pressure. Just to underline it: That’s a two-and-a-half-times increase. And 9% of the hypertensive group reported their ED as severe, compared to only 1.5% of the healthy group (Doumas, 2006).

High blood pressure medications can also cause ED. Diuretics (or water pills) can lessen the force with which blood flows into the penis. Beta blockers can slow the response of nerves, which help produce an erection, leading to ED.

Other causes of ED

A healthy erection requires healthy blood flow. Erectile dysfunction can be related to health conditions that impair blood circulation—like high blood pressure—or heart disease, high cholesterol, or diabetes. The blood vessels in the penis are smaller than in other parts of the body, so ED symptoms sometimes occur before more serious problems such as a heart attack or stroke. When an otherwise healthy man in his 20s experiences ED, it could be cause for concern. Talk with a healthcare provider as soon as possible.

ED can also occur as a side effect of certain medications, including antidepressants. If you’re experiencing ED, be sure to tell a healthcare provider about all the medications you’re taking. They might be able to adjust your dose or substitute another medication.

Lifestyle factors such as having overweight or obesity, being sedentary, or excessively using alcohol, recreational drugs, or tobacco can contribute to ED.

Erectile dysfunction can also result from physical conditions in which the body’s nerves are damaged or don’t function properly, such as nerve and spinal cord injuries and multiple sclerosis.

Treatment options for ED

Oral medications for ED are highly effective. Several are available, including sildenafil (brand name Viagra), tadalafil (brand name Cialis), and vardenafil (brand name Levitra).

If low testosterone is responsible for your ED, testosterone replacement therapy (TRT) is available. This can boost your testosterone levels by an injection, a wearable patch, or gel applied to the skin.

Some men have found natural remedies for ED to be effective. Some studies have shown that certain supplements (such as DHEA, ginseng, L-arginine, L-carnitine, and yohimbe) may be helpful.

Your erections will be best when you’re healthy. Making simple lifestyle changes, such as getting regular exercise, eating a healthy diet, quitting smoking, and limiting your alcohol consumption, might be enough to improve ED.

If you’re experiencing ED, talk with a healthcare provider. They’ll help you find a solution that’s right for you—and potentially catch other health problems before they become severe.