Sex may permeate our popular culture, but conversations about it are still associated with stigma and shame in Indian homes. As a result, most people facing sexual health issues or trying to find information about sex often resort to unverified online sources or follow unscientific advice from their friends.

To combat widespread sex misinformation, publishes this weekly sex column, “Let’s Talk Sex”. We hope to start conversations about sex through this column and address sexual health issues with scientific insight and nuance.

The column is authored by sexologist Prof (Dr) Saransh Jain. In today’s column, Dr. Jain discusses the link between hypertension and erectile dysfunction.

Hypertension (high blood pressure) is one of the main causes of erectile dysfunction; this puts people at a higher risk of erectile dysfunction. When your blood circulates naturally, you can have healthy erections. Natural arousal causes increased blood flow to your penis, causing an erection. This process becomes more difficult with hypertension. In this case, the blood vessels constrict, slowing down the natural flow of blood. High blood pressure not only increases the risk of stroke or heart attack, but it also complicates erections. Men with high blood pressure are nearly twice as likely to have erectile dysfunction and impaired penile blood flow as those with normal blood pressure.

Why hypertension is a silent killer

Hypertension develops for a variety of reasons, including medical conditions such as kidney disease and lifestyle choices such as smoking or a high sodium diet. Sometimes people develop high blood pressure without an identifiable cause.

Whatever the reason you have high blood pressure, untreated chronic high blood pressure damages your heart and blood vessels and eventually leads to life-threatening medical conditions like heart disease and stroke. And because the disease is not accompanied by noticeable symptoms, doctors call it “the silent killer”.

Link between erectile dysfunction and hypertension

To understand how hypertension can lead to erectile dysfunction, you must first understand how erections work. Getting an erection is a complicated process.

In the shaft of the penis, there are two side-by-side chambers of spongy tissue called the corpora cavernosa. They are made up of small arteries and veins, smooth muscle fibers and empty spaces. The chambers are wrapped in a sheath of thin fabric.

This is how you get an erection: signals from the brain travel through nerves to the penis and cause the smooth muscles of the cavities to relax and the arteries to dilate or open. This allows a rush of blood to fill the empty spaces. The pressure of the blood flow causes the sheath of the tissue around the chambers to press on the veins that normally drain blood out of the penis. Which traps blood in the penis. As the blood flows, the penis expands and stiffens, and you get an erection.

High blood pressure damages your blood vessels and arteries, which prevents the arteries that supply blood to your penis from working as they should. It also affects the penis muscle creating an inability to relax. As a result, your penis does not get enough blood to make it erect or keep it erect. Additionally, your risk of having low testosterone is almost twice as high if you have high blood pressure. Although the relationship between high blood pressure and low testosterone is still under investigation, low testosterone can contribute to erection problems and low libido.

Treatment options for men with hypertension and erectile dysfunction

Keeping hypertension under control is imperative for your overall health. This silent killer kills or contributes to nearly half a million deaths each year, but only one in four adults with hypertension have the condition under control.

It’s important to take steps to lower your blood pressure, both through lifestyle changes and medication, if your doctor recommends it. Unfortunately, many medications prescribed to help lower blood pressure can make your erectile dysfunction worse because they impact blood flow. Sometimes the choices some men with hypertension make can make the problem worse. Smoking, in particular, is one of them. Smoking increases blood pressure, damages blood vessels and reduces blood flow in the body.

By adopting a healthy lifestyle and working with your doctor, you may be able to regain normal sexual function. You may have much more success treating erection problems if you incorporate these lifestyle changes to manage blood pressure:

• Eating well and exercising regularly will help prevent and manage high blood pressure.

• If you need help managing your blood pressure, try the DASH diet (Dietary Approaches to Stop Hypertension). It can lower blood pressure in as little as two weeks. In general, the DASH diet emphasizes eating whole grains, vegetables, fruits, and low-fat dairy products while limiting salt, fat, and sugar.

• You should limit sodium to 1500 milligrams per day. It’s about two-thirds of a teaspoon of table salt. Choose fresh foods without added preservatives or fats. Also read food labels to check how much sodium is in a serving and don’t add extra salt.

• Burning calories through exercise helps you tone your body and lose weight. Being overweight makes erectile dysfunction more likely.

• When it comes to exercise, you don’t have to follow intense workouts. Just find a way to get your body moving and your heart rate up with 30 minutes of moderate exercise five days a week.

• If you are a smoker, find out about smoking cessation programs and get help from your doctor, family and friends.

If you experience erectile dysfunction soon after starting treatment with blood pressure medication, talk to your doctor. They can work with you to recommend a substitute for the existing medication or resolve your issue. Keep in mind that different drugs have different half-lives, which means it may take several days or weeks for the drug to leave your body. So it may take some time for your erections to return after stopping blood pressure medication.

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