Erectile dysfunction (ED) is related to different health problems that compromise erection, such as high blood pressure.

In men, the consequences of high blood pressure on sexual life are more physically evident than in women. Loss of sexual interest and trouble getting an erection are the main ones.

To know why blood pressure influences sex life, you must first understand how an erection occurs and the role of blood vessels in it.

Erectile dysfunction is the inability to maintain an erection firm enough for sexual intercourse. Although it may seem tragic, it is more common than you think but often hidden or ignored.

ED affects around 20% of men, i.e., 1 in 5 men may have it. You can suffer from it at any time of life, but it is more common after the 40s with other chronic diseases. 

Although erectile dysfunction may not seem to be a thing for healthy people, the truth is that there are young, healthy men with problems getting an erection. 

Erection is a significant part of any man's sexual life and mental health. Sexuality is a vital piece of life, and problems such as erectile dysfunction can be detrimental to it, seriously affecting relationships and the life quality of both partners.

Penile erection is a natural process involving nervous and vascular action. That is, both the blood vessels and the brain act in combination.

The penis consists of two columns of erectile tissue called corpora cavernosa (producing erection) and a duct (urethra) through which you urinate. The corpora cavernosa constitute the largest part of the penis and the main involved in erection. It contains arteries, nerves, veins, and muscle fibers that allow or stop the blood inflow.

Erection begins when nerve impulses from sexual stimulation release brain chemicals, which stimulate nerves in the corpus cavernosum and induce additional blood chemicals release to act on the penis muscles.

These latter chemicals relax the cavernous muscles, lead to blood vessels dilation, and allow a lot of blood to pass through, increasing the penis size and circumference, which ultimately results in an erection. As more blood flows in, the penis becomes stiffer and larger.

Erectile dysfunction can be organic (physical origin) or psychological. In many men with erectile dysfunction of organic origin, a psychological component (performance anxiety) usually worsens it, often resulting from both.

Accordingly, the causes are:

Vascular: When little blood reaches the penis (arterial) or is not retained within the corpora cavernosa, leading to a blood leak that prevents getting and maintaining enough penis rigidity.

Neurological: When there are problems transmitting orders that the brain and spinal cord send to the penis through the erector nerves.

Hormonal: When the body produces a less male hormone (testosterone) than needed, impairing sexual desire.

Medication: Medications used to treat hypertension or depression can affect erectile function as a side effect.

Psychological: In these cases, the erection is not achieved because of mental problems either due to performance anxiety (fear of not getting an erection, fear of failure), relationship problems, depression, or other problems. Broadly speaking, stress of any kind can affect sexual intercourse.

According to a recent study involving 1255 men, almost 60% had erectile dysfunction even though they considered themselves sexually active.  

High blood pressure can lead to free radicals and continuous oxidative stress and inflammation, damaging blood vessel walls and reducing the elasticity and dilation capacity of corpora cavernosa blood vessels.

In fact, ED can predict the development of a major cardiovascular event five years earlier in 11% of cases. Indicating that it could be considered similar to coronary heart disease. 

Medications to treat high blood pressure, especially diuretics and beta-blockers, can also cause erectile dysfunction, probably as a side effect. Fortunately, it is reversible once the doses are modified or when they withdraw. 

Other situations related to high blood pressure can also decrease penile muscle relaxation, such as smoking, increased cholesterol, and heavy drinking.

The vascular risk factors par excellence are hypertension, diabetes, smoking, or increased cholesterol. These produce small lesions in all arteries that eventually converge and become large lesions. 

ED due to vascular origin is considered an early indicator of heart disease because the penile arteries are thinner and smaller in diameter than the heart arteries and usually clog first. So having ED could mean that the small penile arteries are failing, and within a few years, the heart arteries may also fail.

Men who recognize a flaw in their ability to achieve an erection may not immediately realize that erectile dysfunction is the problem. The quality of erections gradually declines over time. Consequently, they may be unsure whether their erectile problems are persistent or casual and may wait to see if the ED resolves alone, leading to worsening and lower quality of life. 

You are likely to have erectile dysfunction if:

• You achieve just an unstable erection when you want to have sex.

• Despite sexual stimulation, the erection does not last long enough.

• Anxiety or avoidance due to fear of failure during sexual intercourse.

• Low libido or decreased sexual desire.

It is time to consult a specialist if you have any of these symptoms. Do not let it pass you by. There are medications and therapies focused on improving erectile function, related anxiety or depression, and consequently your sex life. The sooner you receive treatment, the better the quality of life of your partner and you. 

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