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Men with high blood pressure sometimes experience problems getting or keeping an erection that’s hard enough for sex. But lowering your blood pressure through a healthy lifestyle, and medications if you need them, can be all you need to improve your erections.

Problems getting an erection can even be a sign of high blood pressure, damaged blood vessels and heart disease. If you have problems getting an erection and don’t know your blood pressure numbers, speak to your GP and get a blood pressure check. It could save you from having a stroke or heart attack.

When you are sexually aroused, your brain sends signals to the nerves in and around the penis. These nerves cause more blood to flow into the penis and for the tissue and blood vessels to relax and open up, allowing blood to flow in to the penis, making it hard.

High blood pressure can damage your blood vessels throughout your body, including the blood vessels in or leading to the penis. They can become too narrow (this is called atherosclerosis), meaning not enough blood can flow through them.

Diabetes, smoking and drinking a lot of alcohol are all major causes of erectile dysfunction. Combined with high blood pressure, these can all damage the blood vessels, putting you at higher risk of heart disease and stroke.

There are a number of other possible causes, including:

Your doctor will ask you about the problems you’re having as well as any other medical conditions and your overall health and wellbeing. They will also check your blood pressure and heart rate and do a physical exam.

These will help your doctor understand the cause of the problem and any underlying health problems that need treating, such as high blood pressure and high cholesterol which could mean you’re at risk of heart attacks, heart disease and stroke.

There are a number of ways to improve your erections. Speak to your doctor about the options that could work for you.

If your erectile dysfunction is caused by high blood pressure, then lowering your blood pressure with healthy changes to your lifestyle, could be enough to improve your erections without any other treatments. These changes will also improve your overall health and lower your risk of serious problems such as heart disease, stroke and diabetes.

You might also be offered blood pressure-lowering medicines if you need them.

If the problem is caused by blood pressure medications, your doctor may be able to lower your dose or try a different medication. Don’t stop taking your medicines without speaking to your doctor first as your blood pressure will quickly go back up.

If your erectile dysfunction is caused by medication for another health problem, your doctor may also be able to try an alternative for this.

If you have an underlying health problem which is causing your erectile dysfunction your doctor will try to find the best treatment for it. For example, cholesterol-lowering drugs, called statins, to treat atherosclerosis.

There are treatments available to help you get an erection which can be used at the same time as changing your lifestyle or blood pressure medications, or afterwards, if you’re still having problems.

Treatments include vacuum pumps, which are devices that encourage blood to flow into the penis. Tablets called PDE5 inhibitors, such as Viagra, can also be an option. Because they allow the blood vessels to widen they can cause lightheadedness, especially if you are taking blood pressure medications, so you will start with a low dose and they might not be suitable if you have angina (chest pain).

Speak to your doctor about which options might be right for you.

It’s normal to feel embarrassed and find it difficult to talk about sex and erections. But sex is a normal part of life and problems getting an erection are very common, so your doctor or nurse will be used to talking about these things. They can talk to you in confidence about any questions or concerns you may have and the treatment options available.

If sex is important to you, not being able to get an erection can have a big impact on your mood and how you feel about yourself, so it’s important to get the support and treatment you need. If you’ve had problems getting an erection this can affect your confidence, which can in turn affect your ability to get an erection. You might find it helpful to speak to a counselor or specialist. They are experts in helping people to overcome these problems.

You can speak to your GP or practice nurse, visit a genitourinary medicine (GUM) clinic or ask to be referred to a specialist. Find the nearest GUM clinic through the British Association for Sexual Health and HIV (BASHH) website.

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