Does Lisinopril Cause ED?

Nearly half of all US adults have high blood pressure (hypertension), and only 25%¹ of them have it under control. Hypertension is when your blood pressure is over 130/80 mmHg for a specific period.

High blood pressure and erectile dysfunction (ED) are often related. Sometimes, you can resolve ED by lowering your blood pressure to an optimal range. If your doctor determines your blood pressure is too high for too long, they may prescribe a prescription drug such as lisinopril to lower it. 

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What is lisinopril, and what are its uses?

Lisinopril is a cardiovascular medication that lowers blood pressure. Many drug classes can do this. Lisinopril is an angiotensin-converting enzyme inhibitor (ACE inhibitor).

Other examples of ACE inhibitors include: 

  • Benazepril 

  • Enalapril 

  • Moexipril 

  • Perindopril 

  • Quinapril 

  • Ramipril 

  • Trandolapril 

All ACE inhibitors lower blood pressure or help prevent heart failure. ACE inhibitors are oral medications, and enalapril can also be administered intravenously in the hospital. 

Doctors mainly prescribe ACE inhibitors for high blood pressure. Hypertension is a common condition that develops when the pressure of blood flow in the arteries increases excessively. 

Many people do not experience any hypertension symptoms. One possible symptom could be ED since these two conditions often accompany one another. 

The most accurate way to determine whether your blood pressure is high is to measure it during a routine appointment with your doctor. 

Lisinopril has other uses as well, although these off-label uses are less common:

  • Diabetic nephropathy 

  • Proteinuric chronic kidney disease

  • Post-transplant erythrocytosis 

Some doctors may prescribe lisinopril for ED when high blood pressure is the underlying cause. 

Additionally, other blood pressure medications that are not ACE inhibitors can cause ED. Because of this, a doctor may consider replacing one of those medications with an ACE inhibitor like lisinopril to keep blood pressure regular while preventing ED. 

If you don’t have high blood pressure, your doctor isn’t likely to prescribe lisinopril because another health issue could be causing your ED. While it's essential to ensure you do not have elevated blood pressure, your doctor must rule out other health problems before they worsen.

How does lisinopril help treat ED?

Lisinopril treats ED by lowering blood pressure when it is too high. Your blood pressure will return to normal when you take the right dose. 

Hence, some have a link between high blood pressure and ED. If you experience ED, but your blood pressure is fine, there could be another reason for it. 

Other factors besides high blood pressure that may cause ED are: 

  • Endocrine disorders

  • Type 2 diabetes

  • Nervous system disorders

  • Psychological conditions such as depression, anxiety, or stress

  • Certain medications, such as heart medications or antidepressants

  • Cardiovascular causes, such as atherosclerosis

  • Obesity

  • Lack of exercise

  • Smoking

  • Drinking too much alcohol 

Lisinopril prevents ED by restoring blood pressure to a normal range. Some experts² claim ED is a symptom of high blood pressure. Therefore, it could be a warning sign that your blood pressure is too high. 

Lisinopril lowers blood pressure by dilating arteries. Not all blood pressure medications work this way, which is why they can cause ED. When your arteries expand, blood flow increases and blood pressure decreases.

This is perfect for attaining and maintaining an erection because blood flow must increase to the penis during an erection. 

If you have any concerns about your medication causing ED or making it worse, ask your doctor to check whether this could happen. Your doctor will have access to a list of known side effects. ED is usually mentioned on those lists if there's a significant chance of it occurring. 

What are the potential side effects of taking lisinopril?

Most people who use lisinopril find that their overall health improves. But, like all medications, there are some side effects. 

Side effects of lisinopril include: 

  • A dry cough

  • Hyperkalemia (too much potassium in the blood)

  • Hypotension (low blood pressure)

  • Headaches and dizziness

  • Renal (kidney) complications

  • Angioedema (swelling under the skin) 

People who tend to experience more side effects are those with renal or autoimmune conditions, especially if they’re collagen vascular conditions, like lupus or rheumatoid arthritis. If you have one of these diseases, your doctor will consider this before prescribing lisinopril.

Another point to consider is that some pre-existing medications you are taking may interact adversely with lisinopril. Medications that interact with lisinopril are: 

  • Diuretics

  • Antidiabetics, such as insulin and oral hypoglycemic agents

  • Non-steroidal anti-inflammatory drugs (NSAIDs)

  • Renin-angiotensin system (RAS) blockers

  • Lithium

  • mTOR inhibitors

Your doctor will consider whether lisinopril is safe for any pre-existing health conditions as it may worsen them. 

Doctors avoid prescribing lisinopril to people with:

  • Hyperkalemia

  • Angioedema

Overall, lisinopril is generally safe, and your doctor will always start you on a low dose if an adverse reaction occurs. However, these reactions are quite rare. Keeping up with regular blood tests will identify any problems early. 

Lisinopril and ED

Lisinopril is more likely to prevent ED than cause it. However, in some rare circumstances (<1%), lisinopril may cause ED. 

One study³ involving 134 hypertensive patients discovered that lisinopril had relatively neutral effects on erectile function and sexual satisfaction. Researchers concluded that while ACE inhibitors are often used for ED, angiotensin receptor blockers (ARBs) showed more promise. 

If ED persists after starting lisinopril, it’s best to look at other potential causes.

Can other blood pressure medications help with ED?

Besides lisinopril, other potential blood pressure medications may improve ED. Therefore, if one treatment doesn't work out for you, there are still other options you can try. 

Other medications you might be able to try are calcium channel blockers (CCBs) or angiotensin II receptor blockers (ARBs). While research⁴ is still in its infancy, both classes are as effective as ACE inhibitors.

Studies⁵ have shown that calcium channel blockers do not cause sexual dysfunction and ED compared to placebo. However, other studies⁶ have shown that while ARBs improved sexual activity among hypertensive men, erectile function showed no significant improvement. 

The take-home message is that we need more research before concluding that CCBs or ARBs may improve some ED symptoms. 

Which blood pressure medications can cause ED?

Blood pressure medications known to make ED worse are beta-blockers and diuretics. Some studies demonstrated that both classes of drugs negatively affected sexual function.

If you are taking one of these medications and experiencing ED, talk to your doctor before discontinuing your medication. Your doctor may have put you on that medicine for a specific reason, so it may be dangerous to stop it suddenly without a substitute. 

If you cannot switch medications, your doctor might offer other solutions. You could also try investigating other potential causes since ED is often a multifactorial condition.

When should you see a doctor?

If ED is a problem for you, do not suffer in silence. Many refuse to seek help because they feel embarrassed about their condition. However, this problem is more common than you may realize, and today there are more treatment options and awareness than ever.

Addressing ED is important because, more often than not, it's caused by an underlying health condition such as high blood pressure. Regardless of what’s causing your ED, you need treatment to prevent your overall health from worsening. 

If you delay treatment for high blood pressure, other problems will arise. For instance, you are more likely to suffer from a stroke, heart failure, or kidney disease. 

The lowdown

Lisinopril is an ACE inhibitor that is commonly prescribed for high blood pressure. For some, ED is caused by elevated blood pressure. Lisinopril is one of the best medications for lowering blood pressure and preventing ED. 

Unfortunately, other blood pressure medications can worsen ED because they do not have the same effects as lisinopril on the body. If you believe your current medication affects your sexual function, speak to your doctor.

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