A Fellow in Public Health at the Centre for Democratic Development (CDD-Ghana), Kwame Sarpong Asiedu, has explained that not all but some hypertension medicines can cause erectile problems when they reduce blood flow to the penile area.

Speaking on the Joy FM Super Morning Show on Thursday, September 10, during a discussion on hypertension and its effects on men, he clarified that although erectile dysfunction can be a side effect of some blood pressure medicines, it is wrong to assume that every person taking hypertension medication will experience the problem.

Explaining the link between chronic disease and erectile dysfunction, Mr Asiedu said the condition can often be connected to problems with blood circulation.

“Let me explain what erectile dysfunction is. It normally is a result of poor circulation into the penile area. That's a major thing,” he said.

He added that diabetes could also affect sexual function through nerve damage.

“Or other things with people with diabetes are a lack of sensitivity in the penile area because of nerve damage and other things. Those are the two major things,” he said.

Mr Asiedu acknowledged that some blood pressure medicines can contribute to erectile dysfunction, but said that this does not apply to all hypertension medication.

He explained that blood pressure is influenced by two main components: cardiac output, which refers to how much blood the heart pumps, and peripheral resistance, which refers to the resistance the blood encounters as it moves through the blood vessels.

“If you look at blood pressure in a human being, there are two components. There's what we call the cardiac output. That is how the heart pumps the blood out,” he said.

“And the peripheral resistance, that's how your veins and arteries block. You look at it like a water hose. They block the flow of blood through it.”

According to him, medicines used to control blood pressure work in different ways. Some reduce the pressure generated by the heart, while others reduce the resistance in the blood vessels.

“In the control of blood pressure, two things are done. You either try to decrease the pressure the heart is pumping, which is the cardiac output, or decrease the peripheral resistance, which is the pressure that the veins and muscles pose to the blood as it flows,” he explained.

He said some medicines that reduce peripheral resistance can contribute to erectile dysfunction by affecting blood flow, but cautioned against generalising this effect to all blood pressure drugs.

“A lot of the drugs that cause this erectile dysfunction are the ones that decrease the resistance,” he said.

“That is why it's correct that it is not all blood pressure medication that would have that side effect.”

Mr Asiedu said a common belief that taking blood pressure medication will inevitably lead to sexual side effects could discourage people from seeking or continuing treatment.

“There is a myth out there that once you have high blood pressure and you take the medication, they would have side effects. That is untrue,” he said.

He said doctors need to assess each patient individually rather than assuming that erectile dysfunction is caused by medication.

“And that's why I am very careful concentrating on the drug, but saying let's look at the individual patients,” he said.

He posed the question of whether every patient with hypertension who takes medication develops erectile dysfunction and answered that the available evidence does not support such a conclusion.

“Are they all suffering erectile dysfunction as a result of the medication they are taking? The answer from the data and everything is no,” he said.

Mr Asiedu further explained that patients can respond differently to the same medication, making it important for healthcare professionals to individualise treatment.

“Even when it comes to the medication, as the cardiologist said, there's something called individualisation of care,” he said.

He rejected the idea that blood pressure medication automatically causes erectile dysfunction in everyone who takes it.

“A medication that might cause erectile dysfunction in Kwame would not cause erectile dysfunction in Kofi,” he said.

He said too much attention was often placed on medication when the underlying disease itself could be responsible for sexual problems.

“I get very worried when we concentrate too much on the medication, because a lot of the time it is what we call the aetiology,” he said.