How High Blood Pressure Can Cause Erectile Dysfunction

Doctor Checking Patient's Blood Pressure
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While nobody knows exactly how high blood pressure and erectile dysfunction (ED) are linked, there are several theories that may explain the relationship. While these theories may seem quite different, they are actually all very closely related. A large amount of clinical and scientific evidence supports each one, meaning that the ultimate answer is probably that a cause of ED is a combination of all of these factors.

Blood Vessel Damage

High pressure within blood vessels is known to damage their physical structure by causing reactionary changes. For example, hypertension can cause damage to the small arterioles that feed the kidneys, impairing the kidney's ability to filter blood.

A similar action may be at work in ED. This theory suggests that high artery pressure in the small vessels of the penis causes microscopic tears to the vessel walls. In the process of repairing these tears, the arteries become thicker and less able to supply needed blood to the spongy, erectile tissues of the penis.

Hormone Changes

Special tissues in the body are responsible for producing chemicals called hormones, which regulate everything from weight gain and bone growth to sexual drive and erection response.

One theory of how high blood pressure contributes to erectile dysfunction is that elevated pressure in the circulatory system changes some of the natural hormone production faculties of the body.

There is some evidence that shows that men with high blood pressure have lower sperm counts and testosterone levels than men with normal blood pressure, leading to speculation that decreased hormonal response to sexual stimulation may play a role in the erectile difficulties these men may experience.

Lower Nitric Oxide Levels

The regulation of blood vessel tone—how wide or narrow the blood vessels are—is a complicated process that employs many chemical and physical mediators.

Of the many substances that affect ​blood vessel tone, nitric oxide is among the most important. Produced by specialized cells in the body, nitric oxide is a powerful agent that makes blood vessels relax, or dilate. Some studies have shown that people with long-term hypertension may produce less nitric oxide over time, causing a decreased capacity for “on demand” blood vessel relaxation.

In these cases, erectile dysfunction may result when the body simply can’t produce enough nitric oxide to sufficiently relax the blood vessels in the penis. As a result, the extra blood required to fill the penis cannot be delivered, leading to erectile dysfunction.

How Venous Leaks May Affect Erections

In order to maintain an erection, blood has to be supplied to the penis and it also has to stay there.

Some research suggests that men with high blood pressure may have difficulty maintaining an erection because the increased pressure actually forces blood out of the erectile tissues of the penis and into the veins.

In this theory, the “push” on the small closing valves of the veins is stronger than the veins’ ability to resist.

As a result, the veins are not able to “close” tightly enough to stop blood from passing out of the penis, causing difficulty in maintaining an erection.

No single theory has yet accounted for all of the observed factors present in men with high blood pressure and erectile dysfunction. Rather than one single theory, the full answer is likely to be some combination of factors related to each of these individual ideas.


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