Podcast episode (host Dr. Anne Truong MD) answering whether the blood pressure medicine amlodipine causes erectile dysfunction (ED). The episode reviews updated ACC/AHA blood pressure thresholds (Aug 2025), explains that evidence is mixed for amlodipine’s effect on sexual function (some studies show increased sexual dysfunction and long-term testosterone reduction; a TOMHS trial reported a 26% decrease in sexual activity over two years in the amlodipine group), and concludes overall research shows amlodipine does not significantly increase ED risk compared with other antihypertensives. The episode identifies thiazide diuretics (e.g., hydrochlorothiazide, chlorthalidone) and beta blockers (e.g., metoprolol, atenolol, propranolol) as the classes most associated with ED, notes ACE inhibitors (e.g., lisinopril, enalapril) and ARBs (e.g., valsartan, losartan) tend to have neutral effects, and recommends consulting a physician before changing medication. Lifestyle interventions (exercise, Mediterranean diet, weight loss) and devices (penis pump) are suggested as adjuncts.
Questions this episode answers
Over 7,000 men.
August 2025.
120 over 80 (120/80).
120–129 systolic = at risk/early; above 129–139 systolic = stage one (episode phrasing).
Systolic over 140 or diastolic over 90.
Chapters
This podcast is for you. The Modern Man I'm Dr. Anne Truong, your host. I'm an intimate health medical doctor and best selling author of the book Erectile Dysfunction Fix. I'll do a deep dive into sexual health and performance and how it affects men of all ages and backgrounds. So let's get started and be sure to visit my website@sexualhealthformenpodcast.com for more information and resources from the show. See you on the inside.
Foreign.
Hello there Modern Man. I'm Dr. Anne Trung. I've treated over 7,000 men with ED. In today's episode we're going to answer the question can the high blood pressure medicine called amlodipine cause ed? I get this question a lot and I want to review what is high blood pressure and what medicine that you take for high blood pressure that contribute to ED. Now in August of 2025, American College of Cardiology as well as American Heart association came out with new guideline that will define what high blood pressure is. So normal blood pressure is considered 120 over 80. It used to be higher, but now it's like lowering down to 120 over 80. And if the top number, which is systolic number is higher than 120 to 129, that means that you are at risk for high blood pressure. You are in early stage of high blood pressure. That's it. Even if the bottom number is 80 or lower. Now if your blood pressure, the top number is above 129 to 139, then you have high blood pressure. Or if your BL blood pressure is over 80 the bottom number then you have stage one high blood pressure. Now stage two high blood pressure, which is one of the more concerning is anything over 140 systolic number and then the bottom number is over 90. So the numbers are lower now. But they're finding that early intervention of high blood pressure can really help with longevity and death. And so it's more important if you have high blood pressure. With high cholesterol and also with diabetes, you really need to manage the blood pressure. Now what medication tend to cause ed? And a lot of people ask about amlodipine. Now amlodipine is a calcium channel blocker so it lower blood pressure by releasing blocks of calcium. So the evidence is mixed and the risk appears to be low that it can contribute to ed. It's mixed because there was some study that showed that men taking amlodipine have a higher occurrence of sexual dysfunction. And then there's another study that shows that it does not. So it is a little mixed. But amlodipine taken for long term does reduce testosterone level as well. And in a major clinical trial which is TOMHS found amlodipine group had 26% decrease in sexual activity through two years. So higher than most other treatments. The bottom line is the comprehensive research shows that amlodipine does not significantly increase the risk of ED compared to other antihypertensive medications. So that's good news. It's very well tolerated. You can usually take it with Viagra or Cialis. You shouldn't take both of it when you're taking blood pressure medicine. But it does reduce testosterone level with long term use. So that is important to know. The other question is what medication tend to contribute more to ed? The number one is thiazide, diuretic medication. That thiazide class that tend to have you go to the bathroom to lower your blood pressure and they usually end with the word thiazide in there. The second class is called beta blocker which lower your heart rate but then by lowering the heart rate also affect your erection. So how does the diuretic affect your erection? So they usually go by the name of hydrochlorothiazide or chlorthalidone. They are the worst offenders for ED, research shows because in the landmark study called the Tom HS found that men on chlorthalidone has 26% decrease in sexual activity over two years. And Mentech and diazide are twice as likely to have ED compared to those of other blood pressure medicine. And they're more than double the incidence of non compliance because of the side effect. Now I'm not saying you stop the medication. Please do not stop the medication. If you're on thiazide or you're on beta blocker. Don't stop your blood pressure medicine. Always discuss with your doctor first. All right? That is the most important thing because if you stop your blood pressure medicine, you're going to start having a hypertensive episode, you're going to start having a heart attack, you're going to may even have a stroke. So do not do that without discussing.
With your doctor, all right?
Now thiazide medication can also cause lower testosterone level because it affect the absorption of zinc and it also decreases blood volume because you're urinating it all out. So therefore it decreases blood flow to the penis and it also lower testosterone. Now the second offender, the beta blockers, they're usually the one would end with all lol, like Metoprolol, Atenolol and propranolol.
Are the ones that cause a higher rate of ed. Atenolol cost a little bit lower. Now there's new medication called nabivolol stands out as the exception. It does not increase ED risk. Now the beta blocker reduce blood flow by decreasing the heart rate and how the heart pump out the blood. But by doing that, the beta blocker.
Actually interferes with the nerve signals needed.
For erection and it can also reduce testosterone levels in some cases as well. And the class like the calcium channel blockers are less likely to cause ed. And another class of blood pressure medicines are called the ACE inhibitors like lisinopril or Nalapril or angiotensin receptor blocker or called arb, like Valsartan or Losartan have neutral effect on sexual function. So please talk with your doctor first.
Before you do anything. And maybe your doctor can switch you.
Over to something like ACE inhibitors or an ARB if you're on the thiazide diuretic and the beta blocker. Okay. My husband's on atenolol at this point. So far it hasn't affected his function yet. He also has heart issue. That's why he is on the heart medication. To summarize that the highest blood pressure medicine that contribute to ED are the thiazod diuretic and then followed by beta blockers. Less involved are the calcium channel blockers, the ACE inhibitors and angiotensin receptor blockers. Please talk with your doctor about your blood pressure medicine if you feel that it's affecting your erection.
And maybe consider a conversation with your.
Doctor about switching to medication that affect erectile function the least. So having said that, just know the new guidelines about the new high blood pressure.
If you're over 120, over 80, then you have high blood pressure, so the.
Guidelines are now lower.
So how do you really treat high blood pressure?
Exercise? Yes. In my last episode I talked about how exercise alone is the one intervention.
You can do to treat ed. But if you exercise, it will also.
Lower your blood pressure as well.
So you don't even have to take.
The blood pressure medicine.
If you exercise, you lose weight, so.
You don't need to take the blood pressure medicine.
You may even have reduced your blood sugars. You may not even need to take.
Your diabetic medication at as well. Okay. So exercise is key, followed by eating a Mediterranean diet, which is recommended by the American Heart association for Heart Health as well as diabetes prevention as well. So Having said that, I hope you.
Find this episode useful and look at your medication and just know that you do not have to suffer with ED in silence.
You do not have to suffer with.
ED on your own.
And check out our Modern man crib.
Here which is the URL ED no more to check out the penis pump which is a device that you can use to treat ED along with exercise and along with Mediterranean diet. Check out the link to the Mediterranean diet here. I want to provide you with all the information and the tools that you need to to beat ed. Most people do not know what to do, so I am here as a resource and my mission is to create a sexual revolution to make sexual health information accessible and to simplify a complex issue to something that you can do at home to start treating your ed. At this point, ED is treatable and it is reversible to just know that you can do that.
All right?
So having said that, check out the Modern man crib@ednomore.com and just know you do not have to suffer in silence. Modern Man. So I will see you in the next episode and make sure you press that subscribe button and notification button to be alert when our next episode will come out. I'll see you in the next episode. Okay, Modern man, you are not alone and you don't have to suffer anymore. ED can feel isolating, frustrating and even defeating. The endless guessing, the quiet shame, the weight of not feeling like yourself. It's exhausting. But here's the truth. You are not broken. You are not alone. And you don't have to figure this out alone anymore. The Get Wood Now Boost program is your step by step path to to sexual confidence and restoration. No more suffering in silence. No more trial and error. Just real solution, real result and the confidence you deserve. It's time to take back your power on your term. Let's get this journey started together. Check out the course@getwoodnow.com I'll see you there.
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