Debowale*, a 28-year-old Nigerian entrepreneur, was diagnosed with hypertension (AKA high blood pressure) in late 2022. He witnessed a sharp decline in his erection after he was placed on anti-hypertensive medication and isn’t as enthusiastic about sex anymore.

“I always had this mad anxiety whenever I had to check my blood pressure. The doctors would wave it off as white-coat syndrome. But after I turned 28, I knew I had to take my health seriously because I started hearing about young people slumping and dying. On a routine hospital visit, I insisted on seeing a senior doctor. He noticed a spike in my blood pressure reading. I made like three more appointments within two weeks, and that was when I was diagnosed. The week I started taking an anti-hypertensive drug, I noticed I couldn’t always get a strong erection anymore. I got worried and mentioned it to my doctor. He said it’s one of the side effects of anti-hypertensive drugs. We’re trying to find one with less side effects, but I don’t look forward to sex like I used to; I’m finding more pleasure in foreplay these days.”

Zikoko caught up with Dr Solomon Ofeimun, a medical professional, and he had some answers for men like Debowale who are fighting silent battles.

“I Lost My Rock-Hard Erection” — Navigating Sex as a Man Living With Hypertension

Are men at a higher risk of hypertension?

Medical statistics show there’s a balance between men and women now. Back in the day, more men were involved in physical activities and providing for their families. Now, all genders go through the same level of stress, but men still tend to get diagnosed later. Pregnancy, menstruation, and other factors that only affect women often drive them to the hospital where doctors can detect irregularities quickly. Many men don’t make hospital trips until sickness takes some form of physical manifestation.

Hypertension wasn’t common among younger folks before 2021. What’s happening?

A rise in pre-employment medical screening is helping us diagnose the condition in a lot of young folks. The trend of diagnoses is most common among youths in urban areas. Those in rural areas aren’t subjected to tests like these, and therefore, don’t get early diagnoses.

As a guy, what happens to your sexual life after diagnosis?

It depends on the stage. There’s the pre-hypertensive stage, hypertensive stage and hypertensive crisis. If anyone has a blood pressure reading of 140/100 or 140/90, with medication, you can still have a pretty regular sexual life. Sex is just like any cardiovascular activity — jogging, walking, etc. It’s good for the heart.

Some people take sexual activities too far, while others don’t get enough of it. I think having daily sex puts too much stress on yourself. But will you say exercising daily is stressing yourself? Moderation is key. If you have sex at an average of ten minutes daily, there should be no worry, compared to someone going for more than one hour.

So how can men who’ve been diagnosed enjoy sex?

Just make sure you take your medications as prescribed and report to your doctor if you notice any side effects. It’s also important for such men to see a licensed cardiologist and not just general practitioners. You can still have orgasms every day if that’s what you want. Just make sure you don’t push your limits. Whatever you need to do to orgasm with your partner within five to ten minutes is fine. When you start aiming for multiple orgasms or trying to impress by going at it for long, then you’ll be stressing your heart.

Anti-hypertensive drugs affect erection in some men. Is it advisable to take sexual enhancement drugs too?

Diagnosed with high blood pressure or not, you shouldn’t take sexual boosters anyhow. As a man, you should consult your urologist first. It’s important to also discuss your sexual worries with a sex therapist. Sometimes, mental or emotional stress can affect your sexual life, in which case, you need to see a psychologist. Sexual boosters should only be taken when prescribed.

But are there anti-hypertensive drugs that don’t interfere with a man’s erection?

Yes, we have some with less side effects. Just discuss your concerns with your cardiologist, and they’ll know what suits your situation best. They know how to modify medications, and sometimes, prescribe a singular tablet that combines everything you need.

Are the rumours about watermelon, tiger nuts and bitter kola true? Do they really help your sex life?

One of the things that helps with a strong erection is sustained blood circulation to the muscles of the penis. That’s what makes it turgid. The fruits you mentioned are good anti-oxidants; they cleanse your body system for proper blood circulation. It’s not just about having stronger erections; it’s about cleansing the system. And of course, once your system is better, your penis will benefit from it.

Can the sexual side effects of these drugs be reversed once you stop the medication?

Reducing the dosage or frequency of usage will not automatically take you to where you’re coming from. As long as your blood pressure is within the normal range, you should be fine. Remember, a lot of factors affect sexual motivation and pleasure, other than blood circulation or hypertension.

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