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60 years old overweight. On BP medicine. Suffering from erectile dysfunction. Any advice?

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General & Family Physician
Practicing since : 2001
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i am a 60 yr old male that can not achieve an erection firm enough for intercourse. i have not smoked in over a year, do not drink or do any drugs and i am reasonably active as i have an industrial job. i am a little overweight, but not bad. i take 50 mg daily metoprolol plus hydrachlorathiazide for high blood pressure which is controlled. i am able to ejaculate with stimulation but no firm erection. i have tried levitra (prescription) and over the counter supplements; stamina r/x, libido-max, yohimbe, etc. and nothing has really worked. please give me some good advice.
Posted Sun, 28 Oct 2012 in Erectile Dysfunction
Answered by Dr. Michelle Gibson James 2 hours later
Hi, thanks for using health care magic

Penile erections involve the integration of processes in the hormonal, vascular(involving the blood vessels supplying the penis), nervous systems.Any problem with any of these systems can result in difficulty in obtaining an erection.
Erectile dysfunction can be associated with vascular conditions such as diabetes, hypertension, high cholesterol.Vascular issues are cause in about half of persons.
Other conditions associated with ED include neurological diseases (stroke, trauma), endocrine conditions (abnormal levels of thyroid hormone,low levels of testosterone), kidney or liver disease, psychological problems (depression, performance anxiety), medications (some antihypertensives, some cholesterol medication), enlarged prostate.

You may need blood tests, the tests needed will depend on the exact details of your medical history.Some blood tests that may be suggested by your doctor include: checking your testosterone levels, checking for diabetes, electrolyte levels,cholesterol, a urine analysis is also done.
There are also other procedures that may be used to assess penile function.

Men with Ed who, even with no symptoms of heart disease are assumed to have cardiac or vascular disease until proven otherwise because vascular disease is the most common cause.
Exercise and weight loss have been shown to improve sexual function.

If a lower dose of the medication does not work, your doctor may increase to a higher dose or change to another medication in the same family of drugs because persons may respond differently to different medications.
There are also other types of medications that can be used , though they are not as common- androgen and medications called vasodilators that improve blood flow to the penis.

You may want to consider visiting a urologist for a full assessment to determine the exact reason your symptoms are occuring

I hope this information helps you, feel free to ask any other questions
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