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Suggest Treatment For Side Effects Of Hydrochlorothiazide

Posted on Mon, 9 Jan 2017

Question: I was prescribed hydroclorothiazide 25 mg by my doctor. One of the side effects was erectile dysfunction and low sperm production and low testosterone production. I have stopped taking the medication and the erectile dysfunction problem has improved, but I still have low production of sperm and I think that my testosterone levels are still low. Is there a way to reverse this condition?

Answered by Dr. Mirjeta Guni (48 minutes later)

Brief Answer:
About hydrochlorthiazide and low testosterone.

Detailed Answer:
Hello,
Thank you for asking on HCM!
About 1% of patients who use hydrochlorthiazide as an antihypertensive drug has reported symptoms of low testosterone.
In all cases the symptoms occured after 6-12 months of treatment.
Except of stopping treatment i would recommend to checkt the testosterone level, if it still persists low i would recommend to start treatment with testosterone ( of course is there are no contraindications).
Hope the information will help.
Kind regards,
Dr.Mirjeta

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Mirjeta Guni (2 hours later)

Hi. I have stopped taking the hydrochlorothiazide and, as stated in the previous message, I've seen some improvement. I also started taking testosterone shots. I've taken two shots at 3 month intervals. The shots were taken however during the time when I was taking the HCTZ and I think that it may have affected the treatment. Also, the HCTZ did not help to control my blood pressure very much. I'm thinking that I need to consult an endocrinologist to get the full picture. I was on the HCTZ for more than a year at 25 mg.

Answered by Dr. Mirjeta Guni (10 hours later)

Brief Answer:
Check the testosterone level.

Detailed Answer:
Welcome back!
I would recommend to check the testosterone level (Total testosterone and SHBG).
If it still persists low you need to continue the treatment.
Stopping the injections when the testosterone level is low, will cause relapse of the symptoms.
Of course a detailed clinical examination and some blood test (horomonal and biochemical) are needed to try to find the cause of low testosterone level.
Since the improvement of the symptoms is under treatment, is difficult to ''blame'' HCTZ at the moment.

Best wishes,
Dr.Mirjeta

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Mirjeta Guni (41 minutes later)

Thank you for your response. One clarification. The improvement only occurred after the doctor reduced the dosage of the HCTZ from 25 mg to 10 mg. So, I think that the reason that the testosterone shots did not work was (1) because I was still on HCTZ, and (2) I received the shots once every 3 months. Now that I'm off of HCTZ all together perhaps the shots will work, and perhaps if they are given closer than every 3 months. But, what ever the case, I think the HCTZ was the cause of the erectile disfunction, as well as some other side effects.

Answered by Dr. Mirjeta Guni (8 hours later)

Brief Answer:
About low testosterone.

Detailed Answer:
Your perception may be right, but is difficult to say for sure HCZT is the cause.
The follow up in dynamic of the symptoms and testosterone level will reveal if it was from the HCZT.
The testosterone shots should be taken at least monthly.
Will be a pleasure to answer further questions in the future.
Wish you good health.
Best wishes.
Dr.Mirjeta

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Above answer was peer-reviewed by : Dr. Prasad