Brief Answer: Need to work on multiple causes of ed. Detailed Answer: Hello, Thanks for your query. I appreciate your efforts for medical consultation in so much distress. Important aspects of your query are: • 51 year old male • Known case of hypertension • Currently on antihypertensive medicines, hrt program and Lipitor. • Complaints of: recent onset ed even with ed medicines after starting lipitor. In treatment Erectile dysfunction (ED) first step is to identify cause of the problem. Erectile dysfunction can be a result of a psychological or physical problem. Psychological causes: These include performance anxiety, emotional weakness, inferiority complex, stress, marital or relationship problems and low mood. Men with psychological problem usually have normal nocturnal erections and erections upon awakening (like in your case), whereas men with physical problem often do not. Physical causes: Include neurological disorders, alcoholism, smoking, hormonal imbalances, diabetes, hypertension, derange lipid profile, blood vessel disease and chronic diseases. I hope you are not taking any alcohol or smoking as sometimes these can also cause erectile dysfunction. There are following medical risk factors for ed in your case: -Hypertension -Derange lipid profile: as you are on lipitor. -Hormonal imbalance. (If hrt mean hormone replacement therapy in your case) Considering above information following steps will be helpful in your case: -Quit smoking and alcohol (if you are taking any) -Eat a healthy diet rich in vitamins, minerals and antioxidants: fruits, milk and eggs -Exercise, particularly aerobic exercise (like: Jogging, skipping and cycling) daily. It will increase blood flow all over body including penis and will reduce stress. -Monitor and control medical risk factors (listed above). -Stop lipitor: Although lipitor is not associated with ed, but as your problem start after its use, I would like to prefer stop it in your case. You can request your physician some other hypolipidemic medicines. -Talk to a therapist/Psychiatrist: Make an appointment to rule out anxiety, stress and mild depression in your case. I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups. Wish you good health. Regards, http://bit.ly/Dr-Ashish-Mittal

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