Key takeaways:
Erectile dysfunction (ED) isn’t a common side effect of lisinopril. In fact, lisinopril can improve erectile dysfunction symptoms in people with high blood pressure.
Lisinopril (Zestril) is a first-choice medication used to treat high blood pressure, but there are other options, too.
If you develop ED symptoms when taking lisinopril, speak to your healthcare provider to rule out other possible causes.
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Erectile dysfunction (ED) and heart disease go hand in hand. Among men with high blood pressure, 35% will also experience ED. But medications can also cause ED. In fact, one-quarter of all ED cases are caused by medications.
Lisinopril (Zestril) is a medication commonly used to treat high blood pressure. You may be wondering how lisinopril may affect your body if you take it. The good news is that ED isn’t a common side effect of lisinopril in men — but there’s still a few things to consider.
How does lisinopril work?
Lisinopril belongs to a class of medications known as ACE (angiotensin-converting enzyme) inhibitors, which are used to treat high blood pressure and heart failure. This medication is typically one of the first-choice treatments for high blood pressure. Lisinopril works by widening blood vessels and increasing blood flow throughout the body.
When ED is caused by high blood pressure and stiff blood vessels (atherosclerosis), treatment with medications like lisinopril can actually increase blood flow to the penis and improve ED. That’s because getting and maintaining enough blood flow to the penis is a key step to getting and keeping an erection.
What are the reported side effects of lisinopril?
Like all medications, lisinopril does have some side effects to be aware of. The most common include:
Dry cough
Dizziness
Diarrhea
Headache
Fatigue
ED isn’t a common side effect of lisinopril. In most cases, it actually improves ED symptoms, which we’ll discuss in more detail later.
There are some rare instances when lisinopril may cause issues with male sexual function, but it’s usually temporary. A study looking at the sexual side effects of two blood pressure medications — lisinopril and atenolol — in men with no prior sexual dysfunction, found that when ED was experienced, it resolved in most people within the first month of treatment.
Does lisinopril affect testosterone?
Probably not in a significant way. Some researchers found lower levels of testosterone in people taking lisinopril, while others did not. There is no evidence to support that lisinopril increases the risk of ED or any other sexual health symptoms by lowering testosterone levels in men.
What about other ACE inhibitors?
Other ACE inhibitors, like benazepril, enalapril, and ramipril, don’t typically cause ED either. Like lisinopril, other ACE inhibitors work by widening blood vessels and increasing blood flow, so it’s more likely that using these medications will improve symptoms of ED if it’s caused by high blood pressure. Again, as with lisinopril, ED is not a common side effect for this class of medications.
What if you take lisinopril and have ED?
If you’ve recently started taking lisinopril and develop new (or worsening) ED symptoms, speak to your healthcare provider. They can help figure out what the underlying cause might be. There are several factors your provider may consider:
Timing: If you’ve recently started lisinopril, your provider may simply have you wait a few weeks to see if the symptoms pass.
Other medications: Medications like antihistamines, antidepressants, and beta-blockers, are common causes of ED. You should keep an updated list of your current medications for your provider to review.
Other health conditions: Diabetes, high blood pressure, and depression or anxiety can all contribute to ED symptoms. Your provider can determine if any of these health conditions may be a factor for you.
Quiz: Is It Erectile Dysfunction?
The bottom line
Lisinopril is a medication often used to treat high blood pressure. It does not commonly cause erectile dysfunction (ED). When ED is caused by high blood pressure, taking lisinopril to treat HBP can actually help to improve ED symptoms.
In the rare case that lisinopril may cause new ED, it usually settles within a month of starting treatment.
If things don’t settle, then it’s likely something else is going on. Maybe your blood pressure is still too high. Maybe another medication, health condition, or life stressor is at the root of it. It may take some detective work to figure it out and your healthcare provider can help with this.
Why trust our experts?
References
Almeida de Oliveira, A., et al. (2021). Hypertension and erectile dysfunction: Breaking down the challenges. American Journal of Hypertension.
Baumhäkel, M., et al. (2011). Cardiovascular risk, drugs and erectile function – a systematic analysis. International Journal of Clinical Practice.
Fogari, R., et al. (1998). Sexual function in hypertensive males treated with lisinopril or atenolol: A cross-over study. American Journal of Hypertension.
Jaffe, A., et al. (1996). Erectile dysfunction in hypertensive subjects. Assessment of potential determinants. Hypertension.
Koshida, H., et al. (1998). Lisinopril decreases plasma free testosterone in male hypertensive patient and increases sex hormone binding globulin in female hypertensive patients. Hypertension.
Olvera, E. L., et al. (2022). Lisinopril. StatPearls.
Smits, O. (2005). Long-term effect of inhibition of the angiotensin-converting enzyme (ACE) on cavernosal perfusion in men with atherosclerotic erectile dysfunction: A pilot study. The Journal of Sexual Medicine.
