A television producer that I had treated for a urinary infection came to see me. The minute I walked into the examining room, I could tell from his facial expression that he had not come to see me only about the infection. Whatever was on his mind was serious, and not something he found easy to talk about. When he finally said, “Doctor, I cannot get hard anymore,” I was shocked. He had a reputation as a Casanova of note. He took great pride in his penis power.

When I took his medical history in preparation for a complete examination, I stumbled upon the cause of his problem. Since I had last seen him, he had been diagnosed with high blood pressure. The good news was that the hypertension itself was not affecting his penis power. The bad news, however, was that the prescription medication he was taking to control it was having an effect on his penis power.

A number of therapeutic drugs can cause erection or ejaculation problems. Unfortunately, very few rigorous scientific studies have been performed on the subject, so most of what we know about penis weakness that is associated with the use of common medicines is anecdotal or reported by manufacturers as possible side effects.

When I suspect that a drug might be responsible for a patient’s problem, I do an informal test. This test consists of reducing the dosage or eliminating the drug entirely to see if the patient’s penis power is restored. This is done with the cooperation of the primary physician and with all possible safeguards observed. In the case of the television producer, it was not long after we safely lowered the dosage of his antihypertensive medicine before he was back to his old tricks.

Blood pressure medications are not the only culprits, although they are probably the most common. If you were to peruse the Physician’s Desk Reference (the bible of drug side effects), you would see that sexual dysfunction is listed as a potential side effect of virtually every antihypertensive agent.

These medications work in different ways to lower blood pressure, so their effects on the penis also vary. If you are taking medication for high blood pressure and suspect that it may be adversely affecting your penis power, then you should consult your physician. You might be able to switch to a class of drugs whose ingredients will not keep you from being a superpotent man.

Other drugs that can diminish penis power include some medications used to increase the output of urine. These drugs are known as diuretics. In addition, certain medications used to treat anxiety, depression, and other psychiatric disturbances can cause diminished libido, retarded ejaculation, or erection problems. Various ulcer medications can also cause impotency in some patients because they disrupt the production of testosterone.

I must caution anyone taking prescription medications not to arbitrarily give them up or alter their dosages. If you suspect that a prescription drug is negatively affecting your penis power, be sure to consult with your physician before doing anything on your own.

Reducing a dosage or stopping the use of a particular medication can cause an extremely complicated and potentially life-threatening situation. Even a well-trained physician is not always able to tell with certainty whether a specific medication is causing the problem. Many forces might be contributing to your inability to get an erection, not just the medication. Most patients who take such drugs (i.e., hypertension medication) are of advanced age, may suffer from more than one illness, may take a variety of medications, and may have other habits that could be adversely affecting their penis power.

More important are the underlying effects of the disease itself. High blood pressure alone can weaken penis power. Approximately 10 percent of patients who require antihypertensive drugs have significant penis weakness before starting treatment.

Similarly, depression triggered by the illness itself can also cause sexual dysfunction. How can we be certain whether it is the disease, the drug, the psychological effects of the sickness, or a combination of all of the above? The sexual side effects of the drugs have to be weighed against the consequences of the diseases themselves.

In some cases, switching medications or adjusting the dosage is an easy solution. However, when that is not possible, it might be wiser to live with diminished penis power than to risk aggravating a serious medical condition by disrupting its treatment.

Such decisions require delicate clinical judgment, which is why it is important to have a frank and thorough discussion with your physician and commit to a rigorous scrutiny of all possible options. The point to take away from this section is do not throw your prescription medications down the toilet in the quest for a firmer erection at the risk of a stroke, heart attack, or even death. Quite simply, “It ain’t worth it!”

Dudley S. Danoff, MD, FACS is the attending urologic surgeon and founder/president of the Cedars-Sinai Medical Center Tower Urology Group in Los Angeles, California. He is the author of Penis Power: The Ultimate Guide To Male Sexual Health (Del Monaco Press, 2011) and Superpotency (Warner Books).

Read discreetly with the Kindle™ edition of Penis Power™ now available for purchase from Amazon. The Nook Books™ edition from Barnes & Noble and the Sony eReader™ edition from Sony’s Reader Store. Available for under $7.00!