Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 6/16/2021
Erectile dysfunction, or ED, is one of the most common sexual performance issues for men, affecting approximately 30 million men in the United States alone.
Many cases of erectile dysfunction are caused by physical or mental health issues. However, it’s also possible for ED to develop as a side effect of certain medications, including medications for cardiovascular health issues, like Lisinopril.
Lisinopril is a medication that’s used to treat high blood pressure. It’s also prescribed for people who’ve suffered from a heart attack and also as a treatment for cardiovascular health issues like congestive heart failure.
Although some lisinopril users report experiencing erectile dysfunction during treatment, studies tend to show that ED isn’t a common side effect of this medication.
But how does lisinopril work? And should lisinopril users be worried about a potential link between this medication and ED?
Lisinopril is a medication used to treat hypertension, or high blood pressure. It belongs to a class of medications called angiotensin-converting enzyme (ACE) inhibitors and is sold under a variety of brand names, including Zestril® and Prinivil®.
As an ACE inhibitor, lisinopril works by reducing the amount of certain types of vasoconstrictive hormones in your body.
These hormones constrict your blood vessels and may increase blood pressure, putting extra stress on your organs and blood vessels.
By relaxing your blood vessels, medications like lisinopril can reduce blood pressure and make it easier for blood to flow throughout your body.
Your healthcare provider might prescribe you lisinopril if you’ve been diagnosed with high blood pressure, a common condition that can affect men of all ages and backgrounds.
Other situations in which you may be prescribed lisinopril include during recovery from a heart attack or if you have been diagnosed with heart failure.
In certain cases, lisinopril and related medications are also used to treat kidney issues such as renal impairment.
Lisinopril is available as a tablet and as a liquid solution. It’s typically prescribed for use once a day.
If you’re prescribed this medication, it’s important to closely follow the dosage instructions provided by your healthcare provider.
Erectile dysfunction, or ED, is a common sexual performance issue that can occur in men of all ages.
While getting an erection might seem simple, there’s a complex behind-the-scenes process that goes on in your body to help you get and stay hard when you’re sexually aroused.
Erections start with stimulation, either physical, mental or both. When you are sexually aroused, signals from your nervous system cause blood to flow to your penis, filling a pair of sponge-like areas of tissue called the corpora cavernosa.
As blood flows into this tissue, your penis becomes firmer and larger, allowing you to have sex with your partner.
If you have erectile dysfunction, you might be able to get an erection sometimes, but not every time you want to have sex.
Sometimes, you might be able to get an erection, but find it difficult or impossible to maintain it during sex.
If your erectile dysfunction is especially severe, you may find it impossible to get an erection at all, even when you feel sexually aroused.
A variety of factors may cause you to experience ED. Some of these are physical health issues, such as atherosclerosis (plaque buildup in your arteries), heart and blood vessel disease and/or high blood pressure.
These physical conditions can affect blood flow throughout your body and reduce the amount of blood that’s able to flow into your penis before and during sex.
In some cases, psychological issues can contribute to ED. For example, issues such as anxiety, depression or fear of sexual failure may affect your level of sexual arousal and make it harder to get and maintain an erection.
Finally, certain medications, including some medications used to treat high blood pressure, may cause ED as a side effect.
Like other medications, lisinopril can potentially cause side effects. According to FDA data, the most common side effects of lisinopril include headache, dizziness, cough, hyperkalemia (high potassium levels), hypotension (low blood pressure) and syncope (passing out).
Some of these side effects may be more common if you’re prescribed lisinopril for heart failure or during recovery after a heart attack.
Erectile dysfunction and other sexual performance issues are not listed as common side effects of lisinopril.
However, some research has found that lisinopril may temporarily cause sexual side effects during the first few months of treatment.
For example, a study published in the American Journal of Hypertension compared the effects of lisinopril and the beta-blocker atenolol on sexual function in a group of men with high blood pressure aged 40 to 49.
The researchers found that both drugs seemed to reduce sexual activity in the short term, but that the men who used lisinopril returned to their normal levels of sexual activity over the long term.
In total, 17 percent of the men prescribed atenolol experienced sexual dysfunction symptoms, compared to just three percent of the men prescribed lisinopril.
In short, you may experience ED or other sexual issues when you first start using lisinopril, but research suggests that this isn’t a long-term issue.
In general, angiotensin-converting enzyme (ACE) inhibitors — the class of medications to which lisinopril belongs — are among the cardiovascular medications least likely to cause ED.
Hypertension, or high blood pressure, is a common cause of erectile dysfunction. In one study performed on men in the country of Qatar, researchers found that 58.3 percent of hypertensive men reported experiencing erectile dysfunction.
Other research has found that incidence of erectile dysfunction is closely related to high blood pressure.
Although the link between lisinopril and erectile dysfunction is mild, other medications for high blood pressure can cause ED.
For example, many thiazide diuretics and sympathetic blocking agents are known to cause erectile dysfunction as a side effect.
Several other ACE inhibitors are commonly prescribed to treat high blood pressure and other heart health issues.
These include benazepril (Lotensin®), enalapril (Vasotec®), candesartan (Atacand®), fosinopril (Monopril®) and others.
In general, erectile dysfunction is rarely a side effect of ACE inhibitors. Other medications for high blood pressure, including alpha-blockers and angiotensin-receptor blockers (ARBs), also rarely contribute to ED.
Currently, the most effective treatments for erectile dysfunction are PDE5 inhibitor medications, such as sildenafil (the active ingredient in Viagra®), tadalafil (Cialis®), vardenafil (Levitra®) and avanafil (Stendra®).
These medications work by increasing the rate of blood flow to the erectile tissue of your penis, making it easier to get and maintain an erection when you’re sexually aroused.
Because PDE5 inhibitors and anti-hypertensive medications both improve blood flow and lower blood pressure, there’s a risk of interactions when ED medications are used with some common medications for high blood pressure.
For example, many medications for ED can interact with organic nitrates and nitrites, as well as alpha-blockers used to treat high blood pressure and/or heart failure.
Our guide to Viagra and nitrates provides more information on these interactions and their often severe health risks.
Research suggests that ACE inhibitors such as lisinopril, on the other hand, do not increase the risk of side effects with ED medications such as sildenafil.
If you currently use lisinopril or other medication to control your blood pressure, it’s important to inform your healthcare provider about this before using any ED medications.
If you’re prescribed lisinopril or similar medication to treat high blood pressure, there are several things that you can do to improve your erections and sexual health naturally:
Keep active. Exercise has been shown to improve ED symptoms in men with a reduced level of blood flow. Research also shows that exercise reduces blood pressure, even in the short term. Try to keep yourself active, even if you just go on a brief daily walk. Even a small amount of exercise can have a positive impact on your health and sexual performance.
Eat a healthy, balanced diet. A 2010 study published in the Journal of Sexual Medicine noted that the Mediterranean diet, which is rich in fruit, vegetables, nuts, fish and whole grains, may help to improve ED symptoms. Interestingly, other research has found that this type of diet may have a favorable impact on the risk of hypertension.
If you smoke, try to quit. Smoking not only raises your blood pressure — it also affects blood flow throughout your body and, according to one study published in the Journal of Sexual Medicine, reduces physiological sexual arousal. Our guide to quitting smoking shares techniques that you can use to deal with cravings and give up smoking for good.
Other habits and lifestyle changes, such as improving your sleep habits only drinking alcohol in moderation, may also help to improve your erections and sexual health.
We’ve covered these in our guide to naturally protecting your erection.
Although some medications used to treat high blood pressure can cause ED, most data shows that lisinopril doesn’t cause any long-term sexual performance issues.
If you’re prescribed lisinopril and find it hard to get or maintain an erection, making changes to your lifestyle and using ED medication may help to improve your sexual function and allow you to enjoy a fulfilling, satisfying sex life.
To avoid interactions, it’s important to inform your healthcare provider about all medications you currently take before using sildenafil or similar medications to treat ED.