Blood pressure tablets and ED

[s0whatsnew?]

The problem with modern medical practice is that each link in the chain prioritises covering their own arse rather than the arse of the patient.

 I'm aged 73 and just beginning to interact routinely with the NHS.  Prostate probs, been self-medicating for years with brazil nuts but now need something stronger.  My GP immediately booked me in with UCH for a bladder cystoscopy, ct scan, blood tests galore, all completely unnneccessarily  IM HUMBLE opinion (before anyone jumps down my throat!)  All of those procedures had nothing to do with my fairly low-level complaint of pee probs.  F'rinstance, the bladder cys..opy checks for bladder cancer despite my having no symptoms of that whatsoever.  The ct scan checks for kidney stones.   But i had no relevant complaints of that !!!    

At UCH, a detailed questionnaire convinced them that a cysto..opy was unneccessary.  CT scan revealed complete normality.  But the urology dept couldn't bear to give up on me and referred me on to the phlebology dept...which has now lost me on their computer !!        Aaagh!  All I want is some concentrated lecithin for my prostate, goddammit !

In the same way that a WG review can only be that specific punter's experience, the value of which is up to the reader to decide, so also any of our medical experiences  are cumulatively valuable intel when taken with a pinch of salt..or iodine..or potassium.. or something.   

[daviemac]

The problem with modern medical practice is that each link in the chain prioritises covering their own arse rather than the arse of the patient.

 I'm aged 73 and just beginning to interact routinely with the NHS.  Prostate probs, been self-medicating for years with brazil nuts but now need something stronger.  My GP immediately booked me in with UCH for a bladder cystoscopy, ct scan, blood tests galore, all completely unnneccessarily  IM HUMBLE opinion (before anyone jumps down my throat!)  All of those procedures had nothing to do with my fairly low-level complaint of pee probs.  F'rinstance, the bladder cys..opy checks for bladder cancer despite my having no symptoms of that whatsoever.  The ct scan checks for kidney stones.   But i had no relevant complaints of that !!!    

At UCH, a detailed questionnaire convinced them that a cysto..opy was unneccessary.  CT scan revealed complete normality.  But the urology dept couldn't bear to give up on me and referred me on to the phlebology dept...which has now lost me on their computer !!        Aaagh!  All I want is some concentrated lecithin for my prostate, goddammit !

In the same way that a WG review can only be that specific punter's experience, the value of which is up to the reader to decide, so also any of our medical experiences  are cumulatively valuable intel when taken with a pinch of salt..or iodine..or potassium.. or something.   

I have to ask, why bother going to the doctors if you don't want them to give you a thorough check to rule out possible causes. You say yourself that your self medicating is not working yet you don't want the prescribed medication designed to alleviate the symptoms of prostate trouble.

I think they should be praised for making sure all possible causes are ruled out and not criticised for doing their job. 

Go to Holland and Barret.

External Link/Members Only[V&S]%20-%20Standard%20Shopping&utm_term=4583657831672409&utm_content=Vitamins%20&%20Supplements%20-%20Supplements&gclid=93bc0c8ebe751f962f636d21a2554e9f&gclsrc=3p.ds

[Doc Holliday]

The problem with modern medical practice is that each link in the chain prioritises covering their own arse rather than the arse of the patient.

 I'm aged 73 and just beginning to interact routinely with the NHS.  Prostate probs, been self-medicating for years with brazil nuts but now need something stronger.  My GP immediately booked me in with UCH for a bladder cystoscopy, ct scan, blood tests galore, all completely unnneccessarily  IM HUMBLE opinion (before anyone jumps down my throat!)  All of those procedures had nothing to do with my fairly low-level complaint of pee probs.  F'rinstance, the bladder cys..opy checks for bladder cancer despite my having no symptoms of that whatsoever.  The ct scan checks for kidney stones.   But i had no relevant complaints of that !!!    

At UCH, a detailed questionnaire convinced them that a cysto..opy was unneccessary.  CT scan revealed complete normality.  But the urology dept couldn't bear to give up on me and referred me on to the phlebology dept...which has now lost me on their computer !!        Aaagh!  All I want is some concentrated lecithin for my prostate, goddammit !

In the same way that a WG review can only be that specific punter's experience, the value of which is up to the reader to decide, so also any of our medical experiences  are cumulatively valuable intel when taken with a pinch of salt..or iodine..or potassium.. or something.   

I understand the points you are making and there is a degree of arse covering for the healthcare professionals (though not prioritised) but differential diagnosis is not always straight forward and you do get caught out if you cut corners. Symptoms are useful indicators which point you in the right direction of investigation, but symptoms vary, may be red herrings or often absent, hence the need for full screening programs.

Misdiagnosis and subsequent incorrect treatment happens and there are consequences for the patient (who may die) the medics (who may lose their career) and the NHS which pays out billions in compensation which it can ill afford. 

Having said all that and specific to your case. I assume that physical examination has confirmed an enlarged prostate and that PSA tests are normal?

[catweazle]

I was diagnosed with hypertension between Christmas and New year 1999. Until then I had been  a regular blood donor - had clocked up 68 donations,  and was aiming for the magic 75.

Anyway, at the blood donor session my BP was sky-high.  Went to my GP , whose comment was " with that reading, I'm surprised it's not squirting out of your ears!".

The next few years were experimentally  trying different combinations of meds to control the BP.  Finally settled on Felodopine and Enalapril together. 

In the intervening years , the BP readings have always been what they should be. The meds have never really had any effect on my sexual performance,  although in about the last 7 years or so, I have needed a little chemical  assistance.  Spoke with my GP, who said that quite possibly the BP meds may be causing  ED, and he was happy to prescribe sildenafil. Another few experimental months of different strengths,  and for over 5 years now, I have carried on with my BP meds and my over the counter sildenafil with no problems.

[PunterNumber69]

I'd advise always checking with your doctor. BP and your heart are important, so take the time to seek proper medical advice.

[Doc Holliday]

I was diagnosed with hypertension between Christmas and New year 1999. Until then I had been  a regular blood donor - had clocked up 68 donations,  and was aiming for the magic 75.

Anyway, at the blood donor session my BP was sky-high.  Went to my GP , whose comment was " with that reading, I'm surprised it's not squirting out of your ears!".

The next few years were experimentally  trying different combinations of meds to control the BP.  Finally settled on Felodopine and Enalapril together. 

In the intervening years , the BP readings have always been what they should be. The meds have never really had any effect on my sexual performance,  although in about the last 7 years or so, I have needed a little chemical  assistance.  Spoke with my GP, who said that quite possibly the BP meds may be causing  ED, and he was happy to prescribe sildenafil. Another few experimental months of different strengths,  and for over 5 years now, I have carried on with my BP meds and my over the counter sildenafil with no problems.

 

[s0whatsnew?]

I have to ask, why bother going to the doctors if you don't want them to give you a thorough check to rule out possible causes. You say yourself that your self medicating is not working yet you don't want the prescribed medication designed to alleviate the symptoms of prostate trouble.

I think they should be praised for making sure all possible causes are ruled out and not criticised for doing their job. 

Go to Holland and Barret.

External Link/Members Only[V&S]%20-%20Standard%20Shopping&utm_term=4583657831672409&utm_content=Vitamins%20&%20Supplements%20-%20Supplements&gclid=93bc0c8ebe751f962f636d21a2554e9f&

gclsrc=3p.ds

But the prescribed medication for the alleviation of the symptoms of prostrate probs is precisely what i DO want and what I asked for.  And to date am still not getting.  H & B, here I come.

[s0whatsnew?]

I understand the points you are making and there is a degree of arse covering for the healthcare professionals (though not prioritised) but differential diagnosis is not always straight forward and you do get caught out if you cut corners. Symptoms are useful indicators which point you in the right direction of investigation, but symptoms vary, may be red herrings or often absent, hence the need for full screening programs.

Misdiagnosis and subsequent incorrect treatment happens and there are consequences for the patient (who may die) the medics (who may lose their career) and the NHS which pays out billions in compensation which it can ill afford. 

Having said all that and specific to your case. I assume that physical examination has confirmed an enlarged prostate and that PSA tests are normal?

Yes, all normal.   I take your points.  To an extent I'm just having a rant against the paternalism of the system which doesn't allow a patient any agency in their  diagnosis or treatment.   

[daviemac]

But the prescribed medication for the alleviation of the symptoms of prostrate probs is precisely what i DO want and what I asked for.  And to date am still not getting.  H & B, here I come.

Am I missing something here you said, quote "All I want is some concentrated lecithin for my prostate, goddammit !" which is a supplement and available without prescription.

I was prescribed Alpha blockers, Tamsulosin in my case and not available over the counter.   

[Henry767]

Am I missing something here you said, quote "All I want is some concentrated lecithin for my prostate, goddammit !" which is a supplement and available without prescription.

I was prescribed Alpha blockers, Tamsulosin in my case and not available over the counter.   

I was prescribed Tamsulosin for an enlarged prostate ( have been through 2 X cystoscopy, rejected offers of having a hole burnt through my urethra to scoop away prostate tissue..) but didn't get on with it, had some leakage, firm but not full erections. And the retrograde ejaculation spoiled the experience for me. It was the nurse, not the consultant. Who suggested that self- cstheterising 3 or 4 times a day. Between natural urinstion, might be s drug free solution. Been doing it for 5+ years now, sleep uninterrupted.

Only after a good come do I naturally piss like a horse. I have asked my GP for a prescription for s nurse practitioner. Preferably Filipino. But so far its not been forthcoming...

[Marmalade]

Addendum...,
Having tests and consulting with cardiac specialist to determine reasons for pre syncope.

Possibly bradycardia..,very slow pulse rate,  occasionally 41/42 BPM (been like that for years). May need pacemaker.
Possibly drop in BP, combination of hot weather, dehydration, and mixing candesartan and sildenafil.

Until results of further tests are known, his advice is don't take the candesartan on the day if you're taking sildenafil.

Good luck with that. Your contributions are valuable so beter look after yourself! 

[daviemac]

Addendum...,
Having tests and consulting with cardiac specialist to determine reasons for pre syncope.

Possibly bradycardia..,very slow pulse rate,  occasionally 41/42 BPM (been like that for years). May need pacemaker.
Possibly drop in BP, combination of hot weather, dehydration, and mixing candesartan and sildenafil.

Until results of further tests are known, his advice is don't take the candesartan on the day if you're taking sildenafil.

Having a pacemaker fitted is nothing to worry about, it's quite a simple operation done under local anaesthetic and once there you don't even notice it.

[Doc Holliday]

Possibly bradycardia..,very slow pulse rate,  occasionally 41/42 BPM (been like that for years). May need pacemaker.

Only just seen that update due to Marmalade quoting you.

Given that we know you are not a highly trained 25 year old athlete, then that is of concern. No wonder you had symptoms.

Hope all goes well.

[Doc Holliday]

Having a pacemaker fitted is nothing to worry about, it's quite a simple operation done under local anaesthetic and once there you don't even notice it.

Indeed. Although if you have had the Covid vaccine you should avoid straying too close to a 5G mast.

[Thephoenix]

Only just seen that update due to Marmalade quoting you.

Given that we know you are not a highly trained 25 year old athlete, then that is of concern. No wonder you had symptoms.

Hope all goes well.

Funny thing is I've had a resting pulse rate below 50 for years.
Had various monitors years ago which indicated bradycardia but no action recommended.
It's only because a young gp who I had a phone consultation with recently seemed concerned and asked me to attend surgery asap for ECG, and not to drive.
ECG was 46 bpm, which again is not unusual for me, but she was concerned enough to consider sending me into hospital to get 'paced'.

I'm having to do further tests i.e treadmill and 7 day monitor.

I'm not too bothered about the pacemaker if I need one.

I was surprised to learn recently that an operational firefighter I know had one.

I suppose I'm a bit concerned if it will affect my punting, which these days mainly consists of fbsm.
I'd hate to think it might start smoking as I'm straining for the climax.

As someone posted earlier, I think these discussions can be useful, as it is a community of mainly friendly folk, and it's not a subject I could really discuss with other family or friends.

[Watts.E.Dunn]

Indeed. Although if you have had the Covid vaccine you should avoid straying too close to a 5G mast.

Yes we have a local "Doris" councillor who rants about them but theres not one anywhere around our way a thats switched on or built even!....

[Thephoenix]

Just an update on why it's vital that everyone consults doctors when mixing ED medication and BP meds, particularly if you're older and possibly have vascular or cardiac conditions.
We're all different and react differently.

Despite all that sensible advice, sometimes it takes a serious reaction to really bring it home.

Following a recent consultation with cardiologist regarding slow pulse and occasional lightheadedness, he wrote to my GP suggesting I discontinue candesartan and review 5 mths( BP meds).....bit of a surprise because prior to them being prescribed I had uncontrolled hypertension.

Ok, so GP advised me to take care and monitor my BP, and review 3 wks
Two days later my my BP reading was 190/85 during the night so started candersartan again in the early hours

That same day I'd prearranged a punt with an old regular, so took 2 x50m Viagra

Later on in the day I took 2 BP readings.
One was 80/48 and one 69/44.
Don't know how I'm still hear. :unknown

The moral of the story...
Combining BP meds and Ed meds can have serious consequences with some people, and personally I won't be taking any ED meds.
Always consult with your GP and consultants, but don't be afraid to question their advice.
Take your health seriously particularly if you have a family.

[Collingwood]

There's been debate about whether this is appropriate for the forum but I think it is. My own experience may help some and might save a life. About 5 years ago aged 63 I had increasing BP but was reluctant to take BP meds because of myths/rumors about them affecting performance. Result was a Cardiac Arrest (lucky to survive) 2 stents and a slow recovery. So point 1 is check your BP regularly and don't ignore increases. Point 2, following on from that I've been on Bisoprolol with few noticeable side effects and my GP also prescribes low dose 25 mg Viagra. The result is reliable normal erections for normal purposes with no side effects  and no problems with "unloading". Have occasionally doubled the dose but not noticed much difference.  However I get my FS FoC from a long term FWB and have no need or interest in SPs other than for massages - hence no FSSP reviews on here from me, but popping one before spending time with my FWB or the lovely masseuses at River Kwai in Gloucester definitely helps with reliability. Hope this has been useful

[GingerNuts]

There's been debate about whether this is appropriate for the forum but I think it is. My own experience may help some and might save a life. About 5 years ago aged 63 I had increasing BP but was reluctant to take BP meds because of myths/rumors about them affecting performance. Result was a Cardiac Arrest (lucky to survive) 2 stents and a slow recovery. So point 1 is check your BP regularly and don't ignore increases. Point 2, following on from that I've been on Bisoprolol with few noticeable side effects and my GP also prescribes low dose 25 mg Viagra. The result is reliable normal erections for normal purposes with no side effects  and no problems with "unloading". Have occasionally doubled the dose but not noticed much difference.  However I get my FS FoC from a long term FWB and have no need or interest in SPs other than for massages - hence no FSSP reviews on here from me, but popping one before spending time with my FWB or the lovely masseuses at River Kwai in Gloucester definitely helps with reliability. Hope this has been useful

You can review massages, legitimate or otherwise. The forum even has a specific massage review section.

[daviemac]

There's been debate about whether this is appropriate for the forum but I think it is. My own experience may help some and might save a life. About 5 years ago aged 63 I had increasing BP but was reluctant to take BP meds because of myths/rumors about them affecting performance. Result was a Cardiac Arrest (lucky to survive) 2 stents and a slow recovery. So point 1 is check your BP regularly and don't ignore increases. Point 2, following on from that I've been on Bisoprolol with few noticeable side effects and my GP also prescribes low dose 25 mg Viagra. The result is reliable normal erections for normal purposes with no side effects  and no problems with "unloading". Have occasionally doubled the dose but not noticed much difference.  However I get my FS FoC from a long term FWB and have no need or interest in SPs other than for massages - hence no FSSP reviews on here from me, but popping one before spending time with my FWB or the lovely masseuses at River Kwai in Gloucester definitely helps with reliability. Hope this has been useful

As has been said there is nothing stopping you from posting reviews about massages in the relevant massage section.

The only thing is you have to abide by the rules and post one review for one service provider and not combine multiple visits to see different SPs in one review.

[Collingwood]

Fair point. Understood. Apologies.

[PatMacGroin]

Most of my life I'd hear the comment, "thats a bit high" following a BP test. At some point a while back a GP decided it was something to be concerned about, so I've been prescribed Ramipril since then. Luckily, I haven't encountered any ED issues as a result, although that doesn't mean they won't creep up on me later.

I'm posting to this thread because I think it's a worth while, punting related discussion to have.

I read the Ramipril leaflet when I started taking it, to check any side effects etc. But it has now become so routine that I haven't considered if any side effects could occur later, at some point down the road. Think I might have a read of that leaflet again with the next box I open.

I've been lucky enough not to need much medical intervention throughout my life so far. But in my experience there is never any harm in trying to educate yourself as you encounter new things in life. As long as you aren't trying to lecture the Dr, I believe they appreciate having a conversation with someone that has made an effort to understand what is going on. And sometimes the input of us as patients can actually help them with their diagnosis.

One medication that I have been taking regularly for years only came to my attention because of a chance conversation with a friend. I had been suffering from skin problems for years. Tried all sorts of treatments and been to all sorts of specialists, to no avail. The friend commented they had the same issues and were taking a medication I hadn't heard of. Turns out it wasn't included in a list of treatments recommended by the NHS at the time, although it was available on prescription. It did the trick, and has been since, and I wouldn't have been able to ask my GP about it without that chance conversation.

Obviously, it's a bad idea to self medicate. And always check with a professional before popping some pill. But open convesations with a sensible attitude can't hurt.

[Marmalade]

Most of my life I'd hear the comment, "thats a bit high" following a BP test. At some point a while back a GP decided it was something to be concerned about, so I've been prescribed Ramipril since then. Luckily, I haven't encountered any ED issues as a result, although that doesn't mean they won't creep up on me later.

I'm posting to this thread because I think it's a worth while, punting related discussion to have.

I read the Ramipril leaflet when I started taking it, to check any side effects etc. But it has now become so routine that I haven't considered if any side effects could occur later, at some point down the road. Think I might have a read of that leaflet again with the next box I open.

I've been lucky enough not to need much medical intervention throughout my life so far. But in my experience there is never any harm in trying to educate yourself as you encounter new things in life. As long as you aren't trying to lecture the Dr, I believe they appreciate having a conversation with someone that has made an effort to understand what is going on. And sometimes the input of us as patients can actually help them with their diagnosis.

One medication that I have been taking regularly for years only came to my attention because of a chance conversation with a friend. I had been suffering from skin problems for years. Tried all sorts of treatments and been to all sorts of specialists, to no avail. The friend commented they had the same issues and were taking a medication I hadn't heard of. Turns out it wasn't included in a list of treatments recommended by the NHS at the time, although it was available on prescription. It did the trick, and has been since, and I wouldn't have been able to ask my GP about it without that chance conversation.

Obviously, it's a bad idea to self medicate. And always check with a professional before popping some pill. But open convesations with a sensible attitude can't hurt.

I think this is a very good point.

You get to hear views, experiences, and sometimes it can empower someone to ask their GP the right question.

GPs generally are rather busy. They may be responsible for more than 1,000 patients each and that’s just in normal times. For instance if a person has been on a med for years and had no complaints the doc may just carry on signing a repeat prescription, even if a better one has been developed meantime or if the patients condition might suggest a lower dose would be acceptable.

Gastrointestinal meds are a classic example. People would be on cimetidine then get upgraded to ranitidine, then there was a hooha over that one and you maybe got famotidine. Then you heard a mate got lansoprazole for the same thing or maybe esomeprazole, newer drugs but the GP never got round to changing them. 

Cimetidine I think boosted the effect of sildenafil (viagra) but those were the days.

Another one is anti-depressants. Anti-depressants IMO are head-fucks. Ok in an emergency but the stats show GPs carry on prescribing them for long periods instead of weaning people off them. Same to a lesser degree with sleeping tablets. Helpful aids, but best to use them as little as possible IMO.

With blood pressure drugs, there’s a massive variety, they all work differently; and also with statins. So if for any reason you find they don’t suit you, ask what might be available instead.

One thing though… not just viagra, but we often have threads talking about supplements. If you’re on various meds it’s always a good idea to check if there is any interaction (it might not be noticeable). You can do a basic check just with the internet then raise it with your GP if there’s any warning signs (some interactions are harmless). The big elephant in the room is St John’s Wort — which has so many possible interactions I’m surprised they’re allowed to sell it.

These are all basic things you can check on the internet. You don’t have to ‘believe’ me or anyone else on a forum; but seeing stuff in discussion may put you in good stead when you have that ten minute appointment!

[Thephoenix]

Most of my life I'd hear the comment, "thats a bit high" following a BP test. At some point a while back a GP decided it was something to be concerned about, so I've been prescribed Ramipril since then. Luckily, I haven't encountered any ED issues as a result, although that doesn't mean they won't creep up on me later.

I'm posting to this thread because I think it's a worth while, punting related discussion to have.

I read the Ramipril leaflet when I started taking it, to check any side effects etc. But it has now become so routine that I haven't considered if any side effects could occur later, at some point down the road. Think I might have a read of that leaflet again with the next box I open.


I've been lucky enough not to need much medical intervention throughout my life so far. But in my experience there is never any harm in trying to educate yourself as you encounter new things in life. As long as you aren't trying to lecture the Dr, I believe they appreciate having a conversation with someone that has made an effort to understand what is going on. And sometimes the input of us as patients can actually help them with their diagnosis.

One medication that I have been taking regularly for years only came to my attention because of a chance conversation with a friend. I had been suffering from skin problems for years. Tried all sorts of treatments and been to all sorts of specialists, to no avail. The friend commented they had the same issues and were taking a medication I hadn't heard of. Turns out it wasn't included in a list of treatments recommended by the NHS at the time, although it was available on prescription. It did the trick, and has been since, and I wouldn't have been able to ask my GP about it without that chance conversation.

Obviously, it's a bad idea to self medicate. And always check with a professional before popping some pill. But open convesations with a sensible attitude can't hurt.

Completely agree.
In civvy life we may often discuss with friends and family the merits and side effects of various treatments.

In conditions such as fibromyalgia which over the years has been poorly understood and resulted in the formation of Fibromyalgia Action UK which is a great resource.
Similarly The Alzheimer's Association has been a great asset to sufferers and carers.

I've found that doctors (more so younger ones), don't feel as threatened or defensive when patients have a good understanding of their ailments and treatment options. In fact over the years consultations have tended to become more of a discussion and treatment plan..... that's apart from some of the older consultants who can still be aloof and up themselves.
If they can see you're intelligent and understand your condition they treat you with respect
Not long ago a young surgeon performed a common reflux operation on me wich resulted in some worrying, temporary adverse effects.
He actually admitted to me later he was worried because it was his first time performing the surgery.
Maybe it's an age thing when they're about the same age as your grandchildren.

Since the advent of group practices and the availability of accessing your medical records, it's become even more obvious that doctors sometimes make mistakes and disagree with each other.
Reputable internet sites and discussions with fellow sufferers can be of benefit.

UKP gives us a platform to discuss ailments and treatments relating to punting which for various reasons we're not able to discuss within our civvy circles.

That obviously goes with the proviso that mods will always emphasise the need to seek professional opinion from gp's etc.

[Doc Holliday]

Three excellent posts in succession, some of which I wholeheartedly agree with and other parts I would contest, but will leave it at that as will take it way off topic.

[Doc Holliday]

 

The big elephant in the room is St John’s Wort — which has so many possible interactions I’m surprised they’re allowed to sell it.

Indeed. I recall a Pharmacist saying to me years ago (jokingly) that there is only one thing worse than prescribing for someone who is taking St John's Wort and that is the patient who swallows it with grapefruit juice!

External Link/Members Only

[catweazle]

The comments about checking BP are interesting. At Christmas, I was given a smartwatch.  One of its various  functions is a BP check.   I have no idea  how accurate it is, although the heartrate checker seems pretty much correct.   In any event with my 22 year history  of hypertension I get regular  checks from the gp.

[thelizard]

Just got off the phone to GP, not my normal male one but a very posh female, not on blood tablets but am on others, asked for Sildenafil as I lost the repeat slip, no problem, done over the phone.

It just feels safer to get it through the GP, who knows your medical history, rather than over the counter or online and taking chances with other meds. They do not bite and are there to serve, asking the question can do no harm.

you are paying your gp's wages, the NHS pays them but they get all thier money from the government, the government has no money, they get it all from the taxpayer, never be worried about hassling GP's.

[DastardlyDick]

Perhaps best off in 'Off topic'

I am on Ramipril for high blood pressure and have definitely got worse in the erection area. Taking a Blue Pill also now causes quite a bad headache.

Interesting - I'm also on Ramipril, yet my GP was perfectly happy to prescribe Viagra for me. I realise everyone's different, but no headaches for me.