Re: Diuretics less likely to cause sexual disfunction than HCTZ?
Truth
> Are there diuretics which are effective in treating hypertension,
> but which are materially less likely to cause sexual problems in men
> than hydrochlorothiazide? Possibilities might include:
>
> Indapamide (Lozol) which is an indoline - not exactly a true
> thiazide.
>
> Furosemide (Lasix) which is a loop diruetic
>
> Triamterene (Dyrenium) which is a potassium-sparing diuretic
>
> Others?
>
> Thanks
Hydrochlorothiazide (HCTZ) is not typically known for causing sexual
side effects for men. If you are on this medication and having sexual
concerns, it may be due to causes other than the HCTZ.
Andrew B. Chung, MD/PhD
>
> Are there diuretics which are effective in treating hypertension,
> but which are materially less likely to cause sexual problems in men
> than hydrochlorothiazide?
Yes.
> Possibilities might include:
>
> Indapamide (Lozol) which is an indoline - not exactly a true
> thiazide.
>
> Furosemide (Lasix) which is a loop diruetic
Other loop diuretics would include torsemide and bumetanide.
> Triamterene (Dyrenium) which is a potassium-sparing diuretic
Not very effective for blood pressure lowering by itself.
> Others?
Spironolactone.
However, this and all the others listed above have the potential for
causing erectile dysfunction (ED) when there is peripheral arterial
insufficiency. For this reason, your physician(s) should be informed
about the ED.
> Thanks
Laus Deo :-)
May you and other dear neighbors, friends, and brethren have a
blessedly wonderful 2008th year since the birth of our LORD Jesus
Christ as our Messiah, the Son of Man ...
... by being hungrier:
http://groups.google.com/group/sci.med.cardiology/msg/f891e617d10bd689?
Hunger is wonderful ! ! !
It's how we know the answer to the question "What does Jesus
want?" (WDJW):
http://groups.google.com/group/sci.med.cardiology/msg/f43db72a7c5c1da0?
Yes, hunger is our knowledge of good versus evil that Adam and Eve
paid for with their and our immortal lives:
http://groups.google.com/group/sci.med.cardiology/msg/52a3db8576495806?
"Blessed are you who hunger NOW...
... for you will be satisfied." -- LORD Jesus Christ (Luke 6:21)
Amen.
Here is a Spirit-guided exegesis of Luke 6:21 given in hopes of
promoting much greater understanding:
http://groups.google.com/group/sci.med.cardiology/msg/cc2aa8f8a4d41360?
Be hungrier, which is truly healthier:
http://groups.google.com/group/sci.med.cardiology/msg/991d4e30704307e7?
Marana tha
Prayerfully in the awesome name of our Messiah, LORD Jesus Christ,
Andrew <><
--
"... no one can say 'Jesus is LORD' except by the Holy Spirit." (1 Cor
12:3)
http://groups.google.com/group/sci.med.cardiology/msg/188fd2ec63b3ba63?
Truth
wrote:
You are wrong, Chung. As usual you are out of touch with medicine.
HCTZ does not cause erectile dysfunction.
Of note: Chung is a mentally ill, socially inept failure of a man who
is not Board Certified in Internal Medicine, has no actual practice or
patient contacts (thank God) and was fired with cause in less than 3
months after starting his first and only post cardiology fellowship
job in Ocala, Fla in 2001. Do not trust anything he says without
verifying it with reliable, third party sources.
Peabody
> However, this and all the others listed above have the
> potential for causing erectile dysfunction (ED) when
> there is peripheral arterial insufficiency. For this
> reason, your physician(s) should be informed about the
> ED.
My doctor knows, and agreed to going off HCTZ to see if the
ED was affected. And indeed, the ED went away completely
within a few weeks.
But of course, the other thing that went up was my BP. So
now we're faced with coming up with a replacement which
doesn't have sexual side effects, at least for me.
Unfortunately, ACEIs and ARBs have virtually no effect on my
BP, so it's either add a second CCB (maybe norvasc) to the
diltiazem I already take, or find a replacement diuretic
that doesn't cause ED. Or both. For the time being, I've
ruled out beta blockers, centrally acting meds, and other
with more grizly side effects.
Peabody
> Hydrochlorothiazide (HCTZ) is not typically known for
> causing sexual side effects for men. If you are on this
> medication and having sexual concerns, it may be due to
> causes other than the HCTZ.
Well, my doctor says it is known for that, and a whole
bunch of Googled sites agree with him. Also, my own
experience has been than the problem came with the HCTZ, and
went away when I stopped taking it.
Andrew B. Chung, MD/PhD
There is always the option of increasing your endogenous ghrelin
(known to lower both heart rate and blood pressure) by eating less,
down to the right amount:
http://groups.google.com/group/sci.med.cardiology/msg/3558812d72ab4e17?
In our collective clinical experience, this works for all hypertensive
men experiencing ED.
May you and other dear friends, brethren, and neighbors have a
Truth
Peabody, instead of this anecdotal "it happened to me" claim, please
cite any reliable, published, third party sources that state that HCTZ
causes sexual dysfunction.
Peabody
> Have you been tested for primary aldosteronism? I
> may've asked before, but I forget. I believe this may
> be a standing test, like renin, 30 minutes upright prior
> to and during the blood draw.
Yes, a while back I insisted on being tested for a list of
possible secondary HTN causes, and the tests included both
renin and aldosterone. Everything was normal.
Andrew B. Chung, MD/PhD
> satan masquerading as truth via a sockpuppet despairingly posted:
Suggested reading about the sockpuppets that post here in these usenet
newsgroups:
http://groups.google.com/group/sci.med.cardiology/msg/3238bedb3f52c95f?
Peabody
> Peabody, instead of this anecdotal "it happened to me"
> claim, please cite any reliable, published, third party
> sources that state that HCTZ causes sexual dysfunction.
Here are the links I saved when I was researching this subject:
http://www.nlm.nih.gov/medlineplus/ency/article/004024.htm
http://www.ncbi.nlm.nih.gov/pubmed/1746997
http://www.webmd.com/erectile-dysfunction/guide/drugs-linked-erectile-dysf
unction
http://drugs.about.com/od/medicationabcs/a/ED_and_Drugs.htm
http://health.nytimes.com/health/guides/disease/hypertension/classes-of-me
dications.html
http://www.drugstore.com/qxa1531_333181_sespider_blood_pressure_medicines_
cause_impotence.htm/
http://www.pharmj.com/editorial/19990529/education/sexualdysfunction.html
from that last one:
"The incidence of sexual dysfunction in men taking diuretics is between
two and six times higher than in men taking placebo. Thiazides may cause
reduced libido, erectile dysfunction and problems with ejaculation."
Andrew B. Chung, MD/PhD
> satan masquerading as the truth via a sockpuppet despairingly posted:
Many thanks, much praise, and all the glory to GOD for His compelling
you rebuke satan as he continues in his delusion that he is a
physician.
Suggested reading for those who are following this thread of written
discussion:
http://groups.google.com/group/sci.med.cardiology/msg/0ad49f78d54cdd4e?
http://groups.google.com/group/sci.med.cardiology/msg/e67c88795850fed4?
http://groups.google.com/group/sci.med.cardiology/msg/5de1532f7c7bc717?
Truth
> Truth says...
>
> > Peabody, instead of this anecdotal "it happened to me"
> > claim, please cite any reliable, published, third party
> > sources that state that HCTZ causes sexual dysfunction.
>
> Here are the links I saved when I was researching this subject:
>
> http://www.nlm.nih.gov/medlineplus/ency/article/004024.htm
>
> http://www.ncbi.nlm.nih.gov/pubmed/1746997
>
> unction
>
> http://drugs.about.com/od/medicationabcs/a/ED_and_Drugs.htm
>
> http://health.nytimes.com/health/guides/disease/hypertension/classes-...
> dications.html
>
> http://www.drugstore.com/qxa1531_333181_sespider_blood_pressure_medic...
> cause_impotence.htm/
>
> http://www.pharmj.com/editorial/19990529/education/sexualdysfunction....
>
> from that last one:
>
> "The incidence of sexual dysfunction in men taking diuretics is between
> two and six times higher than in men taking placebo. Thiazides may cause
> reduced libido, erectile dysfunction and problems with ejaculation."
OK. I stand corrected. My online source, UptoDate
http://www.uptodate.com/online/content/topic.do?topicKey=drug_a_k/124238&selectedTitle=1~129&source=search_result
didn't mention it as a significant side effect and I haven't had
patients bring it up to me as a perceived side effect of the
medication, but I do see that it is certainly a reported association.
Andrew B. Chung, MD/PhD
>
> > http://groups.google.com/group/sci.med.cardiology/msg/6e01386d85dcd1f1?
> >
>
> OK. I stand corrected.
Actually you stand eternally condemned and rebuked:
http://groups.google.com/group/sci.med.cardiology/msg/298d4d9131be066d?
<><
May dear neighbors, friends, and brethren have a blessedly wonderful
Peabody
> OK. I stand corrected. My online source, UptoDate
> didn't mention it as a significant side effect and I
> haven't had patients bring it up to me as a perceived
> side effect of the medication, but I do see that it is
> certainly a reported association.
[trying to stay clear of the religious wars]
No problem. But I come back to my original question. While
sexual dysfunction is listed as a side effect for Lozol
(impadamide) I found a couple statements that it was
significantly less likely to cause such problems than HCTZ.
Lozol is a thiazide-like diuretic, but not strictly a
thiazide. Then there's Lasix, the loop diuretic, which
apparently has no sexual side effects at all. Any thoughts
about using one of these instead of HCTZ?
Truth
In order to make a comment about what medications you should consider,
I'd need to know specific details about your medical history and other
medications taken. That is probably best left to your own physicians.
Andrew B. Chung, MD/PhD
>
> No problem. But I come back to my original question. While
> sexual dysfunction is listed as a side effect for Lozol
> (impadamide) I found a couple statements that it was
> significantly less likely to cause such problems than HCTZ.
> Lozol is a thiazide-like diuretic, but not strictly a
> thiazide. Then there's Lasix, the loop diuretic, which
> apparently has no sexual side effects at all. Any thoughts
> about using one of these instead of HCTZ?
It is likely that they too will cause ED in your case.
If you were my patient, would help you raise your endogenous ghrelin
to help you control your blood pressure without causing ED:
http://groups.google.com/group/sci.med.cardiology/msg/3558812d72ab4e17?