Expert: Stephen W. Leslie, MD - 9/11/2005

Question
I have been on Coversyl for several years .I have noticed a decline in the ability to maintain an errection in this time frame. I wondered if the nature of coversyl, acting as it does to relax blood vessels could be a factor ? Maybe age(74), tried cialis ,very little improvment.My testosterone level was noted as being on the low side of normal. Would I be likely to benefit from additional testosterone supplement or would this be not recommended since I do have BHP.PSA normal for age.

Answer
Coversyl is a long acting ACE inhibitor type of medication used for lowering blood pressure.  It is not known to cause erection difficulty directly although just the fact that it lowers blood pressure can affect erection function.  Coversyl does not directly cause blood vessel relaxation.  If it did, then that would increase erection ability because that's what Cialis, Viagra and similar medications do.

At age 74 I would be reluctant to suggest testosterone replacement.  I would first try Viagra and/or Levitra.  About 50% of the time, one of these agents will work even when Cialis has failed.  Make sure you have tried it correctly, waiting the appropriate amount of time are not on any contraindicated meds.

A short trial on testosterone supplementation can be reasonably attempted to see if that improves the results.  My experience in your age group has not shown it to be terribly effective but that doesn't mean it isn't worth trying.

You should discuss other alternatives with a urologist experienced in ED.  Intracavernosal injections, external vacuum pumps and MUSE therapies are still available to you even if other medications don't work.