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Answers to questions about blood pressure drugs and ED, earwax, and rosacea.

Q Can my blood pressure medication be the cause of my erectile problems?

A If you have high blood pressure, you're already more likely to suffer erectile dysfunction (ED), even without taking medications. Adding to the problem is that several medications for hypertension can cause ED as a side effect. Among the more common culprits are diuretics (especially thiazides, such as chlorthalidone and hydrochlorothiazide) and beta blockers (atenolol, metoprolol, and propranolol are examples). Conversely, blood pressure medications known as calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors, and angiotensin receptor blockers (ARBs) are less likely to cause ED.

Review your treatment options with your doctor. A different medication might control your blood pressure without affecting sexual function. Also, by improving your health and optimizing risk factors for hypertension, such as your weight, salt intake, alcohol, and fitness, you might not need as much medication.

Keep in mind that several classes of drugs besides blood pressure medications can contribute to ED. Review all your medications with your physician, and ask if any of them could be contributing to your problem.

Q I'm having trouble with earwax. What can I do about it?

A Earwax is important for maintaining ear health by blocking dirt, dust, and other foreign material from reaching the eardrum. Normally, old earwax is pushed into the ear opening, where you can remove it easily when you shower or bathe. Sometimes, though, this removal process doesn't work, resulting in an accumulation of earwax in the ear canal.

You might use a cotton swab or other implement to remove the earwax, but in doing so you can push the earwax farther into the ear and risk injuring your eardrum and ear canal. In fact, impacted earwax is a common cause of hearing loss, often due to attempts to clean the ear with a cotton swab.

So, don't insert anything into your ear. Rather, wash the outer ear with a cloth, and try using over-the-counter ear drops or placing a few drops of hydrogen peroxide or baby oil into the ear and letting it drain. Ask your doctor about irrigation, using saline to flush excess wax from your ear. If necessary, an ear, nose, and throat specialist can manually remove the earwax.

Q What is rosacea, and how is it managed?

A Rosacea is a chronic inflammatory condition of the face, occurring most commonly after midlife and in fair-complexioned people of Irish, Scottish, or English descent.

Although it develops as much as three times more commonly in women, rosacea may produce more severe symptoms in men. A survey by the National Rosacea Society found that men with rosacea were more than twice as likely as their female counterparts to develop rhinophyma, an enlargement of the nose that gives it a bulbous appearance.

Signs of rosacea include facial redness, bumps and pimples, eye irritation and swelling, burning or stinging skin, swelling/thickening of the skin, and the appearance of tiny blood vessels. Symptoms also can develop in the neck, chest, scalp, or ears.

The exact cause of rosacea is unknown, but several factors may trigger flare-ups: sun or wind exposure, extreme heat or cold, exertion, emotional stress, and consumption of hot beverages, alcohol, or spicy foods. There is no cure for rosacea, but avoiding the factors that cause flare-ups may help. Rosacea is classified into several subtypes, based on the symptoms that develop, and treatment options may vary for each subtype. Consult a dermatologist to determine which treatment is right for you.


Richard S. Lang,

M.D., M.P.H., EA.C.P.

Vice Chairman,

Cleveland Clinic

Wellness Institute
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Title Annotation:ASK DR. LANG
Author:Lang, Richard S.
Publication:Men's Health Advisor
Date:Jan 1, 2018
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