Dear Doctor, I am 36 and was diagnosed with high blood pressure recently. For the last few months, my manhood has not been active. Could this be related to the disease? Matthew Dear Matthew, You have not specified the nature of the problem. Is it lack of libido, failure of erection or premature ejaculation? Sexual activity depends on the nerve and blood supply of genital parts. Any impairment of any one or both of it can cause impotence. Long standing high blood pressure can affect blood supply of the penis and supporting structures thus resulting in sexual impotence. Drugs like beta blockers used to treat high blood pressure can cause impotence as a secondary adverse effect. Diabetes is the most common morbidity with hypertension and can cause impotence by affecting both the blood as well as nervous supply of reproductive parts. Alcohol can cause and aggravate high blood pressure and is also known to cause sexual impotence by disrupting the hormonal balance of the body. Tobacco is also implicated in causing high blood pressure and impotence. Mental stress is a known risk factor for causing high blood pressure and affecting potency as well as fertility. Porn movies and videos give an exaggerated version of sexual potency and manhood. At times, there may not be any problem, but a person may have unrealistic expectations of how to “perform”. This, if not fulfilled, can lead to feelings of inadequacy. Every individual has a different. amount of libido and the duration of an erection varies from person to person and cannot be quantified as per the same standard. What is important is mutual satisfaction between 2 partners. This can be achieved by mutual love, understanding and adequate foreplay. Hypertension should be adequately controlled by dietary measures, regular exercise and drugs.