DEAR DR. DONOHUE: Why isn’t anyone talking about blood-pressure medicine causing erectile dysfunction? My stepfather refuses to take his medicine because he doesn’t want to “give up his sex life.” My husband takes nifedipine for “somewhat elevated blood pressure.” I can mark his erectile-dysfunction problems to the week he started taking this medicine. He smokes. If he stopped smoking, could he stop the medicine? – G.S.

ANSWER: Everyone – doctors and patients – talks about blood-pressure medicine and erectile dysfunction all the time. The problem isn’t limited to blood-pressure medicines or only to nifedipine. It happens with many other drugs. When a man complains of impotence, the first thing a doctor thinks of is medicines as the cause.

Your stepfather doesn’t have to give up sex to control his blood pressure. All he has to do is tell the doctor that he’s experiencing a problem with the medicine prescribed him. There are hundreds of blood-pressure medicines, and there is one – far more than one – that he can take that won’t cause him erectile dysfunction. It’s a matter of experimenting with different drugs. He should not ignore high blood pressure. That could have him giving up his life.

The same goes for your husband.

Smoking is not an option for your husband. Smoking can contribute to erectile dysfunction. It also contributes to the burden imposed on his heart and arteries by high blood pressure. Both smoking and high blood pressure can be deadly. Both high blood pressure and erectile dysfunction are treatable without side effects. Not smoking might bring his pressure down some. If his pressure remained low, stopping medicine could be considered. He’d have to do other things, like carefully watch his salt intake.

Readers who are interested in a longer discussion of high blood pressure – hypertension – can order the booklet on that subject by writing to: Dr. Donohue – No. 104, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: Several months ago I developed soreness in my neck, legs and arms. I thought it was due to Zocor, which I take for cholesterol. My doctor had me get a sed-rate blood test, and it came back very high. He diagnosed polymyalgia rheumatica and prescribed prednisone daily. My sed rate came down, but not to normal, so he increased the prednisone. Now I do not have any soreness. I feel great, but I’m afraid of prednisone. Is there another treatment for my condition? Are my worries unfounded? – E.H.

ANSWER: Polymyalgia rheumatica is something that happens mostly to people over 65. Twice as many women have it as men.

It’s muscle pain and stiffness, most often of the shoulder, neck, hip or thigh muscles, or all of them. In addition to the muscle symptoms, most patients are completely drained of energy. The cause is unknown.

Prednisone, one of the cortisone drugs, is the best drug to combat this illness. It usually can be given in low doses, and it usually brings a prompt response to all symptoms. It appears that this is what has happened to you. Once there is a response, the dose of prednisone can be lowered, and that lessens any untoward side effects. Treatment, however, can be prolonged – taking years.

Your worries are not unfounded. However, the low dose of prednisone used for this illness is usually well-tolerated, and side effects are few. Side effects of prednisone include osteoporosis, skin-thinning and easy bruising.

If the doctor has to keep a patient on high doses of prednisone, combining it with methotrexate can allow for a reduction in the prednisone dose.

DEAR DR. DONOHUE: When someone breaks a hip, what actually breaks? – J.S.

ANSWER: The thigh bone – the femur – looks like an upside-down hockey stick, with the blade of the stick having a ball at its tip. The ball fits into a depression in the pelvic bone. That is the hip joint. “Hip” refers to the joint and adjacent bone and tissue.

A hip fracture, therefore, is a break in the top part of the femur. More than 350,000 such breaks occur yearly in North America.



Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.