In reviewing current pharmacological literature and clinical observations, I have noted some ambiguity regarding the association between losartan, an angiotensin receptor blocker (ARB), and the onset of erectile dysfunction (ED). While ARBs are generally considered to have a favorable profile concerning sexual function, some reports suggest that adverse effects, including ED, may occur in a subset of patients.
Considering the multifactorial etiology of ED—which involves vascular, neurological, hormonal, and psychological factors—the question arises: Is there a direct pharmacodynamic mechanism by which losartan could contribute to ED, or might observed cases be primarily attributable to confounding comorbidities often present in hypertensive populations? Furthermore, how do we reconcile the vasodilatory action of losartan, which theoretically should enhance erectile performance, with instances where ED symptoms are reported?
I would appreciate insights and references to recent controlled studies or meta-analyses that examine the incidence of ED in patients prescribed losartan compared to those on other antihypertensive agents. Additional discussion on potential dose-dependent effects and the impact of long-term usage on sexual function, as well as clinical management strategies for patients reporting these side effects, would also be valuable.
