When Good Drugs Lead to Bad Sex

Lost That Lovin' Feeling? It Could Be Your Medicine.

April 16, 2001 -- One in four American adults has high blood pressure, putting them at risk for heart attack and stroke. Nearly one in 10 suffers from a depressive illness. Luckily, an expanding array of prescription drugs is available to help treat and control both conditions.

The bad news? As these drugs lower blood pressure and lift mood, they can also mess up normal sexual functioning. So while a given medicine might restore physical and mental health, it can also spark erectile dysfunction, lack of interest in sex, and the potential destruction of a relationship.

The key, say doctors who have studied drugs for hypertension and depression, is to seek help from a physician who is up to date on what treatments are out there and who is willing to work to find the best ones for you . Together, you can choose one that will keep you as healthy as possible while doing the least damage -- or perhaps none at all -- to your sex life.

Lowering pressure

The search for what doctors call "high-yield, low-risk" treatment of high blood pressure has been going on for decades, writes Peter Rudd, MD, a professor of medicine and chief of the division of general internal medicine at Stanford (California) University Medical Center, in an editorial published in the April 1, 2000, issue of the American Journal of Medicine.

In recent years, the old standbys -- thiazide diuretics (such as HCTZ, Maxide) and the beta-blocker drugs (such as Lopressor) have been joined by a tongue-twisting litany of other drug classes. You will likely hear your doctor refer to other types of blood pressure-lowering drugs known as alpha-blockers (Regitine, Dibenzyline), calcium antagonists (Cardizem, Plendil), angiotensin-converting enzyme (ACE) inhibitors (Lotensin), angiotensin II receptor antagonists (Cozaar), and direct vasodilators (Minoxidil, Apresoline). Each works differently to lower pressure.

And despite that smorgasbord of drugs, Rudd tells WebMD, the truth is there is much yet to be learned about the effects of blood pressure-lowering drugs on sexual functioning.

And in women, that goes double, as the "data about female dysfunction is scant," he says.

Physicians do have a good idea of how some of the blood pressure-lowering drugs affect some sexual functioning. Beta-blockers, for instance, can reduce stimulation to the erection center.

Studies have yielded mixed results about which antihypertensive drugs to avoid if you want to keep some romance in your life. Several have shown, for instance that diuretics and beta-blockers are associated with more sexual side effects, according to Rudd.

Despite that, he says, the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure continues to recommend those drugs first.

"Those two drugs classes have been shown to reduce heart attack, stroke, and other major end points of high blood pressure," Rudd adds. But it can be a tradeoff.

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