When Good Drugs Lead to Bad Sex
Lost That Lovin' Feeling? It Could Be Your Medicine.
Lowering pressure continued...
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.
For instance, he says, ACE inhibitors, shown in some studies to
be less likely to cause sexual problems, are also more expensive.
Not all of the studies paint a bleak picture of the old standby
drugs, however. For instance, a study published in the same issue of
American Journal of Medicine that carried Rudd's editorial found no
difference in sexual function between 312 men and women randomly placed on
either the beta-blocker Inderal or an inactive placebo drug.
It's difficult to predict who will and won't notice an effect
on sexual functioning after beginning blood pressure-lowering drugs, Rudd says.
But one study published in the May 1999 issue of Pharmacotherapy found
that nearly every first-line antihypertensive treatment (which includes
diuretics and beta-blockers) has been reported to cause some degree of erectile
dysfunction. But sexual problems can also increase with age and as other
diseases set in, so it's even more difficult to pinpoint exactly what percent
of problems can be blamed on the drugs.
A physician should mention the possibility of side effects when
prescribing a blood pressure-lowering drug, Rudd says, but encourage a patient
to try it before dismissing it because of potential effects. "The only way
to be sure," he tells patients, "is to take a trial of it."
If sex life is affected, doctors can consider many options:
reduce the dose, switch to another drug, or suggest lifestyle modifications
such as exercise, which could help lower blood pressure and reduce the need for