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High blood pressure and sex: Overcome the challenges
Treatment for high blood pressure and satisfaction with sex can go hand in hand — if you're open about the problem and work closely with your doctor.
By Mayo Clinic staffHigh blood pressure often has no signs or symptoms. But the impact on your sex life may be obvious. Although sexual activity is unlikely to pose an immediate threat to your health — such as a heart attack — high blood pressure can affect your overall satisfaction with sex.
A link between high blood pressure and sexual problems is — so far — only proved in men. For women who have decreased sexual satisfaction, it's not yet proved that high blood pressure is to blame, although researchers are investigating if there's a link.
Challenges for men
Over time, high blood pressure damages the lining of your blood vessels and causes your arteries to harden and narrow (atherosclerosis), limiting blood flow. This means less blood is able to flow to your penis. For some men, the decreased blood flow makes it difficult to achieve and maintain erections — often referred to as erectile dysfunction. The problem is fairly common, especially among men who are not treating their high blood pressure.
Even a single episode of erectile dysfunction can cause anxiety. Fears that it will happen again might lead you to avoid sex — and affect your relationship with your sexual partner.
High blood pressure can also interfere with ejaculation and reduce sexual desire. Sometimes the medications used to treat high blood pressure have similar effects.
Challenges for women
High blood pressure's effect on sexual problems in women hasn't been well researched, but it's possible that high blood pressure could affect a woman's sex life.
High blood pressure can reduce blood flow to your vagina. For some women, this leads to a decrease in sexual desire or arousal, vaginal dryness or difficulty achieving orgasm. Improving arousal and lubrication can help. Like men, women can experience anxiety and relationship issues due to sexual dysfunction. Talk to your doctor if you're experiencing these difficulties.
High blood pressure medication side effects in men: Sexual problems
High blood pressure medications that can cause sexual dysfunction as a side effect include:
- Diuretics (water pills). Diuretics can decrease forceful blood flow to the penis, making it difficult to achieve an erection. They can also deplete your body of zinc, which is necessary to make the sex hormone testosterone.
- Beta blockers. These medications can affect your nervous system reaction that causes an erection. Beta blockers can also make it difficult for the arteries in the penis to widen to let in enough blood flow to cause an erection.
To reduce the risk of side effects from these medications, including sexual problems, take your medication exactly as prescribed.
If that doesn't help, ask your doctor about other options. Some high blood pressure medications are less likely to cause sexual side effects, such as:
- Angiotensin-converting enzyme (ACE) inhibitors
- Calcium channel blockers
- Angiotensin II receptor blockers
- Alpha blockers
To help your doctor select the most appropriate medication for you, list all the other medications you're taking now — including herbal supplements and over-the-counter drugs. Sometimes a particular combination of medications contributes to sexual problems.
If your doctor says it's OK, you may be able to stop taking blood pressure medication temporarily to see if your sex life improves. To make sure your blood pressure remains within a safe range, you may need frequent blood pressure readings while you're not taking the blood pressure lowering medication that may be causing your sexual difficulties. Sometimes this can be done with a home blood pressure monitoring device.
If you're considering medication for erectile dysfunction, check with your doctor first. It's usually safe to combine the erectile dysfunction drugs sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis) with high blood pressure medications. But taking these drugs with nitrates for chest pain can cause a dangerous drop in blood pressure.
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