An estimated 103 million Americans have high blood pressure, which is about half the adult population of the United States. Research shows that men are more likely to develop high blood pressure than women, especially men who are younger than 50. Many men are taking antihypertensive drugs to help control their hypertension, but how many know that blood pressure medications affect sex drive?
Numerous studies have been done showing that use of blood pressure medications can contribute to or cause erectile dysfunction. In fact, it is one of the more common and also disturbing side effects of these medications for men who are taking them.
But another side effect not often mentioned is the impact of blood pressure medications on a man’s libido as well as his ability to achieve orgasm. Therefore, blood pressure medications can deliver a double whammy to a man’s sex life.
Which blood pressure medications affect sex drive?
The two classes of blood pressure drugs that are most associated with sexual side effects are diuretics (water pills) and beta-blockers. Diuretics are usually the first antihypertensive medications a doctor prescribes. These can include thiazide diuretics (e.g., chlorthalidone, chlorothiazide, hydrochlorothiazide, indapamide) and potassium-sparing diuretics (e.g., amiloride, bumetanide, furosemide, spironolactone, triamterene).
In many instances, doctors prescribe two diuretics, so men have to deal with two medications that can put a damper on their libido. Another option is to take a diuretic along with a beta-blocker. Acebutolol, atenolol, bisoprolol, metaprolol, nadolol, nebivolol, and propranolol are in the beta-blocker class.
When used in a combination treatment, diuretics have fewer side effects. For example, taking a beta-blocker along with a diuretic should reduce the adverse effects of the latter drug. When talking about loss of sex drive, however, both of these drug classes are associated with this side effect.
Other drug classes that are prescribed to treat high blood pressure are ACE inhibitors (benazepril, captopril, enalapril, fosinopril, lisinopril, perindopril, ramipril, trandolapril), angiotensin-receptor blockers (azilsartan, candesartan, irbesartan,losartan, olmesartan, telmisartan, valsartan), and calcium-channel blockers (amlodipine, diltiazem, felodipine, isradipine, nicardipine, nifedipine, verapamil). Sexual side effects are less likely to occur with these drugs.
How to deal with loss of sex drive from medication
If you are experiencing a lack of libido and you are taking blood pressure medication, you first should determine whether the loss of sex drive could be related to your drug use. If your lower sex drive is new but you have been taking blood pressure medications for a long time, then the drug are likely not the cause of your lackluster libido.
If, however, you recently started taking other medication, that could be a factor. Another reason for a flagging sex drive may be a time factor; that is, the presence of hypertension over time increases the risk of plaque accumulation, which slows blood flow in the penis and can interfere with sex drive and erectile function.
If your sex drive began to decline soon after you started taking your high blood pressure medication, then you should ask your doctor if your dose can be adjusted or if you can stop the drug temporarily to see if your symptoms change.
Sometimes sex drive can be affected by stress over a new medical situation (such as newly diagnosed hypertension).
If your doctor does allow you to stop your meds for a while, you should check your blood pressure frequently at home using a home monitoring device to ensure your pressure does not become elevated.
This is also an excellent opportunity to talk to your doctor about adopting lifestyle changes in diet, exercise, stress management, sleep, and alcohol use as a way to lower your blood pressure without the need for medications. Men who take back control of their health in this way also have a good chance of regaining their sexual desire as well.
Men also should discuss their concerns about a decline or loss of sex drive with their partner. Sometimes frank conversation can alleviate some of the anxiety about the situation and help revive the libido.
American Heart Association News. More than 100 million Americans have high blood pressure, says AHA. 2018 Jan 31
Weiss RJ. Effects of antihypertensive agents on sexual function. American Family Physician 1991 Dec; 44(6): 2075-82