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 Staff
High 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 proved in men. For women who have decreased sexual satisfaction, it's not yet proved that high blood pressure is to blame.
Challenges for men
Over time, high blood pressure damages the lining of blood vessels and causes arteries to harden and narrow (atherosclerosis), limiting blood flow. This means less blood is able to flow to the 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.
High blood pressure can also interfere with ejaculation and reduce sexual desire. Sometimes the medications used to treat high blood pressure have similar effects.
Even a single episode of erectile dysfunction can cause anxiety. Fears that it will happen again might lead men to avoid sex — and affect the relationship with their sexual partner.
Men should discuss any concerns with their doctor.
Challenges for women
High blood pressure's effect on sexual problems in women isn't well-understood. But it's possible that high blood pressure could affect a woman's sex life.
High blood pressure can reduce blood flow to the 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. Women should talk to their doctor if they experience 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:
- Water pills (diuretics). Diuretics can decrease forceful blood flow to the penis, making it difficult to achieve an erection. They can also deplete the body of zinc, which is necessary to make the sex hormone testosterone.
- Beta blockers. These medications, especially older generation beta blockers such as propranolol (Inderal, Innopran XL), are commonly associated with sexual dysfunction.
To reduce the risk of side effects from these medications, including sexual problems, take medications exactly as prescribed. If you still have side effects, talk to your doctor about other possible medications that may have fewer side effects.
Medications less likely to cause sexual side effects
If sexual side effects persist, ask your doctor about other medication 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
To help your doctor select the most appropriate medication for you, tell him or her all the other medications you're taking now — including herbal supplements and over-the-counter drugs. Sometimes a particular combination of medications or supplements contributes to sexual problems.
If your doctor says it's OK, you may be able to stop taking blood pressure medications 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. This can be done with a home blood pressure monitoring device for convenience.
Nov. 11, 2015
- Sex and high blood pressure. American Heart Association. http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/WhyBloodPressureMatters/Sex-and-High-Blood-Pressure_UCM_451787_Article.jsp. Accessed Sept. 22, 2015.
- Sauer WH, et al. Sexual activity in patients with cardiovascular disease. http://www.uptodate.com/home. Accessed Sept. 22, 2015.
- Cronenwett JL, et al. Erectile dysfunction. In: Rutherford’s Vascular Surgery. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2014. http://www.clinicalkey.com. Accessed Sept. 22, 2015.
- Spatz ES, et al. Sexual activity and function among middle-aged and older men and women with hypertension. Journal of Hypertension. 2013;31:1.
- Rakel RE, et al., eds. Human sexuality. In: Textbook of Family Medicine. 9th ed. Philadelphia, Pa.: Elsevier Saunders; 2016. http://www.clinicalkey.com. Accessed Sept. 23, 2015.
- Nascimento ER, et al. Sexual dysfunction in arterial hypertension women: The role of depression and anxiety. Journal of Affective Disorders. 2015;181:96.
- Viigimaa M, et al. Management of erectile dysfunction in hypertension: Tips and tricks. World Journal of Cardiology. 2014;6:908.
- Nehra A, et al. The Princeton III consensus recommendations for the management of erectile dysfunction and cardiovascular disease. Mayo Clinic Proceedings. 2012;87:766.
- Sheps SG (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 29, 2015.