Certain classes of cardiovascular drugs, such as thiazide diuretics and beta-blockers (often used to treat high blood pressure), promote its occurrence
I suffer from high blood pressure and during the summer, when it drops, I suspend the treatment with good satisfaction in terms of my sex life. As soon as I resume the drugs I notice a sharp drop in libido and erectile dysfunction. Is there a relationship between this problem and antihypertensives?
He answers Piero MontorsiFull Professor of Cardiovascular Diseases at the University of Milan, Monzino Cardiology Center (GO TO THE FORUM)
For erectile dysfunction (DE) means the inability to have/maintain an erection that allows for satisfactory sexual intercourse, while a decrease in libido reflects a reduction in desire and/or arousal in response to certain stimuli. The two symptoms can coexist. The causes of ED are psychological or organic, the latter being more frequent and favored by common vascular risk factors such as smoking, diabetes, high cholesterol, hypertension, sedentary lifestyle and obesity. Hypertension is therefore counted among the causes of ED, with percentages exceeding 50%, while some classes of cardiovascular drugs, such as thiazide diuretics and beta-blockers (often used in the treatment of high blood pressure), can favor its appearance. Whether this happens to the drug or whether the drug unleashes a pre-existing but poorly perceived ED, it is difficult to say.
A useful test may be to suspend or replace the drug for 15 days and check if the problem resolves. If so, it will be enough to optimize the treatment of hypertension with other compounds (ACE inhibitors, calcium channel blockers or others). The on-off phenomenon of ED in the summer months could depend on a lower work-related stress load. If, on the other hand, everything does not work out or the drug is essential for effective treatment of hypertension, the use of ED medications may be considered, such as phosphodiesterase-5 inhibitors (sildenafil, tadalafil and others), which are effective and safe with a positive response in 80% of cases. In any case the appearance of DE requires an assessment by the specialist on the vascular systemincluding coronaries.
December 23, 2022 (change December 23, 2022 | 11:07)
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