When hypertension drugs make you lose your ability to have sex
For a man, ability to maintain good erection is affected by many factors. Sade Oguntola reports that drugs for hypertension may also lead to inability to achieve full erection and sexual satisfaction.
IT is a taboo for men to own up that they have poor erection whenever they are to have sex. But it is a fact of life for some men, though not to a fault of theirs. Many cases are related to diseases like diabetes and hypertension and some have to do with drug used for ailments like hypertension. The effects of medications on sexual function remain controversial. While some blinded trials report little difference between placebo and specific medication, others indicate that use of hypertensive drugs increase a man’s chances of maintaining erection, thus, impacting on their quality of life.
Diabetes and hypertension are two diseases that require medical attention and medications. A situation where drugs or medical condition impacts negatively on a man’s sexual function (ability to achieve erection, sexual satisfaction and frequency of sexual activity), would not ensure such men keep taking the recommended drug. Rather, it will lead to a deterioration in the individual’s quality of life. A long term effect on sexual function of five antihypertensive drugs and Nutritional Hygienic Treatment in Hypertensive Men and Women by Richard H. Grimm, Jr; Gregory A. Grandits; Ronald J. Prineas; Robert H. McDonald; Cora E. Lewis; John M. Flack; Carla Yunis; Kenneth Svendsen; Philip R. Liebson; Patricia J. Elmer and Jeremiah Stamler, for the Treatment of Mild Hypertension Study (TOMHS) Research Group at the Shapiro Centre for Evidence-Based Medicine, Minneapolis Medical Research Foundation, and Division of Clinical Epidemiology, Department of Medicine, Hennepin County Medical Centre, Minneapolis, found that problems with sexual function have been a long-standing concern in the treatment of hypertension and may influence the choice of treatment regimens and decisions to discontinue drugs. The Treatment of Mild Hypertension Study (TOMHS) was a double-blind, randomised, controlled trial of 902 hypertensive individuals (557 men, 345 women), aged 45 to 69 years, treated with placebo or one of five active drugs (acebutolol, amlodipine maleate, chlorthalidone, doxazosin maleate or enalapril maleate). All partici-pants received intensive lifestyle counsel-ing regarding weight loss, dietary sodium reduction, alcohol reduction (for current drinkers), and increased physical activity.
Sexual function was ascertained by physician interviews at baseline and annually during follow-up. At baseline, 14.4 per cent of men and 4.9 per cent of women reported problems with sexual function. In men, 12.2 per cent had problems obtaining and/or maintaining an erection; 2.0 per cent of women reported a problem having an orgasm. Erection problems in men at baseline were positively related to age, systolic pressure and previous antihypertensive drug use. The incidences of erection dysfunction during follow-up in men were 9.5 per cent and 14.7 per cent through 24 and 48 months respectively, and were related to the type of antihypertensive therapy. Long-term incidence of erection problems in treated hypertensive men is relatively low but is higher with chlorthalidone treatment. Effects of erection dysfunction with chlorthalidone appear relatively early and are often tolerable, and new occurrences after 2 years are unlikely. The rate of reported sexual problems in hypertensive women is low and does not appear to differ by type of drug. Similar incidence rates of erection dysfunction in placebo and most active drug groups caution against routine attribution of erection problems to antihypertensive medication.
This could be a really big problem in ensuring compliance with medication, Dr. Babatunde Salako, a medical consultant at the University College Hospital (UCH), Ibadan, also corroborated. He said erectile problems in this group of men is more of a complication of the drug they use to maintain their blood pressure at a safe level. According to him, many antihypertensive drugs cause this, including Alomed, a common medication for hypertension,” stressing that different antihypertensive drugs tend to have different side effects and to different degrees in different individuals. He stated, “ what we found is that those drugs don’t cause the same problems in everybody. If drug A causes loss of libido in Mr. A, it may not in Mr. B. Somehow, if you switch to another type of drug in this individual that developed poor libido, the problem resolves. Much as the expert said hypertension on its own as a disease may not cause poor libido, he said it should be expected as a man grows older. Most starts to experience a decrease in their level of libido and it is natural. Even though some believe that poor libido may be related to their being hypertensive, he said “I don’t think it has to be due to age in this group. In most hypertensives, the older one is more likely to develop erectile dysfunction.”
Dr. Salako, however, said there is help for such men. He said there are drugs that would be prescribed for them to correct the problem. He added that all such patients needed to do was tell their doctor for him to take appropriate actions such as change their drugs to another without this side effect or ask them to continue on this same medication but prescribe other drugs to control erectile dysfunction.” He said that “problem of erectile dysfunction is very common in male hypertensive patients but that most people don’t bother to discuss the issue with their doctor. They rather stop their medication on their own rather than speak out.” To show how sensitive the problem of poor erection from anti-hypertensive drugs could be, Dr. Akin Sodipo, medical director, Comfort Medical Centre, Ibadan, said the fact that antiphypertenswive drugs could cause erectile problems can be understood on the ground that achieving erection entails getting more blood pumped into the male organ and that same pressure is what the antihypertensive drugs work upon.
According to him, ensuring compliance to medication is usually not easily achieved in some individuals until the doctor indirectly tries to find out from the patient why he keeps failing in taking his drug. “Most times, it is after we start to probe that we come to understand that compliance had been poor because the man was having problem with his sexual life. Of course, as doctors we wouldn’t just write out the prescription and ask him to go to the pharmacy to take such drugs. We keep such in our consultation room so that we can easily get it and give it to him secretly.
By Sade Oguntola
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