“I am just 45 years old this year, and half a year ago I was diagnosed with hypertension during a physical examination. My blood pressure was over 160mmHg, and the doctor recommended medication to control it. Since then, I have been taking hydrochlorothiazide, a type of antihypertensive medication, every day. However, in the past six months of taking the medication, I have clearly felt a decline in the quality of our marital life compared to before. I heard from online friends that it might be due to the antihypertensive medication. Will stopping the medication show improvement? What should I do?”
This is a question raised by a netizen in the background, regarding the decrease in sexual function among hypertensive patients, which is actually a common issue.
Around 33.5% of hypertension patients in our country, nearly 10 million new cases are detected each year, and the probability of hypertension patients suffering from male erectile dysfunction is 2 to 3 times higher than that of ordinary people. Many hypertension patients endure both discomfort caused by hypertension and the double torment of male ED. Even though many patients actively take antihypertensive drugs, the issue of decreased sexual function has not been alleviated, and in some cases, it may even worsen. So, what are the reasons behind the decrease in sexual function among male hypertensive patients? How should one deal with it? Hypertension and the decrease in sexual function of male patients
The decrease in sexual function among male hypertensive patients is closely related to hypertension itself: abnormally elevated blood pressure affects the normal functioning of endothelial cells, leading to an increase in the secretion of vasoconstrictive substances, causing abnormal vasodilation; on the other hand, abnormally elevated blood pressure causes sclerosis in small arteries like the cavernous artery and systemic blood vessels, leading to increased blood circulation resistance, insufficient blood supply to corresponding organs, and thereby inducing male ED. Statistics show that over 80% of male ED cases have organic causes, with the most common vascular causes being arterial sclerosis of male reproductive organs resulting from chronic diseases like hypertension and diabetes.
Therefore, hypertension itself is a significant cause of the decrease in sexual function among male hypertensive patients.
Antihypertensive Drugs and the decrease in sexual function of male hypertensive patients
Taking antihypertensive medication is an important measure for hypertension patients to control and stabilize blood pressure. However, during the specific medication process, several types of antihypertensive drugs indeed contribute to the decrease in sexual function among patients.
One type is thiazide diuretics, represented by hydrochlorothiazide, which the initial netizen took, as well as chlorthalidone, indapamide, etc. It has been proven in studies that this type of antihypertensive medication has the most significant impact on male sexual function, with an occurrence rate of 3% to 32%! These medications reduce male genital blood flow, decrease vascular smooth muscle responsiveness to catecholamines, and eventually lead to issues such as ED.
Another type is beta-blockers, represented by metoprolol and bisoprolol. Studies have found that these antihypertensive drugs not only cause male ED and decreased libido but also reduce sperm concentration and vitality, which is detrimental to normal marital life for males.
In general, certain antihypertensive drugs indeed lead to the decrease in sexual function among male hypertension patients.
So, can hypertension drugs that cause decreased sexual function in patients be discontinued? Will stopping the medication lead to improvement?
Many patients find this to be a dilemma. On the one hand, they want to benefit from taking antihypertensive medication for blood pressure control, but on the other hand, they don’t want to compromise normal marital life. They are unsure of what to do.
Completely discontinuing antihypertensive medication is not feasible for individuals with significantly elevated blood pressure, especially elderly people with a variety of cardiovascular diseases. Ceasing medication could trigger heart attacks or strokes at any moment, so adhering to medication is necessary. Moreover, hypertension itself exacerbates the decrease in male sexual function.
Fortunately, not all antihypertensive drugs are detrimental to male sexual function. Calcium channel blockers like amlodipine and nifedipine have been clinically found not to affect the sexual function of users. Angiotensin receptor blockers like valsartan and losartan, known as “little Viagra,” have been researched to improve and enhance male sexual function.
Therefore, considering switching to other antihypertensive medications is a viable option. The specific choice of which antihypertensive drug to switch to should be made under the guidance of a doctor, considering the patient’s condition and comorbidities to achieve a dual benefit of lowering blood pressure and restoring normal marital life.
Note: Patients should not discontinue or change medication on their own to avoid unnecessary risks.
