Sex is like any other exercise in as far as the physical benefits derived from exercise are concerned. It gets the heart pumping, but is it safe for people with heart disease? The American Journal of Cardiology, in its July 20, 2000 issue, mentions that it is rare that one would suffer a heart attack during sexual activity and less than 1% of all heart attacks occur during a sexual intercourse. The same, however, cannot be said for people with hypertension as they need to be careful. Sex can be dangerous in cases of chronic high blood pressure or if blood pressure is soaring despite treatment.
There is a typical relationship between blood pressure and sex drive. On one side is the risk that hypertension patients are exposed to, and on the other side is the effect that medications for blood pressure have on sexual functioning.
High blood pressure can affect the sex drive of both men and women. In men, high blood pressure can cause erectile problems by slowing down flow of blood to the penis. Hypertensive women are more likely to experience pain during intercourse due to a significant reduction in lubrication, and they may have difficulty in reaching an orgasm.
The biggest irony of the strange relationship between blood pressure and sex surfaces when you study the affect of high blood pressure medicines on sexual functioning. Some of the medicines used for treating high blood pressure can further deplete sex drive by causing erectile dysfunction. While it is safe to use sexual performance products like Viagra, care has to be taken that they are not taken with nitrates. The combination can lead to a significant drop in blood pressure, which can be life threatening at times.
The sexual function is a complex correlation between hormones, neurotransmitters like dopamine and serotonin, and the sexual organs. While dopamine enhances, serotonin inhibits sexual function. As medicines treat by promoting or curbing particular responses in the body, they can affect sex drive and performance.
Blood pressure medicines that interfere with the production of testosterone necessary for arousal are likely to reduce sex drive. Erection is obtained after a complex coordination between nerves, hormones, blood vessels and psychological factors. Ejaculation is also a complicated reflex action involving the activation of alpha receptors in the prostate gland and seminal fluid. During ejaculation, the bladder neck is closed to allow the semen to flow out of through the penis. Medicines that interfere with this mechanism lead to ejaculatory disturbances like failure to ejaculate.
The most commonly used medicines for treating hypertension or high blood pressure include:
- Antihypertensive medicines like clonidine and methyldopa
- ACE inhibitors like enalapril and lisinopril
- Beta blockers like atenolol and propanolol
- Thiazide Diuretics
All these drugs can potentially cause impotency, delayed ejaculation, failure to ejaculate and a diminished sex drive. Most often, men feel the need to get premature ejaculation treatment, but in the case of blood pressure related problems there is mostly the reverse problem – that of a delay or failure to ejaculate due to the negative impact of the medication. This can prove to be very frustrating as high blood pressure treatment can extend over long periods. Your doctor can suggest an alternative to the medicine that is causing you problems with sex drive. For example, ACE inhibitors cause less of a problem to sex drive than diuretics and loop diuretics are safer than thiazide diuretics.