How will having high blood pressure affect my sex life?

Q. My wife and I have high blood pressure. Will our sex be affected?

A. The link between cardiovascular diseases and sexual health has been researched and the impact is well known in men. Sexual dysfunction tends to become more pronounced with age due to hormonal shifts happening at menopause, but also the development of other chronic diseases requiring medication for long-term management.

Older people are more likely to be on medication for high blood pressure, hyperlipidemia, diabetes and some of the many common drugs have an impact on sexual desire, performance and satisfaction.

Hypertension, untreated, can result in a reduction of the blood flow to the penis causing erectile dysfunction, and to the vagina, leading to a decrease in sexual desire or arousal, vaginal dryness, or difficulty achieving orgasm. Beyond this, the impact of hypertension in women is not well researched and therefore can often go undiagnosed.

Specific to erectile dysfunction, certain blood pressure drugs such as thiazide diuretics, loop diuretics, and beta-blockers can make it difficult to get or maintain an erection. There are other drugs, such as alpha-blockers, ACE inhibitors, and angiotensin receptor blockers, which have less chances of causing erectile dysfunction.

It is therefore worth having the discussion with your healthcare provider if you experience ongoing problems and figure out how to ensure optimal health and sexual satisfaction without defaulting on your medication. Get medical advice before taking any medications or herbal supplements to manage a poor erection.

The stress that comes with managing chronic illness, life and work stressors and intimate relationships can lead to performance anxiety. Share with your sexual partner(s) the types of sexual activity that excite you the most.

Improving arousal and using a water-based lubrication can help women achieve sexual satisfaction and pleasure. It is always best to have open communication about what your desires are and also to be attentive to the needs of your partner.

• Dr Tlaleng Mofokeng (MBChB), sexual and reproductive health practice, Disa Clinic, safersex.co.za.

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