Hypertension Tied to Female Sexual Dysfunction


NEW YORK — Women with hypertension were twice as likely to have sexual dysfunction as normotensive women were, according to a study of 417 women.

The results also showed that women with controlled hypertension had a significantly lower prevalence of sexual dysfunction than did women whose hypertension failed to reach goal levels during treatment, Dr. Michael Doumas reported at the annual meeting of the American Society of Hypertension.

But a third finding was that women who were treated with antihypertensive drugs had a higher prevalence of sexual dysfunction than did untreated women. Dr. Doumas speculated that this was caused by the effects of certain antihypertensive drugs, such as diuretics and β-blockers. Treatment with other drug types, the angiotensin-receptor blockers and angiotensin-converting enzyme inhibitors, appeared to reduce sexual dysfunction, he said.

“We need to treat hypertension because of its effect on adverse cardiac outcomes. But there is a hint that we can lower blood pressure with some drugs and also have good effects on female sexual function,” said Dr. Doumas, a physician in the department of internal medicine at the Hospital of Alexandroupolis in Athens.

The study enrolled 216 women with hypertension and 201 normotensive women. Their average age overall was about 48, and all were sexually active.

The women completed a 19-question form that has been validated as a way to evaluate sexual function. The questions dealt with several domains of female sexual function: desire, arousal, lubrication, orgasm, satisfaction, and pain.

Among the women with hypertension, 42% had scores indicating sexual dysfunction, compared with 19% among the normotensives, a statistically significant difference.

The prevalence of sexual dysfunction increased significantly with the duration of hypertension. Among women who had been hypertensive for fewer than 3 years, 16% had a score indicating sexual dysfunction; the rate rose to 33% among women with hypertension for 3–6 years and 79% among women with hypertension for more than 6 years. Age also showed a significant interaction with prevalence. Among women aged 31–40 years, the prevalence of dysfunction was 21%; the rate rose to 38% among women aged 41–50 and to 57% among women older than 50.

The prevalence of sexual dysfunction was 48% among women treated for hypertension, compared with 33% among the untreated hypertensives, a significant difference. The average age was 48 in both groups. But the prevalence was lower still among the hypertensive women who had their pressure controlled by treatment. With control defined as a pressure of less than 140/90 mm Hg, the prevalence of sexual dysfunction in women with controlled hypertension was 27%, significantly less than the 51% of women with uncontrolled hypertension who had dysfunction.

It's not yet known how antihypertensive drugs exert differing effects on sexual function. In general, drugs that cause vasodilation appear to improve sexual dysfunction, Dr. Doumas said.


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