Sexual dysfunction among females on anti-hypertensive treatment - abstract

ABSTRACT

Sexual dysfunction is a common finding among males treated for essential hypertension, and is frequently cited as a cause of non-compliance with a therapeutic regimen. Reports of sexual dysfunction among treated women have been few, and there is little appreciation of how this problem affects the female patient. The present paper focusses on 112 pre-menopausal females, age 23 to 45 years, referred for evaluation of essential hypertension either as part of a pre-immigration physical examination or for management in a general medical out-patient clinic. Seventy-five women had been on anti-hypertensive treatment in the past or were on treatment at the time of evaluation. Previously treated women were kept on their old regime, and the others were put on a stepped-care protocol. After stabilisation of their blood pressure, all patients were questioned about sexual function while on treatment. Twenty-four women admitted to some degree of sexual dysfunction, loss of libido being the most significant problem. Twelve said they would enjoy sex after activity was initiated by their consorts, but thought their pleasure was considerably diminished by treatment. Four found that sex had become distasteful but continued to please their partners. Sixteen patients reported virtually complete loss of orgasm, and eight cited failure of lubrication as a significant problem. Eleven women admitted to more than one sexual problem. Only one admitted to pre-treatment sexual dysfunction. Four patients were thought to be depressed, by the medical attendant, and three of these responded to anti-depressant therapy plus a change of anti-hypertensive drugs. Of fourteen patients followed by the same physician for more than one year, eleven considered themselves restored to normal, or near normal, sexual function by a change of drug regimen but, in all cases, 2 or more different drugs had been tried before this was achieved. Only two women admitted to discontinuing drugs because of sexual difficulties. Sexual dysfunction in treated hypertensive females would therefore appear to be a significant problem. The present study may actually underestimate its extent, as there was a preponderance of middle-class women among those admitting to dysfunction these females are presumably more educated and articulate and perhaps less embarrassed at discussing sexual matters (AU)