Sex and Hypertension

If you suffer from any type of heart trouble, it’s only natural to have concerns about whether sex is still safe for you. Here’s the good news: According to the American Heart Association, most people with heart trouble can enjoy sex safely — and that includes those with high blood pressure.

Sex — like any other form of exercise — does get the heart pumping. And, in rare cases, the extra exertion could trigger a heart attack. But the risks are encouragingly small. According to a report by the American Journal of Cardiology, fewer than 1 percent of all heart attacks occur during sexual activity.

Still, some people need to be careful. As reported in the journal, sex really can be dangerous for people with severe hypertension that isn’t under control. If you have high blood pressure but aren’t receiving treatment — or if your blood pressure is soaring despite treatment — your doctor may ask you to abstain from sex or other strenuous activity until your pressure is under control. If there’s any doubt about your safety, your doctor will order a stress test to measure the effects of exercise on your heart.

Can high blood pressure affect sexual functioning?

Whether you’re a man or a woman, high blood pressure can definitely put a damper on your sex life. Among men, high blood pressure can cause erection problems by slowing the supply of blood to the penis. A survey of 104 men with hypertension, published in The Journal of Urology, found that the vast majority — 71 patients — had some form of erectile dysfunction. For 47 men — nearly half — the problem was severe.

In recent years, researchers have begun to understand that high blood pressure also takes a toll on female sexuality. A study of 640 women, published in the June 2000 issue of The American Journal of Hypertension, found that the women with hypertension were significantly more likely than others to suffer pain during intercourse. They also were more likely to have decreased vaginal lubrication and trouble reaching orgasm.

How do hypertension medications affect sexuality?

In an unfortunate twist, many drugs that are good for your heart can be hard on your sex life. According to the Mayo Clinic, many diuretics and beta blockers — two very popular classes of blood pressure medicine — can cause erectile problems in men. Though its usually safe to take erectile dysfunction drugs (Viagra, Levitra, Cialis) with high blood pressure medication, don’t take them with nitrates — this can cause a life-threatening drop in blood pressure. Also, a-adrenoceptor blockers such as doxazosin and tamulosin should only be combined with these erectile dysfunction medications under close monitoring by your doctor.

If you develop any sexual difficulties after taking your medication, don’t suffer in silence. Your doctor can usually solve the problem by simply changing the prescription. ACE inhibitors, calcium channel blockers, and alpha blockers can lower blood pressure with fewer risks of sexual side effects.

In fact, some hypertension medicines may actually give a boost to a person’s sex life. A study of 82 men with sexual dysfunction, published in the May 2001 issue of the American Journal of Medicine and Science, found that patients had more reliable erections and more frequent sex after treatment with the drug losartan (Cozaar). Losartan belongs to a class of drugs known as angiotensin II receptor antagonists.

Whatever medicine your doctor prescribes, be sure to follow the instructions to the letter. Taking medicines properly is one of the surest ways to cut down on side effects, sexual or otherwise.


Debusk R et al. Management of sexual dysfunction in patients with cardiovascular disease: Recommendations of the Princeton Consensus Panel. American Journal of Cardiology; 86(2A): 62F-68F.

Burchardt M et al. Hypertension is associated with severe erectile dysfunction. Journal of Urology. October 2000. 164:1188-1191.

Duncan LE at al. Does hypertension and its pharmacotherapy affect the quality of sexual function in women? American Journal of Hypertension. June 2000. 13(6 pt 1): 640-647.

Mayo Clinic. High Blood Pressure and Sex: Overcome the Challenges. August 2006.

Reffelmann, T, Kloner, RA. Sexual function in hypertensive patients receiving treatment. Vascular Health Risk Management. 2006; 2(4): 447-455.

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