Abstract
Introduction: Hypertension and its treatment cause sexual dysfunction (SD), impairing quality of life; and adversely affecting compliance and blood pressure control. SD is reported more often by men than women in most cultures especially ours. This has tended to affect the attitude of clinicians towards SD in female hypertensives.
Methods: A woman who for over 15 years of hypertension and its treatment faced difficulties in all domains of sexual function is hereby reported. On reporting this, the beta blocker in her regimen was replaced by an angiotensin receptor blocker (ARB).
Results: Gradually she regained libido and began to enjoy intercourse once again. This change obviated the need for a 5 phosphodiesterase inhibitor which would have added to cost of treatment.
Discussion/Conclusion: SD occurs in female hypertensives and should be sought. When found, ARB use can reverse the problem with all its attendant benefit on quality of life and blood pressure control.
Keywords: Angiotensin receptor blocker, sexual dysfunction, reversal, female, hypertension
Résumé
L’hypertension et ses traitements causent des mauvais fonctionnements sexuels (SD), déséquilibre de la qualité de la vie; et influence l’obéissance et le contrôle de la pression artérielle. Les mauvais fonctionnements sexuels sont rapportés plus souvent chez les hommes tant bien que les femmes dans la plupart des cultures spécialement la notre. Ceci induit a affecté les attitudes des médecins envers les mauvais fonctionnements sexuels chez les femelles hypertensives. Une femme qui depuis 15 ans de l’hypertension et ses traitements caractérisés par des difficultés sur toutes les domaines des fonctions sexuelles est rapporté. La bloqueurs beta dans son régime était remplacé par le bloqueurs des récepteurs d’angiotensine(BRA). Graduellement elle regagnait sa libido et commençait d’aimer les relations sexuelles encore. Ce changement bloquait le besoin de l’inhibiteur 5 phosphodiesterase qui doit être ajoutée au cout du traitement. SD apparut chez les femelles hypertensives et nécessite des recherches. Lorsque trouvé, l’utilisation du BRA peut renverser le problème avec tous ses bénéfices sur la qualité de la vie et le contrôle de pression artérielle sanguine.
Correspondence: Prof. Basil N. Okeahialam, Department of Medicine, Jos University Teaching Hospital, Jos, Nigeria. E-mail: basokeam@yahoo.com
References
Bansal S. Sexual dysfunction in hypertensive men. A critical review of literature. Hypertens.1998; 12: 1 - 10.
Gired X, Mounier-Vehier C, Fauvel JP, Marquand A, Babici D and Hanon D. Medical management of libido disturbances in treated hypertensive patients: differences between men and women. Arch Mal. Coeur Vaiss. 2003; 96(7-8): 758 - 762.
Prisant LM, Carr AA, Bottini PB, Sorlush DS and Sorlush LP. Sexual dysfunction with antihypertensive drugs. Arch Intern Med. 1994; 154(7): 730 - 736.
Okeahialam BN and Obeka NC. Erectile dysfunction in Nigerian Hypertensives. Afr. J. Med. Med. Sc. 2007; 36: 221 - 224.
Fogari R, Zoppi A, Poletti L, Marasi G, Mugellini A and Corradi L. Sexual activity in hypertensive men treated with Valsartan or Carvedilol: A cross over study. Am. J. Hyp. 2001; 14: 27 - 31.
Doumas M and Doumas S. The effect of antihypertensive drugs on erectile function: a proposed management algorithm.
Fogari R, Preti P, Zoppi A, Corradi L and Mugellini A. Effect of Valsartan and Atenolol on sexual behaviour in hypertensive post menopausal women. Am. J. Hyp. 2004; 17: 77 - 81.
Okeahialam BN and Obeka NC. Sexual dysfunction in female hypertensives. J. Natl. Med. Assoc. 2006; 98(4): 638 - 640.
Okeahialam BN and Ogbonna C. Impact of hypertension on sexual function in women. West Afr. J. Med. 2010; 29(5): 344 – 348.
Matos L. New possibilities in clinical use of angiogenesis II receptor inhibitors. Orv. Hetil. 2003; 144(49): 2419 - 2423.
Hale TM, Hannan JL, Heaton JP and Adams MA. Common therapeutic strategies in the management of sexual dysfunction and cardiovascular disease. Curr. Drug Targets Cardiovasc. Haematol. Disord. 2005; 5(2): 185 - 195.
Phillips NA. Female sexual dysfunction: Evaluation and treatment. Am. Family Physician. 2000; 62: 127 – 136, 141 – 142.
Phillips NA.The clinical evaluation of dysparareunia. Int J. Impot. Res. 1998; 10(Suppl 2): S 117 – S 120.
Simon JA. Low sexual desire – Is it all in the head? Pathophysiology, diagnosis and treatment of hypoactive sexual desire disorder. Postgrad Med. 2010; 122(6): 126 – 136.
Yamamoto S, Kawashima T, Kunitake T, Koide S and Fujimoto H. The effects of replacing dihydropyridine calcium channel blockers with angiogenesin II receptor blocker on the quality of life of hypertensive patients. Blood Press. Suppl. 2003; 2: 22 - 28.
Yang R, Yang B, Wen Y, et al. Losartan, an angiogenesin type I receptor blocker restores erectile function by down regulating the cavernous renin angiogenesis system in streptozotocin induced diabetic rats. J. Sex Med. 2009; 6(3): 696 - 707.
Park K, Shin JW, Oh JK, Ryu KS, Kim SW and Paick J. Restoration of erectile capacity in normotensive aged rats by modulation of angiogenesis receptor type I. J. Androl. 2005; 26(1): 123 - 128.
Hanon O, Mounier-Vehier C, Fauxel JP et al. Sexual dysfunction in treated hypertensive patients. Results of a national survey. Arch. Mal. Coeur Vaiss. 2002; 95(7-8): 673 - 677.
Al Khaja KA, Sequeira RP, al Damanhori AH and Mathur VS. Antihypertensive drug associated sexual dysfunction. A prescription analysis-based study. Pharmaco epidemiol. Drug Saf.2003; 12(3): 203 -212.