Effects of antihypertensive agents on sexual function

Am Fam Physician. 1991 Dec;44(6):2075-82.


Patient compliance with antihypertensive therapy can be improved by minimizing drug-induced sexual dysfunction. Impotence, decreased libido, impaired ejaculation and gynecomastia are potential side effects, depending on the agent prescribed. Centrally acting antihypertensive agents such as methyldopa and clonidine, nonselective beta-adrenergic blockers and potassium-sparing diuretics are the drugs most often associated with sexual dysfunction. Thiazide diuretics cause impotence but may otherwise play a minimal role in sexual dysfunction. Alpha-adrenergic blockers, angiotensin converting enzyme inhibitors and calcium channel blockers have little adverse effect on sexual function. It is important to obtain an adequate history before and after initiating therapy. If sexual dysfunction develops in a patient, a different class of medication can be tried.

Publication types

  • Review

MeSH terms

  • Adrenergic beta-Antagonists / adverse effects
  • Adrenergic beta-Antagonists / pharmacology
  • Antihypertensive Agents / adverse effects*
  • Antihypertensive Agents / pharmacology
  • Benzothiadiazines
  • Diuretics
  • Ejaculation / drug effects
  • Erectile Dysfunction / chemically induced*
  • Erectile Dysfunction / physiopathology
  • Gynecomastia / chemically induced
  • Humans
  • Libido / drug effects
  • Male
  • Sodium Chloride Symporter Inhibitors / adverse effects
  • Sodium Chloride Symporter Inhibitors / pharmacology


  • Adrenergic beta-Antagonists
  • Antihypertensive Agents
  • Benzothiadiazines
  • Diuretics
  • Sodium Chloride Symporter Inhibitors