72).A natural decline in hormone levels may make a difference in sexual response by midlife for both men and women. Complicating matters, health problems such as heart disease, atherosclerosis, high blood pressure, diabetes, and depression can also cause difficulties with arousal and orgasm, vaginal dryness, and erectile dysfunction (72).
But it pays to look into another surprising factor behind a sluggish sex drive: Many medications prescribed to treat the very conditions causing sexual complications can actually lower libido, weaken arousal, and make erectile dysfunction (ED) worse. Drugs for high blood pressure and depression are the worst culprits, but they’re certainly not the only ones to blame. The drugs cause sexual problems in a variety of ways. And if you take more than one of these medications, the combination of effects can really take a toll in the bedroom.
The authors of a study in Current Hypertension Reports noted that some classes of blood pressure drugs, such as diuretics and beta-blockers, have a greater impact on sexual function than others. While people react quite differently to various hypertension medicines, sometimes even within the same class, these two commonly prescribed classes seem to cause the most problems. Diuretics dilate blood vessels and reduce fluid levels in the body, and beta-blockers act on your nervous system to counter stress-related spikes in blood pressure. Both have been shown to lower libido, contribute to ED in men, and delay orgasm in women. For instance, a 2009 study in the Journal of Internal Medicine noted that common side effects of beta-blockers include fatigue, depression, and sexual dysfunction—all of which can have serious consequences for your love life. And in an earlier study in the Archives of Internal Medicine, researchers noted that “Patients taking diuretics reported significantly greater sexual dysfunction than control subjects, including decreased libido, difficulty in gaining and maintaining an erection, and difficulty with ejaculation.” Other classes of blood pressure drugs may pose less risk. In fact, research shows that angiotensin II receptor blockers, or ARBs, may actually improve sexual function in men.
A slew of studies show that selective serotonin reuptake inhibitor (SSRI) antidepressants such as Prozac, Paxil, and Zoloft are notorious for dampening desire, partly because of the way they affect neurotransmitters and other hormones and enzymes that impact your central nervous system. In fact, a study in the Annals of Pharmacotherapy noted that up to 60 percent of SSRI users experience some kind of sexual repercussions, from delayed or nonexistent orgasm to limited libido and ED. And a 2009 review in the Journal of Clinical Psychopharmacology reported that sexual side effects are “one of the predominant reasons” people stop taking the drugs. Monoamine oxidase inhibitor (MAOI) antidepressants and tricyclic antidepressants are less frequently prescribed to treat depression these days, but studies show they may also trigger sexual side effects. Drugs like bupropion (Wellbutrin), which helps balance levels of the neurotransmitters dopamine and norepinephrine, and duloxetine (Cymbalta), which targets both serotonin and norepinephrine, may be less likely to cause problems.
In addition to these main offenders, statins have been linked to ED in men, and prescription or over-the-counter decongestants and antihistamines that dry up your runny nose can also increase vaginal dryness. Drugs for treating heart disease, acid reflux, prostate problems, pain, anxiety, and insomnia (specifically benzodiazepines) often boast unwelcome sexual side effects as well, and your doctor may not think to mention those drawbacks when prescribing.
If you suspect side effects are interfering with your sex life, before you resign yourself to a less-passionate future or turn to ED drugs such as Viagra and Cialis, ask your doctor about reducing your dose, switching to another medicine, or if there are lifestyle approaches to improve the underlying health condition without drugs. And of course, never stop taking a medication without checking first with your doctor.