Sexual dysfunction with beta-blocker therapy: More common than we think?

Experience in a university hypertension unit led to a questioning of the low reported incidence of sexual dysfunction associated with beta-blocker therapy. To examine the question further, 225 patients with hypertension, angina or migraine were surveyed by mailed questionnaire. Changes in energy, mood, sleep and sexual function were compared in groups treated with or without beta-blockers and with or without hypertension. Analysis was done by chi square, male diabetics excluded. Perceived dysfunctions were greater among those on beta-blocker therapy (either alone or in combination) than among those on alternate therapy. Males were more likely to perceive diminished libido than females. Decreases were positively correlated with age in men but not in women. No pattern of female orgasmic change was noted. Hypertension itself seemed unlikely as the important determinant, as prevalence was lower in this group. Many patients attributed perceived decreases in sexual function to medication. Most patients are not told that beta-blocker therapy can alter awareness of sympathetic responses during sexual excitement. The high level of sexual dysfunction in this sample requires confirmation but may have implications for counseling, compliance and hypertension control.