Long-Term Effects on Sexual Function of Five Antihypertensive Drugs and Nutritional Hygienic Treatment in Hypertensive Men and Women: Treatment of Mild Hypertension Study (TOMHS)

Oral α adrenoceptor blockade as a treatment of erectile dysfunction

“…The a 1 AR antagonists in general have depressant eects on blood pressure, and this eect may alter the mechanisms of erection. Nevertheless, the evidence from large hypertension trials on dierent antihypertensive drugs suggests that patients on doxazosin had a lower incidence of ED than the placebo group [16].…”

Erectile dysfunction and atherosclerosis

“…It is known that some of the antihypertensive medications themselves may worsen ED [7,29]. The results of comparative trials suggest that the thiazide diuretics (such as chlorthalidone) are the most likely to induce ED, followed by the β blockers [30][31][32][33][34]. Centrally acting agents also can induce ED.…”

Questionnaires to measure sexual quality of life

“…This plateau may be short or long, but culminates in a rapid release of vasocongestion and muscular tension, or the orgasm [27][28][29] coinciding with a subjective satisfaction. A variety of physiologic, medical and psychological factors can contribute to sexual dysfunction including illness [4,6,19,20,22,[30][31][32][33][34][35][36][37], pharmacologic agents [15,21,[38][39][40][41][42][43][44][45][46], and psychosocial factors [18,22,47]. Physiologic abnormalities can result in inability to achieve or maintain an erection or in ejaculatory disorders in males, and decreased lubrication in females.…”

“…In females, shortening of the vaginal vault, loss of rugal folds, thinning of the vaginal mucosa and lowered acidity of the vaginal secretions may give rise to dyspareunia [2,16,23,24,27,48,49]. Medications such as sedatives [50], selective serotonin uptake inhibitor antidepressants [21,[40][41][42][43][44], and antihypertensives [4,46,[51][52][53] have a direct action on the nervous system and may increase anhedonia, or impair libido, orgasm and erection. Many diseases can adversely affect sexual function by affecting circulatory or neurologic function, hormonal balance or systemic health [54].…”

“…Factors encouraging this may include increased adoption of patient-centered care, and the availability of effective treatments. Accompanying this, there has been greater attention to the assessment of sexual functioning as an outcome measure in clinical studies [21,34,43,45,46,52,62,63].…”