If you suffer from any type of heart trouble, it's only natural to have concerns about whether sex is still safe for you. Here's the good news: According to the American Heart Association, most people with heart trouble can enjoy sex safely -- and that includes those with high blood pressure.
Sex -- like any other form of exercise -- does get the heart pumping. And, in rare cases, the extra exertion could trigger a heart attack. But the risks are encouragingly small. According to a report by the American Journal of Cardiology, fewer than 1 percent of all heart attacks occur during sexual activity.
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Still, some people need to be careful. As reported in the journal, sex really can be dangerous for people with severe hypertension that isn't under control. If you have high blood pressure but aren't receiving treatment -- or if your blood pressure is soaring despite treatment -- your doctor may ask you to abstain from sex or other strenuous activities until your blood pressure is under control. If there's any doubt about your safety, your doctor will order a stress test to measure the effects of exercise on your heart.
Sex does slightly raise your blood pressure during and shortly after, but it only increases the same amount as if you were to go for a walk or climb up a flight of stairs. This has been shown in a study published in August 2008 in Blood Press Monit that observed changes in blood pressure for healthy adults between the ages of 32 and 48.
High blood pressure can affect men through interference with erection and ejaculation and high blood pressure can also reduce sexual desire and libido in women.
Whether you're a man or a woman, high blood pressure can definitely put a damper on your sex life. Among men, high blood pressure can cause erection problems by slowing the supply of blood to the penis. A survey of 104 men with hypertension, published in The Journal of Urology, found that the vast majority -- 71 patients -- had some form of erectile dysfunction. For 47 men -- nearly half -- the problem was severe.
In recent years, researchers have begun to understand that high blood pressure in women also takes a toll on female sexuality. A study of 640 women, published in the June 2000 issue of The American Journal of Hypertension, found that women with hypertension were significantly more likely than others to suffer pain during intercourse. They also were more likely to have decreased vaginal lubrication and trouble reaching orgasm.
During sex, hormones such as serotonin, endorphins, and phenyl-ethylamine are released, which can help you feel less stressed. Your arteries are therefore relaxed, which lowers blood pressure. Though orgasms do mildly raise your heart rate, they only do so for a short period after the fact.
The study published in Blood Press Monit asked participants to measure their own blood pressure at the beginning of each sexual phase and three times after orgasm in 10-minute intervals and then 60 minutes after orgasm. In both men and women, the peak blood pressure level did not appear at orgasm, but at the beginning of the plateau and dropped to a normal level 10 min after orgasm.
In an unfortunate twist, many drugs that are good for your heart can be hard on your sex life. According to the Mayo Clinic, many diuretics and beta blockers -- two very popular classes of blood pressure medicine -- can cause erectile problems in men;
Though erectile dysfunction drugs (Viagra, Levitra, Cialis) are usually safe to take with high blood pressure medication, don't take them with nitrates -- this can cause a life-threatening drop in blood pressure.
A-adrenoceptor blockers such as doxazosin and tamulosin should only be combined with these erectile dysfunction medications under close monitoring by your doctor.
Diuretics and some blood pressure medications, particularly for men who are already taking drugs to enhance sexual performance, have been linked to problems with sexual performance, according to research done by the Mayo Clinic in Rochester, Minnesota.
If you develop any sexual difficulties after taking your medication, don't suffer in silence. Your doctor can usually solve the problem by simply changing the prescription. ACE inhibitors, calcium channel blockers, and alpha blockers can lower blood pressure with fewer risks of sexual side effects.
In fact, some hypertension medicines may actually give a boost to a person's sex life. A study of 82 men with sexual dysfunction, published in the May 2001 issue of the American Journal of Medicine and Science, found that patients had more reliable erections and more frequent sex after treatment with the drug losartan (Cozaar). Losartan belongs to a class of drugs known as angiotensin II receptor antagonists.
Whatever medicine your doctor prescribes, be sure to follow the instructions to the letter. Taking medication properly is one of the surest ways to cut down on side effects, sexual or otherwise.
In many cases, erectile dysfunction (ED) medications do not affect your blood pressure to a level of concern. Many cases of ED are characterized as "vascular" due to their strong statistical association with cardiovascular risk factors. The strong association between cardiovascular disease and ED emphasizes the importance of having cardiovascular patients seeking ED treatment evaluated for cardiac risk before starting on ED medication. This can depend on the patient’s blood glucose level, analysis of cholesterol, and body-mass index.
Patients whose blood pressure is well controlled either naturally or with antihypertensive drugs are considered low-risk and therefore, sexual activity and ED treatment could be safely recommended.
Patients who have very low blood pressure (hypotension) or uncontrolled high blood pressure (hypertension) are at higher risk for complications when taking ED medication.
Some studies have suggested that medical treatment for hypertension or the reduction of hypertension risk factors may decrease the incidence of ED. However, most antihypertensive medications such as thiazides, beta blockers, etc. have been reported as potentially harming sexual function.
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Debusk R et al. Management of sexual dysfunction in patients with cardiovascular disease: Recommendations of the Princeton Consensus Panel. American Journal of Cardiology; 86(2A): 62F-68F. https://pubmed.ncbi.nlm.nih.gov/10913479/
Burchardt M et al. Hypertension is associated with severe erectile dysfunction. Journal of Urology. 164:1188-1191. https://pubmed.ncbi.nlm.nih.gov/10992363/
Duncan LE at al. Does hypertension and its pharmacotherapy affect the quality of sexual function in women? American Journal of Hypertension. 13(6 pt 1): 640-647. https://pubmed.ncbi.nlm.nih.gov/10912747/Mayo Clinic. High Blood Pressure and Sex: Overcome the Challenges. August 2006. http://www.mayoclinic.com/health/high-blood-pressu.Reffelmann, T, Kloner, RA. Sexual function in hypertensive patients receiving treatment. Vascular Health Risk Management. 2(4): 447-455.