Angiotensin Receptor Blockers (ARBs) benefit female sexual function in hypertension, while beta-blockers impair it

Female sexual dysfunction (FSD) is a significant, yet often understudied, comorbidity in women with hypertension. Unlike male sexual dysfunction, the specific impact of various antihypertensive agents on female sexual function remains poorly defined, leading to a gap in evidence-based management strategies. Current standard-of-care for hypertension focuses primarily on blood pressure control, often overlooking potential adverse effects on quality of life, including sexual health. Understanding which antihypertensives are beneficial or detrimental is crucial for holistic patient care, addressing both cardiovascular health and patient well-being.

This review analyzed randomized double-blind clinical trials and cross-sectional studies published between 1991 and 2021 to evaluate the relationship between female sexual function and hypertension, specifically focusing on the effects of antihypertensive agents. Researchers systematically reviewed literature to identify patterns and provide recommendations for managing FSD in hypertensive women, considering different menopausal statuses. The study aimed to synthesize existing evidence to guide clinical decision-making and improve patient outcomes by identifying optimal therapeutic approaches.

FSD incidence was found to be higher in hypertensive women compared to normotensive women. Among antihypertensive agents, beta-blockers emerged as the only class with relatively strong evidence of damaging female sexual function. Conversely, Angiotensin Receptor Blockers (ARBs) were identified as relatively beneficial to female sexual function. The review emphasized that controlling blood pressure is paramount for treating FSD in hypertension. For premenopausal women, specific interventions like flibanserin and bremelanotide can be considered as adjunctive therapies. For postmenopausal women, ospemifene and hormone supplements are preferred options to address FSD. > Beta-blockers are the only antihypertensive agents with relatively strong evidence of damaging female sexual function, while ARBs are relatively beneficial.