Abstract
Introduction: Sexual dysfunction is a potential side effect of cardiovascular drugs: this article
is a critical review of the current literature. Many studies have been published on
this topic. Most of these studies are not methodologically robust, few are RCTs and
most did not use a validated rating scale to evaluate sexual functioning. In addition,
other methodological flaws limit greatly the conclusions of these studies. Most studies
relate to male populations and only a few have been conducted on women. Also, the
majority of studies on sexual dysfunction induced by cardiovascular drugs relate to
antihypertensive drugs. While there is evidence to suggest that older antihypertensive
drugs (diuretics, beta-blockers, centrally acting agents) have a negative impact on
erectile function, newer agents seem to have either neutral (ACE inhibitors, calcium
antagonists) or beneficial effects (i. e., angiotensin receptor blockers, nebivolol).
Other cardiovascular drugs analyzed in this review also appear to have an inhibitory
action on sexual function. For men, there is some weak evidence supporting the use
of specific treatment strategies for sexual dysfunction associated with these drugs.
Methods: This study was conducted in 2014 using the paper and electronic resources of the
library of the “Azienda Provinciale per i Servizi Sanitari (APSS)” in Trento, Italy
(http://atoz.ebsco.com/Titles/2793). The library has access to a wide range of databases including DYNAMED, MEDLINE
Full Text, CINAHL Plus Full Text, The Cochrane Library, Micromedex healthcare series,
BMJ Clinical Evidence. The full list of available journals can be viewed at http://atoz.ebsco.com/Titles/2793 or at the APSS web site (http://www.apss.tn.it). In completing this review, a literature search was conducted using the key words
“cardiovascular”, “adrenergic beta antagonist”, “α1-adrenoceptor antagonist”, “angiotensin
converting enzyme inhibitor”, “angiotensin receptor antagonist”, “angiotensin receptor
blocker”, “beta blocker”, “beta receptor antagonist”, “calcium channel blocker”, “diuretic”,
“antihypertensive”, “sexual dysfunction”, “sexual side effects”, “treatment-emergent
sexual dysfunction”. All resulting listed articles were reviewed.
Conclusion: The review includes studies that investigated the relationship between these drug
treatments and sexual dysfunction. The purpose was to identify possible intervention
strategies for sexual dysfunction related to these drugs.
Key words
cardiovascular drugs - sexual dysfunction - sexual side effects - treatment-emergent
sexual dysfunction