• SexRx: Calcium Channel Blockers and Your Sex Life

    sex rx

    Medications and Their Commonly Used Brand Names

    Medication Brand names
    Amlodipine Norvasc
    Diltiazem Cardizem
    Felodipine Plendil
    Flunarizine Sibelium
    Isradipine DynaCirc
    Nicardipine Cardene
    Nifedipine Adalat, Procardia
    Nimodipine Nimotop
    Nisoldipine Sular
    Verapamil Calan, Isoptin

    What They Are Most Often Prescribed For:

    How They Work:

    Calcium channel blockers (CCBs) affect the movement of calcium into the cells of your heart and blood vessels. As a result, CCBs relax blood vessels and reduce the heart's workload.

    Possible Sexual Side Effects:

    Compared to most other blood pressure drugs, CCBs seem to cause fewer sexual problems. However, several case reports have shown that CCBs have the potential to cause sexual dysfunction in both men and women. Specific effects include:
    • Decreased desire (in both men and women)
    • Decreased erectile rigidity, and in some cases impotence
    • Problems with ejaculation
    • Gynecomastia (breast enlargement in men)
    • Galactorrhea (abnormal discharge of milk from the nipple)

    How They May Cause Sexual Problems

    CCBs block calcium activity, which causes blood vessels to dilate and lowers blood pressure. The same mechanism that causes this decrease in blood vessel constriction can also decrease the contractions essential for penile rigidity and orgasmic sensation.
    Other possible mechanisms by which CCBs may affect sexual activity include:
      Decreasing dopamine activity, which can lead to an increase in prolactin. Increased prolactin can have the following effects:
      • Reduced sex drive
      • Impotence
      • Galactorrhea
      • Infertility
    • Blocking the actions of excitatory peptides that are involved in genital sensation
    Few sexual effects from CCBs have been reported in women with normal sexual functioning. However, for women who already have sexual difficulties, side effects of CCBs that indirectly affect sexual function may worsen the problem. For example, headache, flushing, swelling, bloating, dizziness, and weakness can dampen sexual desire and response for many women.

    Treatment Options

    Wait It Out

    As you adjust to your new medicine, the sexual side effects may go away.

    Change the Drug or Dose

    There are many CCBs, and some may be more likely to affect sexual function than others.
    Ask your doctor if you should try a different CCB. You might also discuss the option of lowering the dosage with your doctor. Never change the dose or stop taking your medicine without guidance from your doctor.

    Switch Medications

    Depending on your condition, there may be other medicines that can manage your medical symptoms without affecting sexual function. For example, ACE inhibitors can sometimes be used in place of CCBs.

    Try an Antidote

    This involves maintaining your current level of CCB while adding a second medicine to offset the sexual side effects. This option is generally less desirable since antidotes frequently have their own side effects and may adversely interact with the primary medicine you are taking. Drugs that may be prescribed as antidotes include:
    • Sildenafil (Viagra)—This medicine is prescribed to men who have erectile dysfunction.
    • Bupropion (Wellbutrin)—This is an antidepressant that is sometimes prescribed to help correct sexual problems.

    Consider Herbal Supplements

    The efficacy of herbal supplements to treat the sexual side effects of CCBs is not clear. Care should also be taken with herbal products because, unlike medicines, they are not strictly regulated. It is very important to talk to your doctor before using herbal supplements. Yohimbine, a supplement sometimes used to treat sexual side effects, should not be used by people with high blood pressure or those who are taking medicines such as CCBs for high blood pressure.

    RESOURCES

    American Heart Association http://www.heart.org/

    National Institutes of Health http://www.nih.gov/

    CANADIAN RESOURCES

    Canadian Urological Association http://www.cua.org/

    SexualityandU.ca http://www.sexualityandu.ca/

    References

    Bupropion. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated April 11, 2011. Accessed August 1, 2012.

    Crenshaw TL. Sexual Pharmacology: Drugs That Affect Sexual Function. WW Norton & Company; 1996.

    Dusing R. Sexual dysfunction in male patients with hypertension: influence of antihypertensive drugs. Drugs. 2005;65(6):773-86.

    Grimm RH Jr, Grandits GA, Prineas RJ, et al. 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) Hypertension. 1997;29(1 Pt 1):8-14.

    Hyperprolactinemia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 5, 2012. Accessed August 11, 2012.

    Mosenkis A, Townsend R. Gynecomastia and antihypertensive therapy. J Clin Hypertens. 2004;6(8):469-70.

    Pena K, Rosenfeld J. Evaluation and treatment of galactorrhea. Am Fam Physician. 2001;63(9):1763-1771.

    Sildenafil. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated April 11, 2011. Accessed August 1, 2012.

    Tanner LA, Bosco LA. Gynecomastia associated with calcium channel blocker therapy. Arch Intern Med. 1988 Feb;148(2):379-80.

    Yohimbe. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated August 2011. Accessed August 11, 2012.

    Revision Information

  • Join WellZones today.

    Make a Change For LifeLearn more

    Wellmont LiveWell is creating a new tradition of wellness in the mountains by providing individuals with tools and encouragement to live healthier lifestyles.

  • HeartSHAPE Spotlight

    At risk for a heart attack? Learn more

    Fight heart disease early and prevent heart attacks with HeartSHAPE® - a painless, non-invasive test that takes pictures of your heart to scan for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.


  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.