Updated July 08, 2014.

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

There are many different classes of blood pressure medications, each working in a slightly different way to help lower your blood pressure. Side effects commonly most commonly mentioned include low blood pressure, dizziness, lightheadedness, and orthostatic hypotension. These are side effects that especially in the elderly population, can be life-altering (i.e., a fall with resultant fracture is a common worry).

Yet there are other side effects that may not be as potentially life threatening as a fall but can dramatically affect your quality of life. Blood pressure meds can affect sexual desire and sexual performance in some people. Not  just blood pressure medications, but many different types of medications can affect your sexual health. When you look at how many kinds of medications an individual takes, this side effect can be increased exponentially. This is why you first need to review all of your medications if you are experiencing this issue.  

Sexual health is vitality, it is an important component of what makes us complete not only as individuals but in maintaining a healthy relationship. If you were to look at the Physician's Desk Reference (PDR), which contains encyclopedic information about all prescription medications, you may effects concerning decreasing sexual arousal/desire and or side effects concerning sexual performance. The side effects listed in a PDR do not mean that an individual will experience EVERY side effect, it lists possible ones that may pertain to your own situation.

Which classes of blood pressure medications can affect sexual health?

*Beta- Blockers: This is  a class of medications for whom major side effects can include depression and decreased sexual desire and performance for some people. In general, doctors and health professionals will not, unless absolutely necessary, prescribe this medication to younger people. With the new high blood pressure guidelines, beta blockers are not considered first line for those with high blood pressure. What "groups" do we prescribe these medications for? Those with congestive heart failure (usually systolic CHF) and those who have had a myocardial infarction (heart attack or MI) as these medications have been shown to improve survival. 

*Diuretics: These medications can help with blood pressure and reduce swelling (or edema). They can also have sexual side effects. Hydrochlorothiazide (HCTZ) and other thiazide diuretics can be a culprit. Aldactone (Spironolactone) is a very commonly prescribed medication because it is very good at lowering blood pressure. It also can affect sexual health and performance as well. 

* Clonidine: This is a medication that is used for difficult to treat blood pressure, i.e., when you have been on a bunch of other medications and nothing else has worked. This can have side effects of depression, lethargy and decreased sexual desire and performance in certain individuals. 

* Because we are all different, any medication has the potential to cause this issue. If you are prescribed a new medication and experience this side effect, speak with your doctor to see if the newly prescribed medication is the culprit. 

Here are some important take home points from this post:

1) Loss of sexual desire and/or performance capability does not mean that your partner is not interested in you. There are other medical reasons that require further investigation, one of the first things is to review all of your medications with your doctor. Sometimes all that it requires is eliminating one medication or changing to another medication in its class. If you have a history of CHF, this requires shared-decision making with you and your doctor as s/he will likely say that  you should be on beta blockers for your heart as well ACE inhibitors/ARBs. Your counter argument to that would be, "What kind of life is if if I cannot make love to my husband/wife/partner/significant other?''  This can facilitates a very nice discussion.

2) Be aware of other medical conditions for which you are taking medications that can affect your sexual health. Diabetes can affect your sexual health and performance as can hypothyroidism. These are two conditions that your provider will likely want to evaluate you for.