Lisinopril sexual side effects
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Lisinopril and Sexual Side Effects: A Comprehensive Overview
Introduction to Lisinopril and Sexual Function
Lisinopril, an angiotensin-converting enzyme (ACE) inhibitor, is commonly prescribed to manage hypertension. However, like many medications, it can have side effects, including those affecting sexual function. This article synthesizes findings from multiple studies to provide a clear understanding of lisinopril's impact on sexual health.
Temporary Decline in Sexual Activity
Initial Impact on Sexual Intercourse Frequency
Research indicates that lisinopril can cause a temporary decline in sexual activity. In a study involving 90 hypertensive men aged 40 to 49, participants experienced a significant reduction in the number of sexual intercourse episodes per month during the first month of lisinopril therapy (from 7.1 to 5.0 episodes per month)1. This initial decline is noteworthy but appears to be temporary.
Recovery Over Time
Interestingly, the same study found that sexual activity tended to recover with continued lisinopril treatment. By the end of the 16-week period, the frequency of sexual intercourse episodes in the lisinopril group returned to levels comparable to the placebo group (7.7 episodes per month)1. This suggests that while lisinopril may initially impact sexual function, the effect diminishes over time.
Comparison with Other Antihypertensive Medications
Lisinopril vs. Atenolol
When compared to atenolol, another antihypertensive medication, lisinopril shows a more favorable profile regarding sexual side effects. The same study highlighted that the percentage of patients reporting sexual dysfunction was significantly higher in the atenolol group (17%) compared to the lisinopril group (3%)1. This indicates that lisinopril is less likely to cause chronic sexual dysfunction than atenolol.
Broader Comparison with Other Medications
Further research involving 240 hypertensive patients compared the effects of six different antihypertensive medications on sexual function. This study found that while medications like betaxolol, hydrochlorothiazide, and SR nifedipine had significant negative effects on sexual function, lisinopril did not show any notable adverse effects2. This positions lisinopril as a relatively safer option concerning sexual health among antihypertensive drugs.
Conclusion
In summary, while lisinopril may cause a temporary decline in sexual activity during the initial phase of treatment, this effect tends to subside with continued use. Compared to other antihypertensive medications, lisinopril has a more favorable profile, with fewer reports of chronic sexual dysfunction. For patients concerned about the sexual side effects of hypertension treatment, lisinopril appears to be a viable option with minimal long-term impact on sexual function.
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Most relevant research papers on this topic
Sexual function in hypertensive males treated with lisinopril or atenolol: a cross-over study.
Atenolol causes a chronic worsening of sexual activity, while lisinopril causes only a temporary decline in sexual activity in hypertensive males.
RCT
Highly CitedThe Effect of the Anti-Hypertensive Medications on the Man's Sexual Function
Anti-hypertensive medications can negatively affect men's sexual function, while Valsartan improves it, while Lisinopril and Urapidil have no notable side effects.
RCTLisinopril decreases plasma free testosterone in male hypertensive patients and increases sex hormone binding globulin in female hypertensive patients.
Lisinopril decreases free testosterone in male hypertensive patients and increases sex hormone binding globulin in female hypertensive patients.
Non-RCTAntihypertensive effectiveness of low-dose lisinopril-hydrochlorothiazide combination. A large multicenter study. Lisinopril-Hydrochlorothiazide Group.
Low-dose lisinopril-hydrochlorothiazide combination effectively reduces blood pressure and is well-tolerated, with the best results achieved with L/H12.5 and L/H25.
RCTFemale preponderance for lisinopril-induced cough in hypertension.
Lisinopril-induced cough is more common in women than men, and nonsmokers report increased cough more often than smokers.
RCT
Large Human TrialHighly CitedEffect of lisinopril on progression of retinopathy in normotensive people with type 1 diabetes
Lisinopril may slow retinopathy progression in non-hypertensive patients with type 1 diabetes and little or no nephropathy.
RCTLarge Human TrialHighly CitedLisinopril attenuates acute hypoxic pulmonary vasoconstriction in humans.
Lisinopril significantly reduces the pulmonary pressor response to hypoxemia without decreasing baseline mean arterial pressure or total pulmonary vascular resistance, suggesting it may be a useful adjunctive treatment for hypoxemic pulmonary hypertension.
RCTSustained improvement of renal graft function for two years in hypertensive renal transplant recipients treated with nifedipine as compared to lisinopril.
Nifedipine improves kidney transplant function more effectively than lisinopril over a 2-year period in hypertensive renal transplant patients treated with cyclosporin.
RCTHighly CitedLisinopril versus lisinopril plus hydrochlorothiazide in essential hypertension.
Lisinopril alone or combined with hydrochlorothiazide effectively lowers blood pressure in patients with essential hypertension without major side effects.
RCTEfficacy and variability of the antiproteinuric effect of ACE inhibition by lisinopril.
The ACE inhibitor lisinopril effectively reduces proteinuria, with a dose and time-related effect, and is strongly dependent on dietary sodium restriction, making it comparable to indomethacin with fewer adverse effects.
Non-RCTHighly Cited