[Medical management of libido disturbances in treated hypertensive patients: differences between men and women].
Decrease in sexual desire is a disturbance affecting treated hypertensive subjects of both sexes. In contrast with erection problems, this abnormality has rarely been studied in hypertensives treated with antihypertensive drugs.


OBJECTIVE
To evaluate, using a self-administered questionnaire, the prevalence of sexual disturbance (decrease in sexual desire) in treated hypertensive subjects and to determine the management of these troubles.


METHODS
In 428 hypertensive subjects, living in France and referred to hypertension specialists, a self-administered questionnaire evaluating the quality of sexual activity was given before the consultation. Nine specific questions focused on the quality of sexual function for the last 6 months in men or women (interest for sexuality, sexual desire, sexual pleasure). Secondly, the doctors were questioned about their management of these sexual disturbances.


RESULTS
In this population of treated hypertensives, including 270 men and 158 women, with a blood pressure level of 139 +/- 20/84 +/- 13 mmHg, a decrease in sexual desire was reported by 47% of men (127/270) and 48% of women (76/158). Sexual disturbance was related to antihypertensive drugs in 46% of cases (93/203), more often in men (59% [75/127]) than in women (24%, [18/76]), p < 0.001). In subjects with sexual disturbance, a specific medical management has been proposed in 35% of cases (71/203), especially in men (in 46% of cases [58/127], and consisted in a specialized consultation for 34% (43/127) and/or the prescription of Sildenafil for 20% (26/127). In women, the lack of management of these troubles was more often observed than in men (82% vs 54%; p < 0.01). Modifications of antihypertensive treatments were rarely observed in 15% of cases (30/203) comparatively in men and women.


CONCLUSIONS
Men and women with treated hypertension are at "high risk" of sexual disturbance. Management of sexual dysfunction in these subjects concerns only 35% of cases, especially men, including specific treatments and/or consultations, but changing in antihypertensive drugs still remains rare.
Girerd
X
X
Service d'endocrinologie métabolisme, hôpital Pitié-Salpêtrière, 83, bd de l'Hôpital, 75013 Paris. xavier.girerd@psl.ap-hop-paris.fr
Mounier-Vehier
C
C
Fauvel
J P
JP
Marquand
A
A
Babici
D
D
Hanon
O
O
D000368:Aged; D000959:Antihypertensive Agents / Q000009:adverse effects*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007989:Libido / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D012735:Sexual Dysfunction, Physiological / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy
D000959:Antihypertensive Agents