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15 July 2009
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Beta blockers and impotence

My husband, 54, has had angina since he was 50 but it has got worse lately and the doctor has put him on drugs called beta blockers. Since he has been taking them our sex life hasn't been the same. I know he's worried about the angina, but could the heart drugs be affecting him, too?

Mary

Dr Trisha Macnair responds

Dr Trisha MacnairBeta blockers can cause impotence, although it's not a very common side-effect of these types of drugs. It's important your husband doesn't just stop taking the beta blockers, because there's a risk his angina will get worse if he comes off them too quickly .

Instead, he should explain to his doctor he may be having problems. The doctor should be able to work out the cause and, if necessary, change your husband's medication. There are a variety of other drugs he could take for angina instead of beta blockers, or his doctor may suggest trying a different type as they have subtly different effects.

Problems with sex

Many men (and women, too) find that they have problems with sex after a heart attack, or a diagnosis of angina (chest pain caused by clogging up of the coronary arteries and an inadequate supply of blood and oxygen to the muscle of the heart). In particular, men may find they can no longer get an erection as easily as before.

Psychological problems

For quite a few men the problem is psychological, induced by a fear that exertion or physical activity will bring on a heart attack. This may be a factor in your husband's case, and it's very hard to overcome this worry. But if the angina is well controlled by medication, there should be no higher risk than the next person.

Physical problems

There may be physical reasons why a man with heart disease becomes impotent. If he has severe coronary artery disease, he may also have arterial disease elsewhere, which can interfere with achieving an erection. Drugs for blood pressure (including diuretics), antidepressants, tranquillisers and some ulcer drugs can also cause impotence.

Side-effects of beta blockers

Beta blockers cause other side-effects, such as:

  • Heart failure
  • Wheezing and asthma
  • Tiredness and fatigue
  • Constriction of blood vessels causing cold hands and feet
  • Masking the symptoms of a low blood sugar in diabetes
  • Depression
  • Nausea
  • Nightmares

This article was last medically reviewed by Dr Trisha Macnair in November 2007

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In Lifestyle

Heart disease: drugs and surgery
Impotence

Elsewhere on bbc.co.uk

Radio 4: Check Up
The human body

Elsewhere on the web

NHS Choices: angina
British Heart Foundation: coronary heart disease
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