Sexual Health and Hypertension

Sexual health and several reproductive disorders have been associated with hypertension and cardiovascular risk. Erectile dysfunction has been extensively studied both as a cardiovascular risk factor and consequence of hypertension or its treatment. On the contrary, women’s sexual health in hypertension or cardiovascular disease has received much less attention. High rates of sexual dysfunction have been detected in women evaluated, and this dysfunction affected all domains of sexual life. In addition, male hypogonadism has been associated with higher cardiometabolic risk, but the benefits of hormone replacement therapy are still controversial. Finally, perimenopause has been associated with higher rates of hypertension and cardiovascular disease, an association, though, that has been difficult to discern from aging. In addition, the cardiovascular benefits of hormone replacement therapy are still debated. The pathophysiologic link between sexual and reproductive disorders and cardiometabolic disease may involve inflammation, oxidative stress, the renin-angiotensin system, and endothelial dysfunction. The association of oral contraceptives with hypertension has been known for decades, mainly driven by their estrogen content. Therefore, in women at risk, progestogen-only contraceptives would be preferred in hypertensive women. The association of oral contraceptives with disturbed sexual life has been controversial.