Duncan L, Bateman D N
Regional Drug and Therapeutics Centre, Wolfson Unit, Newcastle upon Tyne, England.
Drug Saf. 1993 Mar;8(3):225-34. doi: 10.2165/00002018-199308030-00004.
Drug-induced sexual dysfunction is well known to occur with antihypertensive drugs in men. There are much less data on the effects of drugs on female sexual function. The physiology of the female sexual response has similarities to that of the male sexual response and there are therefore good reasons for suspecting that antihypertensive drugs are likely to adversely affect sexual function in women. Present evidence suggests that clonidine, methyldopa, guanethidine and reserpine are associated with adverse effects on sexual function. In healthy volunteers, labetalol appears to reduce vaginal lubrication, but there are no studies in patients receiving the drug therapeutically. Thiazide diuretics may be associated with the worsening of sexual problems, which interestingly appear to be ameliorated by weight reduction. Present evidence on the effects of vasodilators is limited but the evidence suggests that sexual function in women receiving calcium antagonists is not altered by changing to an angiotensin converting enzyme (ACE) inhibitor. Although present evidence suggests that effects on female sexual function may not be very great, it should be recognised that there are very few data in this area. Further work is clearly necessary.
药物引起的性功能障碍在男性中与抗高血压药物一同出现是众所周知的。关于药物对女性性功能影响的数据则少得多。女性性反应的生理机制与男性性反应有相似之处，因此有充分理由怀疑抗高血压药物可能会对女性性功能产生不利影响。目前的证据表明，可乐定、甲基多巴、胍乙啶和利血平与性功能的不良反应有关。在健康志愿者中，拉贝洛尔似乎会减少阴道润滑，但尚无针对接受该药物治疗的患者的研究。噻嗪类利尿剂可能与性问题的恶化有关，有趣的是，体重减轻似乎可以改善这些问题。目前关于血管扩张剂作用的证据有限，但有证据表明，改用血管紧张素转换酶（ACE）抑制剂不会改变服用钙拮抗剂的女性的性功能。尽管目前的证据表明对女性性功能的影响可能不是很大，但应该认识到这一领域的数据非常少。显然有必要开展进一步的研究。
