Background: Sexual dysfunction affects millions of people with an increasing prevalence,
worldwide. The pathophysiology of the disease shares several similarities with cardiovascular disease
(CVD), including atherosclerosis, endothelial dysfunction, structural vascular damage and subclinical
inflammation. Erectile dysfunction (ED) and female sexual dysfunction are common among patients
with CVD and risk factors such as hypertension, diabetes, obesity and metabolic syndrome. Given the
common pathogenesis of the diseases, ED is an independent prognostic factor of future ED events. Patients
with overt ED or risk factors are usually treated with several drugs for the management of these
conditions. Several of these drugs have been evaluated for their effect on sexual activity.
Results and Conclusion: Among the antihypertensive drugs, diuretics and beta-blockers seem to exert a
detrimental impact on sexual function, with nebivolol being the only beta-blocker with favorable properties
through an increase in nitric oxide bioavailability. In contrast, renin-angiotensin system inhibitors
and calcium-channel blockers have a neutral effect on sexual activity. Hypoglycemic drugs have been
less evaluated in the ED setting, with metformin, pioglitazone and liraglutide presenting favorable results.
Statins on the other hand have not provided consistent results with observational studies suggesting
a detrimental role in sexual activity and a few randomized studies indicating a neutral or even beneficial
effect on erectile function.