When your heart pumps blood through your arteries, the blood puts a certain amount of pressure on the walls of your arteries. Hypertension (high blood pressure) happens when your blood puts too much pressure on your artery walls.

Hypertension can affect fertility and sexual health in all genders and can be an important risk factor to manage for a healthy pregnancy. Keep reading to learn about how hypertension can affect fertility and what you can do to treat it.

Language matters

In this article, we use “female and male” to describe someone’s sex, and “women and men” to describe gender — unless quoting from sources using unspecified language.

Sex is determined by chromosomes, and gender is a social construct that can vary between time periods and cultures. Both of these aspects are acknowledged to exist on a spectrum both historically and by modern scientific consensus.

Fertility is a complex issue, and people of any gender are able to become pregnant.

Hypertension is the most common chronic illness reported among men in the U.S., reported being about 30%. Hypertension can affect male fertility in several ways. A 2017 review of studies showed that men with hypertension may have erectile dysfunction and are more likely to have one or more semen abnormalities compared to men with standard blood pressure.

The study showed that men with hypertension may have:

Sperm health and quality are important for fertility because sperm need to swim through the female reproductive tract and fertilize the egg for a pregnancy to occur. The more abnormal or dysfunctional the sperm are, the less likely this is to occur, and therefore the likelihood of a conception decreases.

On the other hand, some medications like steroids, testosterone, or other hormone therapies used in men cause or exacerbate hypertension, and affect sperm production, which can affect male fertility.

If you’re currently using medication to treat your hypertension and have any plans to conceive, make sure to discuss it with your doctor.

Erectile dysfunction is also currently considered an early marker for cardiovascular disease diagnoses, which is frequently diagnosed alongside hypertension.

How does hypertension affect infertility?

Studies show that hypertension can impair sexual health in all genders.

A 2020 study showed that hypertension appears to lead to an imbalance of hormones and changes in the network of blood vessels that carry blood to the gonads. In males, this network includes the testicular vein. In females, this includes the ovarian vein.

Females with high blood pressure may have more trouble conceiving. High blood pressure may be associated with high BMI, insulin resistance, smoking, and advanced age — all of which are also associated with decreased egg quality.

Egg quality is important for fertility because it can impact the quality of embryos produced, which in turn drives success rates for implantation as well as risk of miscarriage or pregnancy failure.

If you have hypertension, you may also have the following symptoms:

Researchers are divided over exactly how hypertension affects female fertility.

A 2015 study of 116,430 female nurses showed that most infertile women were at no greater risk of hypertension compared with women who did not report infertility. However, the study found that women who were infertile because their fallopian tubes were blocked or damaged were at higher risk of hypertension.

Hypertension during pregnancy

Hypertension is the most prevalent medical problem during pregnancy. It involves between 6% to 8% of all pregnancies and accounts for about 25% of all pre-birth hospital admissions. Some newer studies have also found an increased risk of hypertension in women that underwent more invasive assisted-reproductive procedures.

Hypertension is also associated with several significant pregnancy complications including:

If you have preeclampsia, you may also be at a higher risk to keep experiencing higher blood pressure after pregnancy. Make sure to discuss your schedule of check-ups and blood pressure monitoring with your doctor.

While studies are limited, hypertension does seem to be common in intersex individuals.

A 2020 study on the physical and mental health of intersex adults in the U.S. reported that over 43% of study participants rated their physical health as fair/poor and 53% reported their mental health as fair/poor. Health diagnoses included:

At the time of publication, no connection between hypertension and infertility could be found in intersex individuals, however, they may be at higher risk of hypertension because of their genetic makeup and their body’s natural hormone production.

Some intersex people may also be on hormone therapy, which can also increase the risk of hypertension and affect their fertility.

Infertility is often a concern this community deals with from an early age. If you’re an intersex person that’s trying to conceive, talk with your primary healthcare professional about the best way to support your goals.

How do you know if you have high blood pressure?

Blood pressure is measured using two numbers separated by a slash:

  1. The first number measures the pressure in your arteries when your heart is pumping. This is called systolic blood pressure.
  2. The second number measures the pressure in your arteries when your heart is resting. This is called diastolic blood pressure.

According to The Centers for Disease Control and Prevention, a normal blood pressure level is less than 120/80 mmHg. Following guidelines issued in 2017, your doctor will diagnose high blood pressure if your blood pressure is consistently 130/80 mmHg or higher.

Although it’s difficult to investigate whether hypertension itself or the medications used to treat hypertension impair fertility, research shows that medications used to treat hypertension may affect semen. Compared to men not taking medications, men taking medication for hypertension had a statistically significant decrease in semen volume and a trend toward a lower sperm count.

Men who were taking beta-blockers had a decreased volume, concentration, and mobility of sperm compared to men not taking medications. Beta-blockers are one of the most common medications prescribed for hypertension.

If you’re looking to conceive and have high blood pressure, regardless of your gender or sex, make sure to talk with your doctor. Many drugs treating hypertension have the potential to impact your fertility, and your doctor will know the best way to care for you and your future family.

Researchers are divided over whether there is a correlation between fertility treatment and hypertension in women. A 2015 study showed that there was no apparent increase in hypertension risk among infertile women or among women who had undergone fertility treatment in the past.

However, a more recent 2019 study found that hypertension disorders are somewhat more common in women receiving fertility treatments.

If you’re a woman or person assigned female at birth that’s taking fertility treatments, make sure to talk with your doctor about any blood pressure concerns you may have.

Erectile dysfunction also has a close connection with high blood pressure, and some drugs treating hypertension are known to cause ED. However, it’s currently believed to be safe for males with hypertension to take drugs to treat ED. If you’re living with both conditions, talk with your doctor about informed ways to treat them.

Certain health conditions and lifestyle choices can contribute to developing hypertension. Lifestyle adjustments can help you treat your hypertension and increase your chances of conceiving. Below is a list of possible choices:

  • Healthy diet. Try to increase your intake of whole grains, high fiber foods such as fruit and vegetables, legumes such as chickpeas, beans, lentils, and low fat dairy products. Reducing your intake of saturated fats that are found in commercial baked goods and fried foods can also help you.
  • Decrease your salt intake. High sodium consumption contributes to high blood pressure. Try to limit your intake of salt to 1 teaspoon (about 2,300 mg) a day.
  • Exercise. The American Heart Association (AHA) recommends at least 150 minutes of moderate-intensity, aerobic exercise every week, or 75 minutes of high intensity exercise every week.
  • Limit alcohol and don’t smoke. Limiting your intake of alcohol to 1 or 2 drinks a day can help reduce hypertension.
  • Manage stress. Yoga, meditation, and mindfulness can help lower your stress levels. Research shows that mindfulness is a very effective tool that can help you cope with the stress of infertility and fertility treatments.

Getting support

Undergoing fertility treatments can be overwhelming and stressful, even before you add living with hypertension as well. As just mentioned, looking after your mental health is an important part of treating both conditions.

Below is a list of organizations that can help you find the mental health resource that suits your needs.

Hypertension is a complex condition that can affect your fertility in a variety of ways. Medications that treat hypertension can also affect your fertility.

By speaking with your doctor and making lifestyle changes that suit you, you can address your hypertension and increase your chances of conceiving.