Hypertension, that is, high blood pressure, is a non-communicable disease that has increased in prevalence all over the world due to lifestyle factors. Its ill effects on the heart, kidneys, eyes, and other targeted organs are well known, but few people are aware of its adverse effects on reproductive health as well.

ALSO READ: Community health workers to start screening high blood pressure

Previously thought to be a disease of the middle-aged and elderly, it is now being detected in younger people as well, that is, people who are in the reproductive age group and plan to start a family. It reduces blood flow to the reproductive organs, affecting both men and women, in various ways.

ALSO READ: Gestational hypertension; what you should know

In women, hypertension can impair blood flow to the ovaries and uterus, thus affecting egg quality and the environment of the uterus for implantation. It can disrupt hormones crucial for ovulation, resulting in irregular menstrual cycles, which can cause difficulty in conceiving. Studies have shown that women are at a greater risk of developing sterility due to hypertension. Even if a woman becomes pregnant, despite high blood pressure, the risk of developing disorders like pre-eclampsia and eclampsia, which occur due to high blood pressure, is significantly enhanced.

ALSO READ: Women and hypertension: Understanding the risks, taking control

These can lead to complications like placental abruption, intrauterine growth retardation, and even death or pre-term birth. At times, blood pressure increases during pregnancy and is detected when such a problem develops. Some drugs like ACE inhibitors (for example, enalapril and ramipril) can cause severe adverse effects during pregnancy, particularly after the first trimester.

These include poor foetal development, low blood pressure, developmental defects, and kidney problems in the foetus. Antihypertensive drugs like beta-blockers can reduce blood supply to the uterus and damage the vessels. This reduces fertility and can cause disruptions, even when a woman conceives.

In men, hypertension is one of the causes of erectile dysfunction. Some of the medicines used to treat hypertension also cause erectile dysfunction, like thiazide diuretics (water pills) and beta-blockers. Reduced blood flow to the testes due to hypertension can affect sperm health, leading to lower sperm count, lower sperm volume, reduced sperm motility, and abnormal sperm structure. All these factors hinder fertility. Moreover, if high blood pressure is due to abnormal functioning of the thyroid gland, it is an additional factor affecting the ability to have a baby.

Therefore, both men and women need to get their blood pressure checked before planning to conceive, particularly if there is a strong family history of hypertension. If blood pressure is high, it needs to be controlled via lifestyle factors and regular medication. Lifestyle factors include a diet low in salt and fats, avoiding alcohol and tobacco, excess of tea, coffee, and taking plenty of fresh fruits and vegetables, nuts, whole grains, and healthy meat products like fish. Doing regular physical exercise or staying active is beneficial.

Meditation and breathing exercises done regularly help in adequate relaxation and becoming stress-free. If overweight or even underweight, the person should adopt measures to achieve and maintain a normal body weight. If on anti-hypertensive medicines, a person should be compliant in taking them regularly. Those taking medicines like steroids or some anti-cold medicines containing epinephrine or pseudo epinephrine, regularly or frequently, should avoid these medicines if not necessary. Because, if taken for a long time, these medicines can increase blood pressure.

If someone in the reproductive age group has been diagnosed with high blood pressure recently, they should discuss with their healthcare provider regarding their plans of starting a family. Medicines and blood pressure monitoring should be planned accordingly. Even after getting pregnant, a woman should be careful to take medicines as prescribed and get her blood pressure checked regularly.

High blood pressure should not be a hindrance to conceiving and delivering a healthy, full-term baby.

Dr Rachna Pande is a specialist in internal medicine.