Physical Exercise in the Management of Erectile Dysfunction in Patients with Heart Failure

Abstract

Erectile dysfunction (ED) is a highly prevalent problem that affects the quality of life, prognosis and survival of patients with heart failure (HF). In the management of ED, physical exercise is a therapeutic strategy that reduces disease-related symptoms and optimizes drug use. However, the repercussions of physical exercise on ED in individuals with HF still need to be elucidated. In this sense, the objective of this study was to evaluate the effects of physical exercise on erectile function (EF) in HF patients. This was a systematic review conducted according to PRISMA guidelines. Patients with HF, male and ejection fraction ≤ 45% were submitted to physical exercise of different modalities. The search for scientific articles was conducted in the electronic databases (PubMed, LILACS, Cochrane-Library, Science Direct) from the inception until October 2018, according to the MeSH dictionary descriptors, which were suitable for all databases. Results: Three studies were analyzed, includinng 99 male subjects, age ranging from 53 years (± 7.48) to 58 years (± 12). Seventy subjects were submitted to a physical exercise program and 29 were in the control group. In all studies, physical exercise showed positive results in the management of ED regardless of erectile dysfunction (ED) classification status and intensity of exercise used. It was concluded that physical exercise of different intensities was considered an effective therapeutic intervention to improve EF in individuals with HF and ED. Recently, it has been demonstrated that men with HF, younger than 66 years, monogamous, with ejection fraction below 35% are the individuals who report more difficulties in sexual life. 12,14 ED is defined and characterized as the inability to reach out and maintain the erection of the penis for enough time to allow

Acceptability of Health Professionals’ Address of Sexuality and Erectile Dysfunction - A Qualitative Interview Study with Men in Cardiac Rehabilitation

“…These findings are interesting as i-PAVED is intended as a potential motivator for men to increase their level of physical activity and thereby improve their lifestyle and overall cardiovascular health. [5][6][7] The results can be useful in designing the i-PAVED component by presenting the men's perspectives (Figure 3) A previous study used acceptability as an important criterion in implementation of an intervention focusing on sexual health for patients with cardiovascular diseases. 64…”

“…4 Acceptability is a multi-faceted construct that reflects to which extent people receiving a health care intervention consider the intervention to be appropriate. 1 This study is part of a project developing the complex intervention: Regular aerobe Physical Activity to reduce Vascular Erectile Dysfunction (PAVED), [5][6][7] which implies that health professionals (HPs) address sensitive issues such as sexuality and erectile dysfunction (ED). 5,7,8 The intervention PAVED consists of two main interacting components (Figure 1).…”

“…5,7 The other is men's action being performance of aerobe physical activity to enable the desired physiological effect: reduced vascular ED. [5][6][7] Regular aerobe physical activity is currently a core intervention in cardiovascular secondary prevention and rehabilitation. 9 The focus of this pre-intervention study is the communicative component, i-PAVED, and not on adherence to the core intervention of regular physical activity.…”

“…20,21 ED is defined as the inability to attain or maintain a penile erection of sufficient quality to perform satisfactory sexual activity, 22,23 and is currently one of the most common sexual dysfunctions for men worldwide. 5,6 Studies show that ED negatively affects men's self-esteem, sex life and quality of life. [5][6][7]24 ED is frequently symptomatic of underlying endothelia dysfunction and arteriosclerosis, 5,7,25 and among health-related lifestyle factors, a physically inactivity lifestyle is the most important risk factor for vascular ED.…”

“…5,6 Studies show that ED negatively affects men's self-esteem, sex life and quality of life. [5][6][7]24 ED is frequently symptomatic of underlying endothelia dysfunction and arteriosclerosis, 5,7,25 and among health-related lifestyle factors, a physically inactivity lifestyle is the most important risk factor for vascular ED. 26 Physical inactivity, obesity, hypertension, metabolic syndrome and cardiovascular diseases are recognised as independent risk factors for vascular ED.…”