Sexual Function and Psychological Status among Males and Females with Ischemic Heart Disease

Abstract

Introduction Patients with coronary artery disease (CAD) may also suffer from mental and sexual problems, and we should consider the mutual influence such conditions have on each other. However, the interrelation between sexual and mental problems in the context of CAD has not been fully investigated, especially when it comes to gender. Aim Our aim was to evaluate sexuality and psychiatric symptoms among patients with CAD and the relation between them in each gender. Methods In this cross-sectional study, 550 (397 men and 153 women) patients with documented CAD were surveyed for anxiety and depression using the hospital anxiety and depression scale (HADS) self-administered questionnaire as well as the relation and sexuality scale (RSS). Three subscores were calculated for sexual function, frequency, and fear, with higher scores indicative of a poorer condition. Main Outcome Measures The HADS and the RSS. Results Depressive symptoms and anxiety were more severe among our female subjects than they were among the male ones. In addition, the scores for sexual frequency, sexual function, and the total RSS were significantly higher in women, while men had a significantly higher score for sexual fear. The total RSS score correlated with depressive symptoms in women (r = 0.19, P = 0.03), but not in the male subjects. Considering the subscores, a higher score for sexual frequency correlated with depressive symptoms in both genders; however, being afraid of sexual relation correlated with depressive symptoms only in men with CAD and their spouses (r = 0.18, P = 0.001). Conclusion We found that women with CAD have poorer sexual relation and more severe depressive symptoms than men do. Among men with CAD and their wives, fear of sexual relationship is a more serious problem. Such gender-specific characteristics and their interrelations ought to receive due consideration in the management of CAD.

Sexual dysfunction and cardiovascular diseases: a systematic review of prevalence

“…The rates of SD increased to 34.8%, 21.5% and 20.1%, respectively, 12 weeks after MI. Finally, in 2007, Kazemi et al (28) examined sexual activity and psychiatric symptoms among patients with CAD and the relationships between these variables for each gender in 550 married patients with CAD (397 men and 153 females; average age = 57 years). The data revealed that 45.8% of women with CAD showed anxiety symptoms and that 20.3% suffered from depression.…”

“…In women, this process occurs during menopause and can cause various sexual problems (21). Depression is an important risk factor for SD, as this condition may compromise sexual desire, and unsatisfying sexual performance is related to depression (20,23,24,28). In the absence of sexual desire, sexual fantasies are rare or fleeting sexual stimuli and may not occur efficiently, preventing completion of the sexual response cycle (2).…”

“…Fear of sexual intercourse, a mental factor in the context of CAD, is comorbid with decreased desire, satisfaction and sexual frequency among male and female patients (23,24,28). After the onset of CVD, SD might be due to apprehension regarding sexual activity.…”

Ansiedade e depressao entre homens e mulheres submetidos a intervencao coronaria percutanea

“…Studies indicate that symptoms of anxiety and depression are more severe in women with CAD compared with men (9)(10) . The results, however, are inconclusive.…”

PHACTR1 and SLC22A3 gene polymorphisms are associated with reduced coronary artery disease risk in the male Chinese Han population

“…The annual mortality rate due to ischemic heart disease is currently 5% among males and 3.65% among females [4]. Several studies have identified gender differences in CAD susceptibility that likely account for the higher mortality rate among males [5, 6]. …”