Sexual function of patients with heart failure: facts and numbers

Abstract

Approximately 60% to 87% of patients with heart failure (HF) report sexual problems, and numbers as low as 31% of HF patients younger than 70 have normal sexual function. When compared with healthy elders, the amount of perceived sexual dysfunction might be similar (around 56%), but patients with HF are reporting more erectile dysfunction (ED) and also perceive that their HF symptoms (20%) or HF medication (10%) is the cause for their problems. The prevalence of ED is highly prevalent in men with cardiac disease and reported in up to 81% of cardiac patients, compared with 50% in the general older population. In total 25–76% of women with HF report sexual problems or concerns.The physical effort related to sexual activity in cardiac patients can be compared to mild to moderate physical activity. The related energy expenditure of sexual activity falls in the range of three to five metabolic units (METs), which can be compared to the energy needed to climb three flights of stairs, general housework, or gardening.Information about sexual activity is often overlooked by health care professionals treating HF patients. Advice and counselling about this subject are needed to decrease worries of patients and partners, avoid skipping medication because of fear for side effects, or prevent inappropriate use of potency enhancing drugs or herbs.

Figures of the Heart Failure Association (HFA): Prof. Dr. Tiny Jaarsma, HFA Board Member (2018–2020), Coordinator Patient Care: Management and Delivery Committee and Co‐Chair HFA Task Force on Palliative Care

“…I have had the honour to be in the first HFA board lead by Prof. Brutsaert and since that time the HFA has grown stronger and been leading important developments in the field. For example, guidance documents that influence practice have been developed, facts and numbers that help us to form adequate research questions and curricula that help clinicians to deliver high quality care are made available. The nurse curriculum has been developed and was also updated .…”

The Impact of Self-Efficacy and Depression on Self-Care in Patients with Heart Failure: An Integrative Review

“…As only one of the studies dealt with sexual self-efficacy, it was not possible to draw any definite conclusions regarding the relationship between sexual self-efficacy and depression. This issue needs urgent further exploration, as sexual dysfunction has been reported in 60% -87% of the patients with HF [65]. Furthermore, reliance upon the BDI [50], which includes a number of symptoms (e.g., sexual incompetence and fatigue) common to both HF and depression, may have contributed to inaccuracies regarding the measurement of depression.…”

Metabolic disorders in heart failure and cancer

“…13 Newer research has shown that oncometabolites, secreted by tumours, can also cause cardiovascular dysfunction independent of cardiotoxic effects of anti-cancer treatments, 14,15 but much more research is needed is this area. So far, a lot of research has focused on anaemia, 40 52,53 Newer research in heart failure and cancer also focuses on the understanding and more importantly, on how to treat anorexia, 54,55 cachexia, 56,57 and sarcopenia. 18-20 Vice versa it is currently unclear whether heart failure itself can cause cancer.…”

“…So far, a lot of research has focused on anaemia, 40,41 iron deficiency, 42,43 kidney disease, 44,45 chronic obstructive pulmonary disease, 46,47 sleep apnoea, 48,49 liver dysfunction, 50,51 and sexual dysfunction. 52,53 Newer research in heart failure and cancer also focuses on the understanding and more importantly, on how to treat anorexia, 54,55 cachexia, 56,57 and sarcopenia. 58,59 These rather new areas of research are a common problem in chronic diseases, gaining growing attention from the scientific community.…”