The prevalence and clinical relevance of sexual dysfunction in women and men with chronic heart failure

Abstract

Sexual dysfunction is a common problem of increasing incidence that is associated with multiple co-morbid conditions and chronic diseases. In heart failure, however, exact numbers are unknown, in part secondary to under-reporting and under-interrogating by health care providers. A genderspecific questionnaire was modified from established sexual dysfunction questionnaires to correspond to a non-randomized outpatient heart failure population, to assess the prevalence and demographic distribution of sexual dysfunction and potential treatments expectations. Onehundred patients in a stable hemodynamic condition in New York Heart Association classes I-III participated. Eighty-seven percent of women were diagnosed with female sexual dysfunction compared to 84% of men with erectile dysfunction. Eighty percent of women reported reduced lubrication, which resulted in frequent unsuccessful intercourse in 76%. Thirty-six percent of patients thought that sexual activity could harm their current cardiac condition; 75% of females and 60% of men stated that no physicians ever asked about potential sexual problems. Fifty-two percent of men considered sexual activity in their current condition as an essential aspect of quality of life and 61% were interested in treatment to improve sexual function. Sexual dysfunction appears to be high in prevalence in both men and women with chronic compensated heart failure and represents a reduction in quality of life for most. Despite the fact that most patients are interested in receiving therapy to improve sexual dysfunction, treatment options are rarely discussed or initiated.

Cardiac Rehabilitation Staff Views about Discussing Sexual Issues with Coronary Heart Disease Patients: A National Survey in Ireland

“…Individuals with heart disease may hold negative perceptions of their bodies as being fragile and develop a negative relationship with their body [4]. While exact incident rates of sexual dysfunction are difficult to ascertain due to under reporting and a lack of investigation by health service providers [7,8], it is important to understand the issues of sexual dysfunction in patients with underlying cardiovascular disease [4,9]. Internationally the prevalence of patients with CHD continues to rise due to improvements in prognosis, reduction in population risk factors, improved treatment, changes in health behaviours and lifestyles and an increase in the age of the population [3,4,10].…”

Sexual Behavior, Function and Satisfaction in Headache Associated with Sexual Activity: A Systematic Review of Literature

“…If so, our results may be challenged invalid as HSA patients may selectively report committing intercourse only with spouses or usual partners but not extradyadic ones to protect their dyadic relationship. Indeed, sexuality is an embarrassing topic in consultation although patients generally hope to get more information about the impact of sexual activity on their health [56]. Nevertheless, these challenges are merely speculated unless more objective evidence can be raised to support them.…”

Sexual function of patients with heart failure: facts and numbers

“…But ED is reported in up to 81% of cardiac patients14 across different cultures and ethnic groups 15. Although in most studies more male patients report sexual problems, also women with cardiac disease are known to have more frequent sexual problems compared with women in the general population 16, 17. Women may experience other types of sexual dysfunction than men, including decline in sexual interest or desire, decline in sexual arousal, orgasmic disorder, or painful sexual intercourse 17.…”

“…Furthermore, the use of beta blockers can reduce sexual function;8, 23 however, data on third generation beta blockers currently used for HF treatment are inconsistent 23. HF patients have even reported an improvement of sexual performance with beta blockers, which is likely to be a result of both a reduction of HF severity and the ancillary properties of some of the third generation beta blockers 17. In addition, a nocebo effect, in which a patient's knowledge that a drug has been associated with ED, is often at least as important a contributing factor to a patient's ED as any physiological effect, particularly with contemporary blockers 8.…”