Skip to main content
SpringerLink
Log in

Discussing sexual function in the cardiology practice

  • Original Paper
  • Published:
Clinical Research in Cardiology Aims and scope Submit manuscript

Abstract

Background

In patients with cardiovascular disease, sexual dysfunction is frequently encountered. Erectile dysfunction shares the same modifiable risk factors as coronary artery disease and the fear of triggering cardiovascular events can create stress and anxiety impacting the sexual lives of patients and their partners. To optimise healthcare, knowledge of cardiologists’ attitude and practice patterns regarding the discussion about sexual function is essential.

Methods

A 31-itemed anonymous questionnaire was mailed to 980 members of the Netherlands Society of Cardiology (cardiologists and residents in cardiology training). The questionnaire addressed awareness, knowledge and practice patterns about sexual dysfunction in cardiac patients.

Results

Of the cardiologists 53.9 % responded. Sixteen percent stated to discuss sexual function regularly. In the past year, an estimated mean of 2 % of patients was referred for help with a sexual problem. The majority (70 %) of cardiologists advised patients never or seldom about resuming sexual activity after myocardial infarction. PDE5-inhibitor use was assessed by 19.4 % of the cardiologists. Important reasons not to discuss sexual function were lack of initiative of the patient (54 %), time constraints (43 %) and lack of training on dealing with SD (35 %). Sixty-three percent of the cardiologists stated they would be helped with a directory of sexual healthcare professionals where they can refer patients to.

Conclusion

Sexuality is not routinely discussed in the cardiology practice. Explanations for the lack of attention toward sexual matters are ambiguities about responsibility and a lack of time, training and experience regarding the communication and treatment of sexual dysfunction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Laumann EO, Paik A, Rosen RC (1999) Sexual dysfunction in the United States: prevalence and predictors. JAMA 281(6):537–544

    Article  PubMed  CAS  Google Scholar 

  2. Gott M, Hinchliff S (2003) How important is sex in later life? The views of older people. Soc Sci Med 56(8):1617–1628

    Article  PubMed  Google Scholar 

  3. Ayta IA, McKinlay JB, Krane RJ (1999) The likely worldwide increase in erectile dysfunction between 1995 and 2025 and some possible policy consequences. BJU Int 84(1):50–56

    Article  PubMed  CAS  Google Scholar 

  4. Miner M, Esposito K, Guay A, Montorsi P, Goldstein I (2012) Cardiometabolic risk and female sexual health: the Princeton III summary. J Sex Med 9(3):641–651

    Article  PubMed  Google Scholar 

  5. Addis IB, Ireland CC, Vittinghoff E, Lin F, Stuenkel CA, Hulley S (2005) Sexual activity and function in postmenopausal women with heart disease. Obstet Gynecol 106(1):121–127

    Article  PubMed  Google Scholar 

  6. Jaarsma T (2002) Sexual problems in heart failure patients. Eur J Cardiovasc Nurs 1(1):61–67

    Article  PubMed  Google Scholar 

  7. Jaarsma T, Dracup K, Walden J, Stevenson LW (1996) Sexual function in patients with advanced heart failure. Heart Lung 25(4):262–270

    Article  PubMed  CAS  Google Scholar 

  8. Taylor HA Jr (1999) Sexual activity and the cardiovascular patient: guidelines. Am J Cardiol 84(5B):6N–10N

    Article  PubMed  Google Scholar 

  9. Roose SP, Seidman SN (2000) Sexual activity and cardiac risk: is depression a contributing factor? Am J Cardiol 86(2A):38F–40F

    Article  PubMed  CAS  Google Scholar 

  10. Grimm RH Jr, Grandits GA, Prineas RJ, McDonald RH, Lewis CE, Flack JM et al (1997) Long-term effects on sexual function of five antihypertensive drugs and nutritional hygienic treatment in hypertensive men and women. Treatment of Mild Hypertension Study (TOMHS). Hypertension 29(1 Pt 1):8–14

    Article  PubMed  CAS  Google Scholar 

  11. Chevret-Measson M, Lavallee E, Troy S, Arnould B, Oudin S, Cuzin B (2009) Improvement in quality of sexual life in female partners of men with erectile dysfunction treated with sildenafil citrate: findings of the Index of Sexual Life (ISL) in a couple study. J Sex Med 6(3):761–769

    Article  PubMed  Google Scholar 

  12. Karavitakis M, Komninos C, Theodorakis PN, Politis V, Lefakis G, Mitsios K et al (2011) Evaluation of sexual function in hypertensive men receiving treatment: a review of current guidelines recommendation. J Sex Med 8(9):2405–2414

    Article  PubMed  Google Scholar 

  13. Jackson G (1981) Sexual intercourse and angina pectoris. Int Rehabil Med 3(1):35–37

    PubMed  CAS  Google Scholar 

  14. Nehra A, Jackson G, Miner M, Billups KL, Burnett AL, Buvat J et al (2012) The Princeton III Consensus recommendations for the management of erectile dysfunction and cardiovascular disease. Mayo Clin Proc 87(8):766–778

    Article  PubMed  Google Scholar 

  15. Barclay S, Todd C, Finlay I, Grande G, Wyatt P (2002) Not another questionnaire! Maximizing the response rate, predicting non-response and assessing non-response bias in postal questionnaire studies of GPs. Fam Pract 19(1):105–111

    Article  PubMed  Google Scholar 

  16. Chun J, Carson CC III (2001) Physician–patient dialogue and clinical evaluation of erectile dysfunction. Urol Clin N Am 28(2):249–258 viii

    Article  CAS  Google Scholar 

  17. Giuliano FA, Leriche A, Jaudinot EO, De Gendre AS (2004) Prevalence of erectile dysfunction among 7689 patients with diabetes or hypertension, or both. Urology 64(6):1196–1201

    Article  PubMed  Google Scholar 

  18. Moller J, Ahlbom A, Hulting J, Diderichsen F, de FU, Reuterwall C et al (2001) Sexual activity as a trigger of myocardial infarction. A case-crossover analysis in the Stockholm Heart Epidemiology Programme (SHEEP). Heart 86(4):387–390

    Article  PubMed  CAS  Google Scholar 

  19. Yildiz H, Pinar R (2004) Sexual dysfunction in patients with myocardial infarction. Anadolu Kardiyol Derg 4(4):309–317

    PubMed  Google Scholar 

  20. Kloner RA, Jarow JP (1999) Erectile dysfunction and sildenafil citrate and cardiologists. Am J Cardiol 83(4):576–582 A7

    Article  PubMed  CAS  Google Scholar 

  21. Debusk R, Drory Y, Goldstein I, Jackson G, Kaul S, Kimmel SE et al (2000) Management of sexual dysfunction in patients with cardiovascular disease: recommendations of the Princeton Consensus Panel. Am J Cardiol 86(2A):62F–68F

    Article  PubMed  CAS  Google Scholar 

  22. Kostis JB, Jackson G, Rosen R, Barrett-Connor E, Billups K, Burnett AL et al (2005) Sexual dysfunction and cardiac risk (the Second Princeton Consensus Conference). Am J Cardiol 96(2):313–321

    Article  PubMed  Google Scholar 

  23. Rerkpattanapipat P, Stanek MS, Kotler MN (2001) Sex and the heart: what is the role of the cardiologist? Eur Heart J 22(3):201–208

    Article  PubMed  CAS  Google Scholar 

  24. Jackson G, Betteridge J, Dean J, Eardley I, Hall R, Holdright D et al (2002) A systematic approach to erectile dysfunction in the cardiovascular patient: a Consensus Statement—update 2002. Int J Clin Pract 56(9):663–671

    PubMed  CAS  Google Scholar 

  25. Levine GN, Steinke EE, Bakaeen FG, Bozkurt B, Cheitlin MD, Conti JB et al (2012) Sexual activity and cardiovascular disease: a scientific statement from the American Heart Association. Circulation 125(8):1058–1072

    Article  PubMed  Google Scholar 

  26. Tsimtsiou Z, Hatzimouratidis K, Nakopoulou E, Kyrana E, Salpigidis G, Hatzichristou D (2006) Predictors of physicians’ involvement in addressing sexual health issues. J Sex Med 3(4):583–588

    Article  PubMed  Google Scholar 

  27. Parish SJ, Rubio-Aurioles E (2010) Education in sexual medicine: proceedings from the international consultation in sexual medicine, 2009. J Sex Med 7(10):3305–3314

    Google Scholar 

Download references

Acknowledgments

We would like to thank Prof. T. Jaarsma at the University of Linköping, Sweden and Tialda Hoekstra from the University Medical Center Groningen, the Netherlands. We partly based our questionnaire on a survey by their design. Furthermore we thank Joyce van Bavel for helping us with the import of the data.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Urology, Leiden University Medical Center, J3P, PO Box 9600, 2300 WB, Leiden, The Netherlands

    M. P. J. Nicolai, R. C. M. Pelger & H. W. Elzevier

  2. Department of Psychosomatic Gynecology and Sexology, Leiden University Medical Center, Leiden, The Netherlands

    S. Both

  3. Department of Cardiology, Amstelland Hospital, Amstelveen, The Netherlands

    S. S. Liem

  4. Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands

    H. Putter

  5. Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands

    M. J. Schalij

Authors
  1. M. P. J. Nicolai
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Both
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S. S. Liem
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R. C. M. Pelger
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. H. Putter
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M. J. Schalij
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. H. W. Elzevier
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. P. J. Nicolai.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOC 106 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nicolai, M.P.J., Both, S., Liem, S.S. et al. Discussing sexual function in the cardiology practice. Clin Res Cardiol 102, 329–336 (2013). https://doi.org/10.1007/s00392-013-0549-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00392-013-0549-2

Keywords

Search

Navigation