Sexual problems common in women with heart disease

Many women with Heart disease continue to have sex into their 70s, according to new research, and most of these women experience problems with sexual function.

The study, of nearly 2,800 older women with Heart disease, found that among those who were sexually active, two-thirds said they suffered discomfort during sex or other forms of sexual dysfunction.

The findings, say the study authors, suggest that doctors need to be aware that many older women will remain sexually active after a diagnosis of Heart disease-and will be likely to have some bothersome symptoms.

The results also underscore a need for “holistic” therapies for older women with sexual dysfunction, according to Dr. Ilana B. Addis, an assistant professor of obstetrics and gynecology at the University of Arizona in Tucson and the study’s lead author.

It will be difficult to develop a Viagra-like “magic pill” to improve women’s sex lives, said Addis. Instead, doctors need to address the problems that underlie a woman’s symptoms, she said.

Statistically speaking, more women than men suffer from a reduced sex drive. A number of factors such as stress, diet, age, hormonal fluctuations, and occupation contribute to this startling problem.

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Certain problems that arise with menopause, like vaginal dryness or atrophy, are “easy to fix” with lubricants or topical estrogen, respectively, Addis noted. But, she said, doctors often do not bring up the topic.

Heart disease and other chronic conditions like diabetes and depression, as well as certain medications such as High Blood Pressure drugs, may also directly affect a woman’s sexual function. However, there’s been relatively little research on the prevalence and causes of female sexual dysfunction, according to Addis and her colleagues.

For their study, published in the journal Obstetrics & Gynecology, the researchers looked at data on 2,763 postmenopausal women with coronary heart disease who had taken part in a hormone replacement trial. At the start of that study, the women answered questions on sexual activity and functional problems such as lack of interest or enjoyment, pain during sex or difficulty with arousal or orgasm.

Overall, 39 percent of the women said they were sexually active, and of those, 65 percent reported at least one functional problem.

The oldest women in the study—those in their 70s—and women who felt their health was poor to fair were more likely than others to have sexual dysfunction. High blood pressure medications were not a factor in women’s sexual problems, nor were SSRI antidepressants; however, the researchers note, few women used SSRIs, which have been linked to sexual dysfunction in other studies.

Sexual dysfunction could be one reason that 60 percent of the women in this study said they were not sexually active, according to Addis, though Heart disease and other health problems can also have more direct effects. And some heart patients, the researchers note in the report, may be fearful about becoming sexually active again—even though experts say that people with Heart disease can safely have sex.

Still, the current findings show that many women with heart disease do stay sexually active well into their 70s, according to Addis and her colleagues.

“Physicians should be aware that postmenopausal patients are sexually active,” they write, “and address the problems these women experience.”

SOURCE: Obstetrics & Gynecology, July 2005.

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