Sexual problems common in women with heart disease

By Amy Norton

NEW YORK (Reuters Health) – 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, Addis told Reuters Health.
Instead, doctors need to address the problems that underlie a
woman’s symptoms, she said.

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.