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Sexual difficulties common after acute MI, especially in women
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Impaired sexual activity and sexual dysfunction were prevalent for younger adults, especially women, in the year after acute MI, according to a study published in JAMA Cardiology.
Stacy Tessler Lindau, MD, MAPP, from the departments of obstetrics and gynecology, and medicine-geriatrics, University of Chicago, and colleagues sought to find patterns of sexual activity and function and to identify indicators of the probability of loss of sexual activity in the year after acute MI.
Stacy Tessler Lindau
The researchers analyzed data from the prospective, multicenter, longitudinal VIRGO study conducted from August 2008 to January 2012 at hospitals in the United States (n = 103) and Spain (n = 24).
Patients (n = 2,802; 67.4% women; median age, 49 years) were assessed at baseline, 1 month and 1 year, and multinomial logistic regression analyses were used to assess characteristics associated with loss of sexual activity.
Differences by sex
At all points of the study, 637 women (40%) and 437 men (54.9%) were sexually active. Among those sexually active at baseline, men were more likely than women to resume sexual activity by 1 month (63.9% vs. 54.5%; P < .001) and 1 year (94.4% vs. 91.3%; P = .01).
In the cohort who were sexually active before and after acute MI, women were less likely than men to report no sexual function problems in the year after (40.3% vs. 54.8%; P < .01). Also, more women than men who displayed no sexual problems at baseline developed one or more incident problems in the year after acute MI (41.9% vs. 30.5%; P < .01).
At the 1-year mark, the most frequent sexual problems for women were lack of interest (39.6%) and lubrication trouble (22.3%). For men, erectile difficulties (21.7%) and lack of interest (18.8%) were the most prevalent.
High stress levels (adjusted OR = 1.36; 95% CI, 1.01-1.83) and having diabetes (adjusted OR = 1.9; 95% CI, 1.15-3.13) strongly indicated the probability of loss of sexual activity at the 1-year mark, whereas those who had not spoken with a physician about sexual activity in the month after acute MI were more likely to delay resuming sexual activity (adjusted OR = 1.51; 95% CI, 1.11-2.05).
Challenges to be met
“When a health condition or its treatment affects sexual function, the difficulty that results is relatively unique in terms of the effect on relationships and the shame that can accompany sexual problems,” Kevin P. Weinfurt, PhD, of the department of psychiatry and behavioral sciences, Duke Clinical Research Institute, Duke University School of Medicine, wrote in an accompanying editorial.
“Problems with desire, erectile function and lubrication can create significant challenges for couples to negotiate. If not addressed, these problems may erode the patient’s relationship with his or her partner — a relationship that can influence the patient’s health outcomes,” Weinfurt wrote. – by James Clark
Disclosure: Lindau and Weinfurt report no relevant financial disclosures. Please see the full study for a list of the other researchers’ relevant financial disclosures.
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