Women with PAH have ‘unique challenges’ around sexual health-related quality of life
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A new study highlights significant burdens and challenges regarding sexual health-related quality of life for women with pulmonary arterial hypertension.
Researchers conducted semi-structed, in-depth interviews with 13 female attendees with PAH (mean age, 46 years) at the Pulmonary Hypertension Association’s International Pulmonary Hypertension Conference and Scientific Sessions in 2016. Researchers identified salient themes regarding challenges and perspectives related to sexual health-related quality of life from interviewee responses.
Ten women had WHO functional class II PAH. Four women were on IV or subcutaneous prostanoids, eight were on endothelin receptor antagonists and seven were on phosphodiesterase inhibitors.
Most women (92%) reported declines in the frequency of sex after receiving their PAH diagnosis. Sixty-two percent of women experienced fear of having sexual intercourse due to cardiopulmonary symptoms. All women reported compensatory behaviors and/or strategies during and around sexual intercourse. Some women who were on subcutaneous prostanoids also reported timing sexual intercourse to coincide with infusion site changes, and thus interrupted treatment.
Women also reported changing positions during intercourse in an attempt to reduce breathlessness and some reported removing their oxygen to avoid interrupting intimacy.
Most women (54%) reported having a negative body image related to their PAH medications, external oxygen supplementation and/or weight fluctuations.
In addition, many participants reported never discussing sexual practices with their health care professionals but highlighted a need for increased communication with their providers.
“In combination with earlier survey results, these data highlight both the unique challenges around sexual health-related quality of life that women with PAH face, as well as their attempts to overcome challenges or, at least, minimize PAH’s impacts, including patient understandings of relationship dynamics overburdened by medical treatment and caregiving,” Daniel C. Yee, MD, internist in the division of pulmonary, critical care and sleep medicine and the department of medicine at Rhode Island Hospital in Providence, and colleagues wrote in Annals of the American Thoracic Society.