Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

The prevalence and clinical relevance of sexual dysfunction in women and men with chronic heart failure

International Journal of Impotence Research volume 20, pages 85–91 (2008)Cite this article

Abstract

Sexual dysfunction is a common problem of increasing incidence that is associated with multiple co-morbid conditions and chronic diseases. In heart failure, however, exact numbers are unknown, in part secondary to under-reporting and under-interrogating by health care providers. A gender-specific questionnaire was modified from established sexual dysfunction questionnaires to correspond to a non-randomized outpatient heart failure population, to assess the prevalence and demographic distribution of sexual dysfunction and potential treatments expectations. One-hundred patients in a stable hemodynamic condition in New York Heart Association classes I–III participated. Eighty-seven percent of women were diagnosed with female sexual dysfunction compared to 84% of men with erectile dysfunction. Eighty percent of women reported reduced lubrication, which resulted in frequent unsuccessful intercourse in 76%. Thirty-six percent of patients thought that sexual activity could harm their current cardiac condition; 75% of females and 60% of men stated that no physicians ever asked about potential sexual problems. Fifty-two percent of men considered sexual activity in their current condition as an essential aspect of quality of life and 61% were interested in treatment to improve sexual function. Sexual dysfunction appears to be high in prevalence in both men and women with chronic compensated heart failure and represents a reduction in quality of life for most. Despite the fact that most patients are interested in receiving therapy to improve sexual dysfunction, treatment options are rarely discussed or initiated.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3
Figure 4

Similar content being viewed by others

References

  1. Lue TF . Erectile dysfunction. N Engl J Med 2000; 342: 1802–1813.

    Article  CAS  Google Scholar 

  2. Schwarz ER, Rodriguez J . Sex and the heart. Int J Impot Res 2005; 17: S4–S6.

    Article  Google Scholar 

  3. Schwarz ER, Rastogi S, Kapur V, Sulemanjee N, Rodriguez JJ . Erectile dysfunction in heart failure patients. J Am Coll Cardiol 2006; 19: 1111–1119.

    Article  Google Scholar 

  4. Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB . Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 1994; 151: 54–61.

    Article  CAS  Google Scholar 

  5. Kostis JB, Jackson G, Rosen R, Barrett-Connor E, Billups K, Burnett AL et al. Sexual dysfunction and cardiac risk (the Second Princeton Consensus Conference). Am J Cardiol 2005; 96: 85M–893M.

    Article  Google Scholar 

  6. Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Pena BM . Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res 1999; 11: 319–326.

    Article  CAS  Google Scholar 

  7. Petrone L, Mannucci E, Corona G, Bartolini M, Forti G, Giommi R et al. Semi-structured interview on erectile dysfunction (SIEDY): a new multidimensional instrument for quantification of pathogenetic issues on erectile dysfunction. Int J Impot Res 2003; 15: 210–220.

    Article  CAS  Google Scholar 

  8. Chevret M, Jaudinot E, Sullivan K, Marrel A, De Gendre AS . Quality of sexual life and satisfaction in female partners of men with ED: psychometric validation of the Index of Sexual Life (ISL) questionnaire. J Sex Marital Ther 2004; 30: 141–155.

    Article  Google Scholar 

  9. Rodriguez JJ, Al Dashti R, Schwarz ER . Linking erectile dysfunction and coronary artery disease. Int J Impot Res 2005; 17: S12–S18.

    Article  Google Scholar 

  10. NIH Consensus Development Panel on Impotence. JAMA 1993; 270: 83–90.

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

    Article  CAS  Google Scholar 

  12. Kinsey AC, Pomeroy WB, Martin CE . Sexual Behavior in the Human Male. WB Saunders: Philadelphia, USA, 1948.

    Google Scholar 

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

    Article  CAS  Google Scholar 

  14. Wassertheil-Smoller S, Blaufox MD, Oberman A, Davis BR, Swencionis C, Knerr MO et al. Effect of antihypertensives on sexual function and quality of life: the TAIM Study. Ann Intern Med 1991; 114: 613–620.

    Article  CAS  Google Scholar 

  15. Neri A, Zukerman Z, Aygen M, Lidor Y, Kaufman H . The effect of longterm administration of digoxin on plasma androgens and sexual dysfunction. J Sex Mar Ther 1987; 13: 58–63.

    Article  CAS  Google Scholar 

  16. Rutledge T, Reis VA, Linke SE, Greenberg BH, Mills PJ . Depression in heart failure a meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes. J Am Coll Cardiol 2006; 48: 1527–1537.

    Article  Google Scholar 

  17. Sidi H, Puteh SE, Abdullah N, Midin M . The prevalence of sexual dysfunction and potential risk factors that may impair sexual function in Malaysian women. J Sex Med e-pub ahead of print, 13 October 2006.

  18. Berman JR, Berman L, Goldstein I . Female sexual dysfunction: incidence, pathophysiology, evaluation, and treatment options. Urology 1999; 54: 385–391.

    Article  CAS  Google Scholar 

  19. Berman JR . Physiology of female sexual function and dysfunction. Int J Impot Res 2005; 17: S44–S51.

    Article  Google Scholar 

  20. Westlake C, Dracup K, Walden JA, Fonarow G . Sexuality of patients with advanced heart failure and their spouses or partners. J Heart Lung Transplant 1999; 18: 1133–1138.

    Article  CAS  Google Scholar 

  21. Kloner RA, Mullin SH, Shook T, Matthews R, Mayeda G, Burstein S et al. Erectile dysfunction in the cardiac patient: how common and should we treat. J Urol 2003; 170: S46–S50.

    Article  Google Scholar 

  22. Hayes RD, Bennett CM, Fairley CK, Dennerstein L . What can prevalence studies tell us about female sexual difficulty and dysfunction? J Sex Med 2006; 3: 589–595.

    Article  Google Scholar 

  23. Oksuz E, Malhan S . Prevalence and risk factors for female sexual dysfunction in Turkish women. J Urol 2006; 175: 654–658.

    Article  Google Scholar 

  24. McKinlay JB . The worldwide prevalence and epidemiology of erectile dysfunction. Int J Impot Res 2000; 12: S6–S11.

    Article  Google Scholar 

  25. Kiowski W, Brunner H, Schalcher C . Sex, the heart, and heart failure. Semin Cardiothorac Vasc Anesth 2006; 10: 256–258.

    Article  Google Scholar 

  26. Montorsi F, Briganti A, Salonia A, Rigatti P, Margonato A, Macchi A et al. Erectile dysfunction prevalence, time of onset and association with risk factors in 300 consecutive patients with acute chest pain and angiographically documented coronary artery disease. Eur Urol 2003; 44: 360–365.

    Article  Google Scholar 

  27. Dunn KM, Croft PR, Hackett GI . Sexual problems: a study of the prevalence and need for health care in the general population. Fam Pract 1998; 15: 519–524.

    Article  CAS  Google Scholar 

  28. Schwarz ER . Sex and the Heart. What women need to know about erectile dysfunction—a scientific approach to preventing and managing impotence in men. Friedel & Ernst Academic Press: Los Angeles, USA, Haldorf, Germany, 2006.

    Google Scholar 

  29. Kaiser DR, Billups K, Mason C, Wetterling R, Lundberg JL, Bank AJ . Impaired brachial artery endothelium-dependent and -independent vasodilation in men with erectile dysfunction and no other clinical cardiovascular disease. J Am Coll Cardiol 2004; 43: 179–184.

    Article  Google Scholar 

Download references

Acknowledgements

There was no funding for the study. The authors have no conflict of interest.

Author information

Authors and Affiliations

  1. Division of Cardiology, Department of Medicine, Cedars Sinai Medical Center and University of California Los Angeles (UCLA), Los Angeles, CA, USA

    E R Schwarz

  2. Division of Cardiology, Department of Internal Medicine, The University of Texas Medical Branch (UTMB), Galveston, TX, USA

    E R Schwarz, V Kapur, S Bionat, S Rastogi, R Gupta & S Rosanio

Authors
  1. E R Schwarz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. V Kapur
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S Bionat
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S Rastogi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. R Gupta
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. S Rosanio
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to E R Schwarz.

Appendix

Appendix

NYHA classification: New York Heart Association heart failure functional classification system, classes I–IV

NYHA functional classes are I (asymptomatic), II (symptomatic with ordinary activity), III (symptomatic with less than ordinary activity) and IV (symptomatic at rest).

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schwarz, E., Kapur, V., Bionat, S. et al. The prevalence and clinical relevance of sexual dysfunction in women and men with chronic heart failure. Int J Impot Res 20, 85–91 (2008). https://doi.org/10.1038/sj.ijir.3901613

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijir.3901613

Keywords

This article is cited by

Search

Advanced search

Quick links