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


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.

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

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Correspondence to E R Schwarz.



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).

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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).

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  • heart failure
  • sexual dysfunction
  • erectile dysfunction

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