In most rehabilitation programs, sexual counseling is not given to cardiac patients. This while the cardiac disease could influence the sex life of patients. There are physiological and pharmacological causes that can influence sex life of patients. Also, the disease can increase fear, anxiety & depression and relationships could change. If the disease negatively influences a patients’ sex life, this could impact their quality of life and well-being. Patients could choose to skip medication in the case sexual problems occur, order online PDE5 inhibitors, or experience side effects of other treatments than their cardiac treatment (e.g. herbal treatment). A changing sex life will not only impact a patient’s life, but also their partner’s, who report sexual concerns as a significant stressor. We have to realize that sexual satisfaction and communication satisfaction is associate with marital satisfaction. The sex life of patients with heart failure deteriorate in 25% of the patients, where half of these patients consider this as a serious problem.
Two-third of patients report that sex was never discussed in their cardiac care, where about half of the patients would like to have to opportunity, or more opportunity to discuss sex with a health professional.
The question now is not if, but how we should provide sexual counselling in cardiac care. It is important to find the underlying reasons why the disease influence the sex life of the patients, assess the patient’s expectation and unravel misconceptions.
Patients at two months post myocardial infarction preferred written material (69%), individual discussion (57%), video tape for home viewing (55%), consultation telephone line (23%) or group discussions for sexual counselling (19%). There are a lot of brochures with information of sex and cardiac disease. For patients with heart failure, there is a nice web-site where they could find information on sex and heart failure:
Excerpt from heartfailurematters.org
There are also questionnaires that could be used in practice, such as the multidimensional sexual-concept inventory or the sexual adjustment subscale. But you could also just ask. An example how you could ask is:
– Some people with cardiac disease have problems with resuming sex after diagnose. How is this for you?
– Some people report sexual problems as a result of prescribing medication. If you feel this is the case for you, please feel free to talk to me about this.
To read and hear more about this subject, please watch the web seminar on sexual counselling of cardiac patients: theory and practice by Dr. Molly Byrne and professor Tiny Jaarsma.
Leonie Klompstra is a Nurse Scientist at the Linköping University in Sweden. Her primary focus is on heart failure and rehabilitations.