Cardiac rehabilitation linked to improved sexual functioning and frequency

December 6, 2018, Elsevier

A new systematic review of the literature comparing the sexual health of patients with cardiovascular disease (CVD) who attended cardiac rehabilitation (CR) with patients who did not, found that rehab attendance is associated with improved sexual function and sexual frequency. Published in the Canadian Journal of Cardiology, the study validates the benefit of exercise training and points to the need for more high quality research to better understand the role of counseling and other therapies in easing the sexual repercussions of a cardiac event. The investigators also conclude that more evidence is needed to clarify whether CR has an impact on sexual satisfaction, sexual activity resumption, and other aspects of sexual health.

"As patients live longer with chronic CVD, it is important to focus not just on clinical effectiveness of interventions, but also to understand how interventions affect patients' quality of life. We know that sexual activity is important to patients as it allows them to feel well and vital and close and connected with their partner. Evidence shows that patients with CVD suffer from decreased sexual activity due to , medication side effects, and psychological barriers. Although CR has been shown to improve mortality and morbidity, this is the first review to explore its effects on sexual health outcomes," said lead investigator Karen L. Tang, MD, MSc, FRCPC, Assistant Professor, Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

This comprehensive review of the published literature identified 341 potentially relevant published studies, of which 14 met criteria to be included in this investigation. A variety of sexual health outcomes were assessed, including sexual resumption after a cardiac event, sexual function (primarily relating to erectile dysfunction), sexual frequency, and sexual satisfaction. The results indicate that there may be potential benefits from CR on sexual outcomes. Of six studies pertaining specifically to sexual function, three showed improvement after CR, two showed mixed results, and one showed worsened . Interestingly, the effects on sexual health do not appear to depend on sex-specific counseling.

According to the investigators, CR may provide the perfect opportunity to address the sexual health of patients with CVD. Similar to assessing outcome measures, such as physical limitations and exercise capacity, it is important for physicians to ask about a patient's sexual health before and after CR attendance. In addition, the majority of CR programs in this review included lifestyle and risk factor reduction counselling components. Given their holistic nature, attendance in CR programs would also be a good time to address physical and psychological barriers to sexual activity.

The investigators also explore the question of whether exercise training in CR influences sexual health outcomes by increasing cardiovascular and muscle functioning. They identify this as a topic for further study.

"Understanding the importance of sexual health and the potential impacts that CR has on sexual outcomes are imperative in improving patient quality of life after a cardiovascular event. We need to more effectively examine how CR might be used and innovated to improve quality of life outcomes like sexual health," commented Dr. Tang.

Noting that the National Institutes of Health's Obesity-Related Health Interventions Trial (ORBIT) framework responds to well-defined needs, the investigators suggest conducting an assessment of physical and psychological barriers to in CVD patients before and after an intervention. This view is echoed in an accompanying editorial by Claudio Gil Soares de Araújo, MD, Ph.D., Exercise Medicine Clinic—CLINIMEX, Rio de Janeiro, Brazil. "Whether sexual counseling should become a formal part of a comprehensive CR program, and if so, how should it be implemented, are still under debate. However, , and in particular, cardiologists, should be aware of the need to discuss and offer prompt and adequate advice regarding sexual life for patients with heart disease. This could be carried out by the CR team or, if felt appropriate, by referral to a professional specialist in sexuality."

Explore further: Do sexual minority women receive appropriate sexual and reproductive health counseling?

More information: "The Effect of Cardiac Rehabilitation Attendance on Sexual Activity Outcomes in Cardiovascular Disease Patients: A Systematic Review," Canadian Journal of Cardiology, doi.org/10.1016/j.cjca.2018.08.020

The accompanying editorial is "Sexual Counseling in Cardiac Rehabilitation: An Urgent Need for More Consideration and Study," Canadian Journal of Cardiology, doi.org/10.1016/j.cjca.2018.09.001

Related Stories

Do sexual minority women receive appropriate sexual and reproductive health counseling?

November 6, 2018
According to a new study that used data from the National Survey of Family Growth 2006-2015, lesbian women were less likely to report receiving a birth control prescription or birth control counseling compared with heterosexual ...

CDC: many adults not receiving sexual risk assessments

March 30, 2018
(HealthDay)—Less than half of women and a quarter of men with recent sexual activity receive sexual risk assessment, according to a March data brief published by the U.S. Centers for Disease Control and Prevention's National ...

Urinary incontinence may have negative effects on sexual health

April 5, 2018
In a new BJU International study, women with urinary incontinence reported declines in sexual activity and arousal over the last year, and they expressed increased concern about their frequency of sexual activity and ability ...

What sex is safe for heart patients: A new approach using the KiTOMI model

November 5, 2015
Changes in sexual satisfaction and decreases in sexual activity are often reported by heart patients. Both patients and partners may have misconceptions about the perceived dangers of sexual activities and commonly restrict ...

Study examines the effects of childhood trauma on later sexual well-being

October 19, 2015
Among 96 former Swiss indentured child laborers, 22 individuals showed post-traumatic stress disorder (PTSD) symptoms and 53 reported having experienced childhood trauma. Men reported a significantly higher prevalence of ...

Study identifies desire and arousal as the main players in women's sexual health

May 4, 2015
In a 4-year study of 178 pre- and 329 postmenopausal women, investigators found that women's sexual functioning was moderately stable over time. The main predictors of changes in sexual functioning and satisfaction were desire ...

Recommended for you

Can stem cells help a diseased heart heal itself? Researchers achieve important milestone

December 14, 2018
A team of Rutgers scientists, including Leonard Lee and Shaohua Li, have taken an important step toward the goal of making diseased hearts heal themselves—a new model that would reduce the need for bypass surgery, heart ...

Higher risk of heart attack on Christmas Eve

December 12, 2018
The risk of heart attack peaks at around 10pm on Christmas Eve, particularly for older and sicker people, most likely due to heightened emotional stress, finds a Swedish study in this week's Christmas issue of The BMJ.

Your weight history may predict your heart failure risk

December 12, 2018
In a medical records analysis of information gathered on more than 6,000 people, Johns Hopkins Medicine researchers conclude that simply asking older adult patients about their weight history at ages 20 and 40 could provide ...

Age is the biggest risk for heart disease, but lifestyle and meds have impact

December 12, 2018
Of all the risk factors for heart disease, age is the strongest predictor of potential trouble.

New understanding of mysterious 'hereditary swelling'

December 12, 2018
For the first time ever, biomedical researchers from Aarhus University, Denmark, report cellular defects that lead to a rare disease, hereditary angioedema (HAE), in which patients experience recurrent episodes of swelling ...

Researchers have found that incidence of heart failure was around two-fold higher in people with diabetes

December 11, 2018
Researchers have found that incidence of heart failure was around two-fold higher in people with diabetes.

2 comments

Adjust slider to filter visible comments by rank

Display comments: newest first

Anonym976595
not rated yet Dec 06, 2018
I have found that as I'm getting older I'm not performing as I use too i explore my options with my doctor and want have me use medication to help ..but I'm concerned about side effects..so I did some research and found this interesting article bit.ly/Health-tip which has really been able too helpl
Anonym882494
not rated yet Dec 07, 2018
Our body is just working like a machine. So we must take care of each and every organ. The heart is playing an important role. The sexual health issue is linked with the heart and the nervous system. Regular treatment will give the best results to the body. Thanks for providing so many useful information. Potassium is really good for heart health. bit.ly/2BUwANS

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.