Discussing sexual function in the cardiology practice

In patients with cardiovascular disease, sexual dysfunction is frequently encountered. Erectile dysfunction shares the same modifiable risk factors as coronary artery disease and the fear of triggering cardiovascular events can create stress and anxiety impacting the sexual lives of patients and their partners. To optimise healthcare, knowledge of cardiologists' attitude and practice patterns regarding the discussion about sexual function is essential.

A 31-itemed anonymous questionnaire was mailed to 980 members of the Netherlands Society of Cardiology (cardiologists and residents in cardiology training). The questionnaire addressed awareness, knowledge and practice patterns about sexual dysfunction in cardiac patients.

Of the cardiologists 53.9 % responded. Sixteen percent stated to discuss sexual function regularly. In the past year, an estimated mean of 2 % of patients was referred for help with a sexual problem. The majority (70 %) of cardiologists advised patients never or seldom about resuming sexual activity after myocardial infarction. PDE5-inhibitor use was assessed by 19.4 % of the cardiologists. Important reasons not to discuss sexual function were lack of initiative of the patient (54 %), time constraints (43 %) and lack of training on dealing with SD (35 %). Sixty-three percent of the cardiologists stated they would be helped with a directory of sexual healthcare professionals where they can refer patients to.

Sexuality is not routinely discussed in the cardiology practice. Explanations for the lack of attention toward sexual matters are ambiguities about responsibility and a lack of time, training and experience regarding the communication and treatment of sexual dysfunction.