Sexual functioning after the age of 40 in adults with moderate or severe congenital heart disease

Sexual health and functioning are significant, yet often overlooked, components of psychosocial well-being of adults with congenital heart disease (ACHD). Prior research reports inconsistent findings, limited data on older adults with CHD, and few studies have compared patients with controls from the general population. This study investigated sexual functioning in middle-aged and elderly ACHD patients and compared it with controls.

This was a Swedish sub-study of the international APPROACH-IS II project. Patients 40 years or older with moderate or severe CHD were recruited, along with controls from the general Swedish population. The design was case control. Erectile dysfunction (ED) in males was assessed using the International Index of Erectile Function. Sexual dysfunction (SD) in females was assessed using the Female Sexual Function Index.

Overall, 146 individuals were included in the study; 90 patients with CHD and 56 controls. Among males, the prevalence of ED was higher in patients (n = 57) than in controls (n = 37), (21% vs. 2.7%, p = 0.01). ED was associated with increasing age (OR = 1.11; 95% CI 1.03-1.20). Among females, no difference in the prevalence of SD was observed between patients (n = 33) and controls (n = 19) (27% vs. 30%, p = 0.76).

Sexual dysfunction was more common in male patients than controls, whereas no differences were observed between female patients and controls. Given that approximately one in five males and one in four females with CHD reported sexual dysfunction, increased empirical and clinical attention is warranted.