Sexual function in patients with heart failure: Narrative article

Background:Approximately 60% to 87% of patients with heart failure (HF) report sexual problems. numbers as low as 31% of HF patients younger than 70 have normal sexual function. patients with HF are reporting more erectile dysfunction (ED) and also perceive that their HF symptoms (20%) or HF medication (10%) is the cause for their problems. We wanted to identify patients view concerning possible improvements in sexual health and Prevalence, Factors related, Medication, Counseling and Care.Method:Data Sources search was contain: PubMed, EMBASE, Web of Science, Springer ،Elsvier،Scopus and Cochrane Central Register of Controlled Trials were searched using MeSH. Magiran ،IranMedex ،SID from 2000 to 2018. 27 Article was found and by eligibility criteria 12 articles was included.Results:The prevalence of ED is estimated to be 50% in 60-year-old men. But is reported in up to 81% of cardiac patientsacross different cultures. These problems include a marked decrease in sexual interest and activity, and one quarter of patients with HF report that they have stopped sexual activity altogether. Sexual problems include a lack of interest in or fear for having sex, orgasmic difficulties, or erectile dysfunction (ED) in men. Women may experience other types of sexual dysfunction than men, including decline in sexual interest or desire, decline in sexual arousal, orgasmic disorder, or painful sexual intercourse.HF specific factors that are related to sexual problems are HF symptoms such as dyspnea, fatigue, and activity intolerance. In addition, HF patients often suffer from comorbidity; up to 35% of HF patients suffer from COPD,and the overall prevalence of diabetes in HF is 20–25%.Most patients attribute their sexual problems to their HF symptoms; they perceived that shortness of breath (20%), fatigue (20%), medication use (10%), and limited circulation (11%) are causing their sexual problems.Thiazide diuretics may impact erectile function. Digoxin and mineralocorticoid receptor antagonist are alsodescribed to have an effect on sexual performance or libido.HF patients have even reported an improvement of sexual performance with beta blockers, which is likely to be a result of both a reduction of HF severity and the ancillary properties of some of the third generation beta blockers.The basic idea of Counseling and treatment approach is that all patients with HF should be given the opportunity to talk about sexual health in a more general way by informing them that this is an issue that patients might worry about and that they are welcome to discuss this with the health care provider. Some patients with HF might need specific information about activities they can undertake, as well as clear information and treatment to help cope with sexual problems. Some patients might wish to be treated in case of ED. Phosphodiesterase type 5 (PDE-5) inhibitors are generally safe and effective for the treatment of ED.Conclusion:Sexual problems are common in men and women with HF and should be addressed to avoid possible fears and worries. Sexual function can be reduced by HF symptoms and treatment or by co-morbidities that commonly occur in HF patients. Obstacles to appropriate sexual counseling have been documented in the literature but the current review is aimed to give the readers knowledge and insight in order to optimally manage an HF patient’s sexual problems. Although several reviews exist that summarize the knowledge on HF and sexual dysfunction, there is still a lack of original research in this patient population. Further research is also needed to better understand sexual needs and concerns of those living with HF in a variety of practice settings.

کلیدواژه ها:

Sexual Function ، Sexual Problems ، Erectile Dysfunction ، Heart Failure