In the year after a heart attack, people younger than age 55 often have difficulties with sexual function, according to a study of patients in the U.S. and Spain.
"A large proportion of men and women with no prior sexual problems developed one or more sexual problems in the year after heart attack. However, women are far less likely to be counseled about these expected outcomes," lead author Dr. Stacy Tessler Lindau of the University of Chicago told Reuters Health by email.
"The hopeful message," she added, "is that 40 percent of women and 55 percent of men have no sexual function problems after heart attack and nearly a third of patients who reported having problems in the year before reported having none in the year after," she said.
Lindau and her colleagues studied data on more than 2,800 patients at 103 hospitals in the U.S. and 24 hospitals in Spain.
Of patients who were sexually active before their heart attacks, men were more likely than women to have resumed sexual activity. One month after the heart attack, 64 percent of men and 55 percent of women had resumed sex. One year afterwards, 94 percent of men and 91 percent of women were active again, according to the report in JAMA Cardiology.
In the year after the heart attack, more women (42 percent) than men (31 percent) with no sexual problems beforehand developed one or more issues, though.
For women, lack of interest was most common, with 40 percent reporting it, followed by trouble lubricating for 22 percent. For men, 22 percent had erectile difficulties and 19 percent said they lacked interest.
Despite high rates of sexual function problems, particularly among women, the investigators write, few participants reported having any conversation with a physician about resuming sex.
In both countries, women were less likely than men to receive counseling about resuming sex at any time in the year after heart attack - with 27 percent of women and 41 percent of men reporting they had received counseling.
Those who had not talked to a physician about sex in the first month were about 50 percent more likely to have delayed resuming sexual activity.
"The rate of loss of sexual function after heart attack was on a par with the loss of general physical function in this study group and was several fold higher than the (10 percent) incidence of depression," Lindau said.
In addition, "treatable conditions like stress and diabetes were strong indicators of loss of sexual activity after heart attack," she said. "We find that people value their sexual function as an important aspect of health, which suggests that we should also attend to recovery of sexual function after heart attack."
Dr. Kevin P. Weinfurt, author of an accompanying editorial, agreed. He told Reuters Health by email that such a framework of care is needed to help address this aspect of recovery for women and men.
"We also require a corresponding commitment from physicians to address sexual functioning with their patients to manage patients' expectations and offer help when it is needed," Weinfurt, of the Duke University School of Medicine in Durham, North Carolina, writes in his editorial,