Many Women Sexual Despite Heart Troubles

Long after menopause, sex remains an important part of women's lives -- even if they have heart disease.

Nearly 40 percent of postmenopausal women with heart disease have active sex lives, find Ilana B. Addis, MD, MPH, and colleagues.

Addis, assistant professor of obstetrics and gynecology at the University of Arizona Health Sciences Center in Tucson, was part of a team that analyzed data on 2,763 postmenopausal women. The women ranged in age from 50 to 79. Their average age was 67; nearly half were in their 60s and 37 person were in their 70s.

"Sex is a part of the physical and psychological health of women of all ages," Addis tells WebMD. "In this group of postmenopausal women with heart disease, they do remain sexually active."

The findings appear in the July issue of Obstetrics & Gynecology.

Read Web MD's "Sex in the Senior Years."

Sexual Activity, Sexual Problems

Overall, nearly 40 percent of the women were sexually active. About two-thirds of these sexually active women reported at least one sexual problem.

That number may sound high, but studies show that 40 percent to 60 percent of all women -- young and old, with and without heart disease -- report some problem with sex.

The fact that women with heart trouble are sexually active and, like other women, encounter sexual problems does not surprise Stephen Bashuk, MD, who is an assistant professor of obstetrics and gynecology at Emory University School of Medicine in Atlanta.

"I don't think there is anything unique about the heart disease thing," Bashuk tells WebMD. "The idea many people have is if you have heart disease you are unable to have sex. But that is not true among men and it is not true among women."

Addis says the main sexual problems reported by women with heart disease were discomfort during sex -- mostly due to vaginal dryness -- and lack of sexual interest.

"Every day in my practice I see women who complain of lack of interest in sex and problems with arousal," Bashuk says. "Lack of interest, in my experience, is mainly due to a side effect of antidepressants. About 30 percent of women in that age group use them. And a lot of the heart medications have these side effects. So a lot of times this is medical."

Vaginal discomfort, too, may have a medical solution.

"Once the body loses estrogen, women get vaginal dryness," Bashuk says. "That can be treated with topical estrogen that will not have the cardiac problems a hormone pill would have."

Read Web MD's "Sex in Menopause City."

Great Sex After 60

Women with heart disease are often afraid to have sex, says sex therapist and psychologist Jeanne Shaw, PhD.

"Anybody who has ever had a chest pain or a heart attack or a diagnosis of heart disease has got that fear that an orgasm is going to kill them, or that the exertion of a sexual encounter will give them another heart attack," Shaw tells WebMD. "But if they can climb two flights of stairs without chest pain or shortness of breath, they can have sex without fear."

What many people fail to realize, Shaw says, is that women are sexy in their 60s and beyond.

"Older women are probably the most sexual women alive," Shaw says. "They are not acrobatic, but they are very sensual, very sexual. They know how to use their bodies, and, when they have a partner, they are very active sexually."

Bashuk encourages women who want sex but who have sexual problems to talk with their doctor about it. He also encourages doctors to have these discussions with older women -- just as they would with younger women.

Often, Addis points out, the issue isn't a medical problem, it's a relationship problem.

"I am a gynecologist, not a psychologist, but I certainly ask patients with sexual problems about their relationship," Addis says. "And a lot of patients, when you get down to it, their sexual dysfunction is they are unhappy with their partner."

Read Web MD's "Women's Heart Risks Often Misunderstood."

By Daniel J. DeNoon, reviewed by Brunilda Nazario, MD

SOURCES: Addis, I.B. Obstetrics & Gynecology, July 2005; vol 106: pp 121-127. Ilana B. Addis, MD, MPH, assistant professor of obstetrics and gynecology, University of Arizona Health Sciences Center, Tucson. Jeanne Shaw, PhD, clinical psychologist; and certified sex therapist, Atlanta. Stephen Bashuk, MD, assistant professor of obstetrics and gynecology, Emory University, Atlanta.