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Sexual problems common in younger people after a heart attack

Despite 90 percent of all heart attack patients under 55 expecting a conversation about sex with their doctors, many never have one.

By Stephen Feller

CHICAGO, Aug. 31 (UPI) -- Although most people consider sex an important part of life, many younger heart attack patients find themselves left unsatisfied after recovery and clinicians almost never address the issues, according to a new study published in JAMA Cardiology.

Researchers at the University of Chicago found most heart attack patients under age 55 never have a conversation with their doctors about sex, with women far less likely than men to be counseled about physical performance issues and an overall lack of interest experienced by many who previously had active sex lives.

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Most heart attack survivors who were sexually active when they had a heart attack resume their sex lives within a year after recovery. But for many, trouble with lubrication, getting or maintaining an erection, and less overall interest in sex are issues that never come up when discussing life after recovery from a heart attack.

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Sex is not considered an essential health function, and so is not often addressed by doctors, but a diminished sex life affects everything from self-esteem to relationships. These potential effects, researchers say, can play into other health issues.

"Progress has been made in assessing outcomes such as pain, sleep quality, physical function, fatigue and depression in clinical research," Dr. Kevin Weinfurt, a researcher at Duke University, wrote in an editorial published in JAMA Cardiology with the study. "But greater efforts are needed to incorporate the assessment of sexual activity and function as part of a profile of patient-centered outcomes."

For the study, researchers analyzed data on 2,802 heart attack patients between the ages of 18 and 55 in the United States and Spain collected between August 2008 and January 2012. Study participants were interviewed when they entered the study, one month later and one year after starting the study.

Of the participants, 40 percent of women and 55 percent of men were sexually active at all time points during the study. Among those active when entering the study, 64 percent of men and 55 percent of women had resumed sex within one month after a heart attack and 94 percent of women and 91 percent men had resumed sex a year after heart attack.

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Among those who were sexually active before and after their heart attack, women were about 15 percent less likely than men to report no sexual function issues in the year after a heart attack. Women were 11 percent more likely to develop one or more sexual problems in the year after their heart attack.

For women, 40 percent reported a lack of interest in sex, 22 percent had trouble lubricating and 19 percent reported difficulty breathing during intercourse. Meanwhile, 19 percent of men saw decreased interest and 22 percent had erectile difficulties. Despite the higher proportion of problems women experienced, just 27 percent received counseling about resuming sex, compared to 41 percent of men.

The researchers were surprised doctors didn't initiate more conversations about sex, despite 89 percent of women and 95 percent of men in the study considering it appropriate for a doctor to discuss sexual concerns and nearly the same number of patients feeling comfortable having the conversations.

"Patients want to know what level of sexual function to expect during recovery from acute myocardial infarctions [heart attack]," researchers wrote in the study. "Our findings can be used to expand counseling and care guidelines to include recommendations for advising patients on what to expect in terms of post-AMI sexual activity and function."

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