Sexuality and subjective wellbeing in male patients with congenital heart disease.

OBJECTIVE

To assess physical and psychological concerns related to sexuality, the prevalence of erectile dysfunction and their relationship to patients' quality of life.

DESIGN

Questionnaire-based survey.

SETTING

Tertiary care centre.

PATIENTS

Consecutive sample of 332 men with congenital heart disease (age 18-59 years; median 23).

MAIN OUTCOME MEASURES

Besides various components concerning sexuality, the International Index of Erectile Function, a generic health-related quality-of-life instrument (SF-12) and a depression scale (ADS) were included.

RESULTS

Men under the age of 40 engage less frequently in sexual relationships than their peers from the general population. Fears before or during sexual intercourse (9.9%), as well as physical symptoms such as dyspnoea (9.0%), feelings of arrhythmia (9.0%) or chest pain (5.1%) are common. 10.0% reached a score on the International Index of Erectile Function indicative of an erectile dysfunction. Men with erectile dysfunction scored significantly worse on the SF-12 mental (43.5 vs 51.8, p<0.001) as well as on the physical sum scale (46.3 vs 52.6, p = 0.002) than patients without erectile problems. Additionally, in the group of men without erectile dysfunction only 3.2% showed signs of depressive symptoms, whereas among men with erectile dysfunction this figure increased to 33.3% (p<0.001)

CONCLUSIONS

The concern of sexuality should be integrated into the regular consultations of these patients. The strong association between sexual health and subjective wellbeing emphasises the need for diagnosis and, if necessary, treatment of these problems.