Fischer Stacy, Bekelman David
1 Division of General Internal Medicine, Anschutz Medical Campus, University of Colorado School of Medicine , Aurora, Colorado.
2 Department of Veterans Affairs, Eastern Colorado Health Care System , Denver, Colorado.
J Palliat Med. 2017 Aug;20(8):890-894. doi: 10.1089/jpm.2016.0476. Epub 2017 Mar 20.
Problems with sexual function can have a detrimental effect on quality of life. Symptomatic heart failure has been associated with problems with sexual function, although the majority of reports are focused on men and erectile dysfunction. Understanding women's perception of and gender differences in problems with sexual function in heart failure could yield new insights.
To determine the gender differences in reporting and bothersomeness of problems with sexual function, defined as sexual interest or activity.
Observational, cross-sectional study of adults with symptomatic heart failure from three health systems participating in a clinical trial. Eligible participants completed baseline surveys of symptom prevalence and bothersomeness. Logistic regression modeling was used to identify patient-level factors associated with problems with sexual interest or activity.
Among 314 patients with heart failure, we found large differences in reporting a problem with sexual function or interest in men (62.4%, n = 154/247) compared with women (37.9%, n = 25/66, p = 0.0004). When the symptom was reported, both men and women found it equally bothersome; 73.4% of men and 64.0% of women responded that this problem bothered them quite a bit or very much (p = 0.33). After adjusting for age, marital status, and income, men relative to women were still more likely to report problems with sexual function (OR 3.5, 95% CI 1.8-6.8).
While men more commonly reported problems with sexual function, both genders were similarly highly bothered by this problem. These findings support the need for further research to assess and manage this symptom in both men and women with heart failure.
性功能问题会对生活质量产生不利影响。有症状的心力衰竭与性功能问题有关，尽管大多数报告集中在男性和勃起功能障碍上。了解女性对心力衰竭中性功能问题的看法以及性别差异可能会产生新的见解。
确定性功能问题（定义为性兴趣或性活动）在报告和困扰程度方面的性别差异。
对来自三个参与临床试验的医疗系统的有症状心力衰竭成年人进行观察性横断面研究。符合条件的参与者完成了症状患病率和困扰程度的基线调查。采用逻辑回归模型确定与性兴趣或性活动问题相关的患者层面因素。
在314例心力衰竭患者中，我们发现男性（62.4%，n = 154/247）报告性功能或性兴趣问题的比例与女性（37.9%，n = 25/66，p = 0.0004）相比有很大差异。当报告该症状时，男性和女性都同样感到困扰；73.4%的男性和64.0%的女性回答这个问题让他们相当困扰或非常困扰（p = 0.33）。在调整年龄、婚姻状况和收入后，男性相对于女性仍然更有可能报告性功能问题（比值比3.5，95%置信区间1.8 - 6.8）。
虽然男性更常报告性功能问题，但两性对这个问题的困扰程度相似。这些发现支持需要进一步研究以评估和管理心力衰竭男性和女性的这一症状。
