Enhancing sexual performance in COPD.

The fear of dyspnea and reduced exercise tolerance in patients with chronic obstructive pulmonary disease (COPD) are often limiting factors in their participation in sexual activity. When the patient and health care practitioner approach sexual activity as any other physical activity, factors can be identified that promote sexual performance. Initial evaluation includes the patient's preferences, priorities and current physical capacity. The phases of sexual intercourse can be correlated with the energy requirements of other activities, such as walking or household tasks, to determine an individual's activity tolerance. Energy conservation techniques and breathing retraining can then be coordinated with sexual activity. In addition, cardiopulmonary reconditioning exercises are initiated to increase overall activity tolerance. Throughout this process, education is critical to assure the patient that well-tolerated exercise may include dyspnea, and that dyspnea during sex is not more dangerous than during other well-tolerated exercise.