Over half of PH patients experience symptoms during sex: Small study

One-third of patients consider it important to bring up topic with doctor

Margarida Maia, PhD avatar

by Margarida Maia, PhD |

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More than half of people with pulmonary hypertension (PH) may experience symptoms during sexual activity, such as difficulty breathing (dyspnea), heart palpitations, and chest pain, a small study found.

However, around 2 in 3 patients don’t consider it important to bring up the topic of sexuality to their healthcare providers, perhaps because they feel uncomfortable or embarrassed.

“It is therefore important for doctors and (specialized) nurses to discuss sexuality with patients to adequately inform the patients and refer them for specialized sexological healthcare if necessary,” researchers wrote.

The study, “Sexual function is impaired in women and men with pulmonary hypertension,” was published in the journal Clinical Research in Cardiology.

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PH is an abnormally high blood pressure in the lungs that occurs when the blood vessels that carry blood from the heart to the lungs become narrowed or blocked, making it harder for blood to flow through them.

Living with PH can be challenging and people with the disease also may have to deal with mental health problems such as depression and anxiety, low vitality, and emotional distress. Less is known about how men and women with PH experience sexuality.

To know more, a team of researchers in the Netherlands asked 78 people with PH to fill out questionnaires about their sexual health and experiences. One of the questionnaires comprised a series of four semi-structured interviews focused on PH-specific sexual health-related quality of life.

The study included 49 people with pulmonary arterial hypertension and 29 people with chronic thromboembolic pulmonary hypertension (CTEPH). Their median age was 53 years, and about two-thirds (66.7%) were women. Most (77.3%) were in a committed relationship.

The researchers found that more than half of patients experienced symptoms of PH during sexual activity, such as dyspnea (52.6%), heart palpitations (32.1%), and chest pain (10.3%). In almost half (43.3%), these symptoms resulted in less sexual activity.

“The majority of men and women with PAH and CTEPH experience symptoms during sexual activities, the most prevalent symptom being dyspnea,” the researchers wrote.

Seventeen (21.8%) patients had a pump for continuous delivery of medication, which according to the researchers, can make patients “experience low self-esteem and an impaired body image.”

Indeed, a proportion of these patients said that the presence of an intravenous (into-the-vein) pump affected their sexual activity (17.6%). One patient said the same about the presence of a subcutaneous (under-the-skin) pump.

Less than one-third (30.8%) of patients find it important to discuss sexuality with their healthcare providers, with men finding this more important than women (46.2% vs. 23.1%).

Sexual dysfunction occurred more often in men and women with PH than in the general population. “Both men and women experienced a broad range of sexual problems, including lower sexual drive, arousal, orgasm, orgasm satisfaction and impaired lubrication or erectile function,” the researchers wrote.

Up to 2 in 3 women experienced sexual dysfunction, particularly difficulty with orgasm and pain during sexual activity. All men experienced low satisfaction during sexual activity, and almost all (92.3%) experience low sexual desire; erectile dysfunction occurred in almost half (48%).

Women who took diuretics were four times as likely as those who didn’t take diuretics to experience sexual dysfunction. In contrast, PAH-specific medication was not linked to sexual dysfunction, nor was medication delivered via an intravenous or subcutaneous pump.

It is important to note that the study included only people with PAH and CTEPH, and its findings may not hold true for people with other types of PH, the team noted.

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