Erectile dysfunction in primary care: Sexual health inquiry and cardiovascular risk factors among patients with no previous cardiovascular events

Dias, Ricardo; Alarcão, Violeta; Mata, Sara da; Miranda, Filipe Leão; Simões, Rui; Carreira, Mário; Rocha, Evangelista; Galvão-Teles, A

doi:10.1016/j.rpsp.2016.06.001

Cited by 8 publications

(6 citation statements)

References 49 publications

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“…Overall, patients with a history of MI have a different distribution of traditional risk factors for CVD and their impact on health [ 24 , 25 , 26 ]. ED has been shown to be significantly more common in patients with multiple risk factors for CVD [ 27 ]. The severity of ED also depends on the extent of IHD: patients with MI who have had one coronary artery injury have been found to be less likely to have any difficulties with achieving an erection than patients with two or three coronary artery diseases [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

The Prevalence of Erectile Dysfunction and Its Association with Cardiovascular Risk Factors in Patients after Myocardial Infarction

et al. 2021

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Background and Objectives: This study estimates the prevalence and severity of erectile dysfunction and its association with cardiovascular risk factors in patients after a myocardial infarction. Materials and Methods: This study included men aged 35–80 years, diagnosed with myocardial infarction and examined in the Department of Preventive Cardiology of Vilnius University Hospital Santaros Klinikos between 2016 and 2020. Anthropometric characteristics, blood pressure, lipid profile, blood glucose levels and prevalence of cardiovascular risk factors were evaluated. The International Index of Erectile Function-5 was used to assess patients’ erectile function. Results: A total of 171 patients were analysed. The mean age was 57.6 ± 8.8 years. Of the patients, 42.1, 25.1 and 11.7% had three, four and five established cardiovascular risk factors, respectively. Of the patients, 100% were diagnosed with dyslipidaemia, 90.0%—arterial hypertension, 14.6%—diabetes, 23.3%—smoking, 43.7%—positive familial history and 54.5%—insufficient physical activity. The overall prevalence of erectile dysfunction was 62%. It was scored mild in 37.4%, mild-to-moderate—15.2%, moderate—5.3% and severe in 4.1% of the patients. The mean age was significantly different between severity groups (p < 0.001). The study demonstrated a negative correlation between age and total score of the questionnaire (r = −0.308, p < 0.001). Arterial hypertension was more frequent in the patients with erectile dysfunction (p = 0.02). Other cardiovascular risk factors were distributed similarly. Conclusions: Erectile dysfunction is common in patients after a myocardial infarction and its severity is age dependent. The prevalence of cardiovascular risk factors is high, with arterial hypertension significantly more frequent in patients with erectile dysfunction.

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Section: Introductionmentioning

confidence: 99%

The Prevalence of Erectile Dysfunction and Its Association with Cardiovascular Risk Factors in Patients after Myocardial Infarction

et al. 2021

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“…Thus, it is important that physicians consider and look after a patient’s sexual health along with other medical health problems 5 . Additionally, patients state that sexual health is an important component of their overall health and well-being, 6 and they expect their physicians to be willing to talk about their sexual health concerns 7, 8…”

Section: Introductionmentioning

confidence: 99%

Medical Students Indicate the Need for Increased Sexuality Education at an Austrian Medical University

2019

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Introduction: The quantity and quality of education in the field of human sexuality vary greatly in medical education programs in the United States and Europe. Aim: The current state of medical school education with regard to human sexuality was assessed at an Austrian medical university. Methods: Self-constructed questionnaires and the Beliefs About Sexual Functioning Scale were filled out by 391 medical students (mean age ¼ 24.0, SD ¼ 2.5; 52.4% women, 47.6% men). Descriptive statistics are reported for summarizing students' responses, and structural equation models were calculated to reveal associations between variables of interest. Main Outcome Measures: The outcome variable in the structural equation models was students' confidence in addressing sexual health concerns of patients. Results: Most students were not instructed in sexual history taking (96.9%), sexual behavior (94.3%), love (97.4%) or sexuality in elderly persons (95.1%), and they reported having poor knowledge of these topics. Most students (72.5%) reported having little or no confidence in addressing patients' sexual health concerns. The number of addressed topics was positively associated with male (b ¼ 0.47, P < .001) and female students' (b ¼ 0.52, P < .001) knowledge. Knowledge was positively associated with male (b ¼ .49, P < 0.001) and female students' (b ¼ 0.33, P < .001) confidence in addressing sexual health concerns and was negatively associated with stereotypical sexual functioning beliefs in the male subsample (b ¼ À0.26, P ¼ .009). Conclusions: Most medical students revealed that the teaching of important sexual health content (eg, sexual history taking) was deficient at this medical university. Education in sexual health issues needs to be increased to positively influence students' knowledge of and consequently their confidence regarding dealing with patients' sexual health concerns. Komlenac N, Siller H, Hochleitner M. Medical Students Indicate the Need for Increased Sexuality Education at an Austrian Medical University. Sex Med 2019;7:318e325.

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“…This is also known as automated reasoning and is common in decision-making. 40 If there was deliberate or deep and analytical thinking 41 about the symptoms the hypothetical patients presented with, they might have considered other risks, such as the microvascular complications that also occur in the genitalia, for example, erectile failure in men, which is common knowledge but still not optimally addressed in primary care, 42 and, perhaps less known, clitoral vascular resistance in women with insulin resistance. 43 They considered cardiovascular disease; however, did not consider that erectile dysfunction is also an early biomarker of cardiovascular disease, and thus, it is a good clinical practice to screen for it.…”

Section: Discussionmentioning

confidence: 99%

Sexual history taking: Doctors’ clinical decision-making in primary care in the North West province, South Africa

Pretorius

Couper

Mlambo

2021

African Journal of Primary Health Care & Family Medicine

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Background: Clinical reasoning is an important aspect of making a diagnosis for providing patient care. Sexual dysfunction can be as a result of cardiovascular or neurological complications of patients with chronic illness, and if a patient does not raise a sexual challenge, then the doctor should know that there is a possibility that one exists and enquire.Aim: The aim of this research study was to assess doctors’ clinical decision-making process with regards to the risk of sexual dysfunction and management of patients with chronic illness in primary care facilities of the North West province based on two hypothetical patient scenarios.Setting: This research study was carried out in 10 primary care facilities in Dr Kenneth Kaunda health district, North West province, a rural health district.Methods: This vignette study using two hypothetical patient scenarios formed part of a broader grounded theory study to determine whether sexual dysfunction as comorbidity formed part of the doctors’ clinical reasoning and decision-making. After coding the answers, quantitative content analysis was performed. The questions and answers were then compared with standard answers of a reference group.Results: One of the doctors (5%) considered sexual dysfunction, but failed to follow through without considering further exploration, investigations or management. For the scenario of a female patient with diabetes, the reference group considered cervical health questions (p = 0.001) and compliance questions (p = 0.004) as standard enquiries, which the doctors from the North West province failed to consider. For the scenario of a male patient with hypertension and an ex-smoker, the reference group differed significantly by expecting screening for mental health and vision (both p = 0.001), as well as for HIV (p 0.001). The participating doctors did not meet the expectations of the reference group.Conclusion: Good clinical reasoning and decision-making are not only based on knowledge, intuition and experience but also based on an awareness of human well-being as complex and multidimensional, to include sexual well-being.

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Erectile dysfunction in primary care: Sexual health inquiry and cardiovascular risk factors among patients with no previous cardiovascular events

Cited by 8 publications

References 49 publications

The Prevalence of Erectile Dysfunction and Its Association with Cardiovascular Risk Factors in Patients after Myocardial Infarction

The Prevalence of Erectile Dysfunction and Its Association with Cardiovascular Risk Factors in Patients after Myocardial Infarction

Medical Students Indicate the Need for Increased Sexuality Education at an Austrian Medical University

Sexual history taking: Doctors’ clinical decision-making in primary care in the North West province, South Africa

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