Medication use and predictors of sexual activity in men and women with CVD

Abstract

Purpose To examine the influence of cardiac and noncardiac medications on sexual activity by drug classification and generation of the drug, among men and women with cardiovascular disease. Data sources This study was a subanalysis (n = 224) of survey data from a cross‐sectional sample of 336 cardiac patients. Self‐reported medications were categorized by generic drug name, classification, and subclass and/or generation of the drug. Sexual activity was the presence or absence of current sexual activity in the last 2 months. Conclusions Patients taking generation one beta blockers, particularly men; diuretics as a class; and loop diuretics, were significantly less likely to be sexually active, with diuretics negatively influencing sexual activity in women, but not men. Certain antidepressant medications positively influenced sexual function, particularly for women. Nearly 20% of the variances in sexual activity were explained by younger age, fewer number of medications, higher education, and having a sexual partner. Implications for practice A new finding meriting further study was that loop diuretics negatively impacted sexual activity, particularly for women; and further studies of women overall are clearly needed. Advance practice nurses play an important role in evaluating medications, proactively choosing drugs within a class or subclass less likely to cause sexual problems, and in promoting sexual quality of life of cardiac patients.

Blood Pressure, Sexual Activity, and Dysfunction in Women with Hypertension: Baseline Findings From the Systolic Blood Pressure Intervention Trial (SPRINT)

“…Strippoli et al 40 , studying 1472 women with end-stage renal disease who were undergoing dialysis, found that diuretic use was associated with sexual dysfunction as assessed with the FSFI. In particular, thiazide diuretic use is postulated to be associated with decreased libido and vaginal lubrication 41 . However, as the authors state, future research is needed to determine whether diuretic treatment in CKD patients is directly associated with sexual dysfunction, or whether it reflects comorbidity 40 .…”

Barriers and Promoting Strategies to Sexual Health Assessment for Patients with Coronary Artery Diseases in Nursing Practice: A Literature Review

“…The experience of living with CADs is associated with a variety of consequences that influence patients' sexual health [9]. Patients with CADs complain of different sexual health problems including decrease of sexual activities, interest in sex and level of sexual satisfaction [10], physical discomfort during sexual activities [11], and alterations in both frequency and quality of sexual activity [12].…”

Coronary heart disease and sexual activity

“…While medications are conventionally known to contribute to sexual problems and changes in sexual activity patterns, the effects of cardiac medications on sexual function are restricted to a few drugs which have been identified as causing erectile dysfunction. Diuretics, particularly thiazides, are the drugs most strongly linked to sexual dysfunction, both in men and women, causing impotence, decreased libido and erectile dysfunction 8. β-blockers are probably the best known drug class deemed capable of inducing sexual disorders.…”

“…β-blockers are probably the best known drug class deemed capable of inducing sexual disorders. However, this was mainly the case with the older generation of β-blockers given to men 8. Use of more recent β-blockers, such as nebivolol, has been shown to affect sexual function positively 8.…”

“…However, this was mainly the case with the older generation of β-blockers given to men 8. Use of more recent β-blockers, such as nebivolol, has been shown to affect sexual function positively 8. Classes of drugs which have no reported deleterious effects on sexual function include α blockers, ACE inhibitors, angiotensin receptor blockers (ARBs), and calcium channel blockers 8…”