title: Discussing sexual function in the cardiology practice.
abstract: BACKGROUND
  In patients with cardiovascular disease, sexual dysfunction is frequently encountered. Erectile dysfunction shares the same modifiable risk factors as coronary artery disease and the fear of triggering cardiovascular events can create stress and anxiety impacting the sexual lives of patients and their partners. To optimise healthcare, knowledge of cardiologists' attitude and practice patterns regarding the discussion about sexual function is essential.
  
  
  METHODS
  A 31-itemed anonymous questionnaire was mailed to 980 members of the Netherlands Society of Cardiology (cardiologists and residents in cardiology training). The questionnaire addressed awareness, knowledge and practice patterns about sexual dysfunction in cardiac patients.
  
  
  RESULTS
  Of the cardiologists 53.9 % responded. Sixteen percent stated to discuss sexual function regularly. In the past year, an estimated mean of 2 % of patients was referred for help with a sexual problem. The majority (70 %) of cardiologists advised patients never or seldom about resuming sexual activity after myocardial infarction. PDE5-inhibitor use was assessed by 19.4 % of the cardiologists. Important reasons not to discuss sexual function were lack of initiative of the patient (54 %), time constraints (43 %) and lack of training on dealing with SD (35 %). Sixty-three percent of the cardiologists stated they would be helped with a directory of sexual healthcare professionals where they can refer patients to.
  
  
  CONCLUSIONS
  Sexuality is not routinely discussed in the cardiology practice. Explanations for the lack of attention toward sexual matters are ambiguities about responsibility and a lack of time, training and experience regarding the communication and treatment of sexual dysfunction.
authors: Department of Urology, Leiden University Medical Center, J3P, PO Box 9600, 2300 WB Leiden, The Netherlands. mpjnicolai@lumc.nl
authors: M P J
authors: MP
authors: Nicolai
authors: S
authors: S
authors: Both
authors: S S
authors: SS
authors: Liem
authors: R C M
authors: RC
authors: Pelger
authors: H
authors: H
authors: Putter
authors: M J
authors: MJ
authors: Schalij
authors: H W
authors: HW
authors: Elzevier
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D002309:Cardiology; D016009:Chi-Square Distribution; D003142:Communication; D003376:Counseling; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006331:Heart Diseases / Q000150:complications* / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians'; D012017:Referral and Consultation; D018570:Risk Assessment; D012307:Risk Factors; D012725:Sexual Behavior; D012735:Sexual Dysfunction, Physiological / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D011795:Surveys and Questionnaires; D055815:Young Adult
references: J Sex Med. 2012 Mar;9(3):641-51; quiz 652
references: 22372651
references: Heart. 2001 Oct;86(4):387-90
references: 11559674
references: J Sex Med. 2006 Jul;3(4):583-588
references: 16839313
references: Mayo Clin Proc. 2012 Aug;87(8):766-78
references: 22862865
references: Am J Cardiol. 1999 Feb 15;83(4):576-82, A7
references: 10073864
references: Int Rehabil Med. 1981;3(1):35-7
references: 6116679
references: Am J Cardiol. 1999 Sep 9;84(5B):6N-10N
references: 10503570
references: Obstet Gynecol. 2005 Jul;106(1):121-7
references: 15994626
references: Urol Clin North Am. 2001 May;28(2):249-58, viii
references: 11402578
references: Eur J Cardiovasc Nurs. 2002 Feb;1(1):61-7
references: 14622869
references: Am J Cardiol. 2005 Jul 15;96(2):313-21
references: 16018863
references: Int J Clin Pract. 2002 Nov;56(9):663-71
references: 12469980
references: BJU Int. 1999 Jul;84(1):50-6
references: 10444124
references: Fam Pract. 2002 Feb;19(1):105-11
references: 11818359
references: Am J Cardiol. 2000 Jul 20;86(2A):62F-68F
references: 10899282
references: J Sex Med. 2010 Oct;7(10):3305-14
references: 21029381
references: Eur Heart J. 2001 Feb;22(3):201-8
references: 11161931
references: Anadolu Kardiyol Derg. 2004 Dec;4(4):309-17
references: 15590359
references: Soc Sci Med. 2003 Apr;56(8):1617-28
references: 12639579
references: Urology. 2004 Dec;64(6):1196-201
references: 15596196
references: J Sex Med. 2009 Mar;6(3):761-9
references: 19143916
references: J Sex Med. 2011 Sep;8(9):2405-14
references: 21676187
references: Circulation. 2012 Feb 28;125(8):1058-72
references: 22267844
references: Heart Lung. 1996 Jul-Aug;25(4):262-70
references: 8836742
references: Am J Cardiol. 2000 Jul 20;86(2A):38F-40F
references: 10899277
references: JAMA. 1999 Feb 10;281(6):537-44
references: 10022110
references: Hypertension. 1997 Jan;29(1 Pt 1):8-14
references: 9039073