title: Sexual Activity and Function in the Year After an Acute Myocardial Infarction Among Younger Women and Men in the United States and Spain.
abstract: Most younger adults who experience an acute myocardial infarction (AMI) are sexually active before the AMI, but little is known about sexual activity or sexual function after the event.
  
  
  
  To describe patterns of sexual activity and function and identify indicators of the probability of loss of sexual activity in the year after AMI.
  
  
  
  Data from the prospective, multicenter, longitudinal Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients study (conducted from August 21, 2008, to January 5, 2012) were assessed at baseline, 1 month, and 1 year. Participants were from US (n = 103) and Spanish (n = 24) hospitals and completed baseline and all follow-up interviews. Data analysis for the present study was conducted from October 15, 2014, to June 6, 2016. Characteristics associated with loss of sexual activity were assessed using multinomial logistic regression analyses.
  
  
  
  Loss of sexual activity after AMI.
  
  
  
  Of the 2802 patients included in the analysis, 1889 were women (67.4%); median (25th-75th percentile) age was 49 (44-52) years (range, 18-55 years). At all time points, 637 (40.4%) of women and 437 (54.9%) of men were sexually active. Among people who were active at baseline, men were more likely than women to have resumed sexual activity by 1 month (448 [63.9%] vs 661 [54.5%]; P < .001) and by 1 year (662 [94.4%] vs 1107 [91.3%]; P = .01) after AMI. Among people who were sexually active before and after AMI, women were less likely than men to report no sexual function problems in the year after the event (466 [40.3%] vs 382 [54.8%]; P < .01). In addition, more women than men (211 [41.9%] vs 107 [30.5%]; P < .01) with no baseline sexual problems developed 1 or more incident problems in the year after the AMI. At 1 year, the most prevalent sexual problems were lack of interest (487 [39.6%]) and trouble lubricating (273 [22.3%]) among women and erectile difficulties (156 [21.7%]) and lack of interest (137 [18.8%]) among men. Those who had not communicated with a physician about sex in the first month after AMI were more likely to delay resuming sex (adjusted odds ratio [AOR], 1.51; 95% CI, 1.11-2.05; P = .008). Higher stress levels (AOR, 1.36; 95% CI, 1.01-1.83) and having diabetes (AOR, 1.90; 95% CI, 1.15-3.13) were significant indicators of the probability of loss of sexual activity in the year after the AMI.
  
  
  
  Impaired sexual activity and incident sexual function problems were prevalent and more common among young women than men in the year after AMI. Attention to modifiable risk factors and physician counseling may improve outcomes.
authors: Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois2Department of Medicine-Geriatrics, University of Chicago, Chicago, Illinois3University of Chicago Comprehensive Cancer Center, Chicago, Illinois4The MacLean Center on Clinical Medical Ethics, University of Chicago, Illinois.
authors: Stacy Tessler
authors: ST
authors: Lindau
authors: Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois.
authors: Emily
authors: E
authors: Abramsohn
authors: Centro Nacional de Investigaciones Cardiovasculares (CNIC), Instituto de investigación i+12, Madrid, Spain6Cardiology Department, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Spain.
authors: Hector
authors: H
authors: Bueno
authors: Yale University School of Medicine, New Haven, Connecticut.
authors: Gail
authors: G
authors: D'Onofrio
authors: Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut.
authors: Judith H
authors: JH
authors: Lichtman
authors: Department of Internal Medicine, Yale University, New Haven, Connecticut.
authors: Nancy P
authors: NP
authors: Lorenze
authors: Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois.
authors: Rupa Mehta
authors: RM
authors: Sanghani
authors: Yale University School of Medicine, New Haven, Connecticut.
authors: Erica S
authors: ES
authors: Spatz
authors: Saint Luke's Mid America Heart Institute, Kansas City, Missouri12University of Missouri-Kansas City, Kansas City, Missouri.
authors: John A
authors: JA
authors: Spertus
authors: Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut.
authors: Kelly M
authors: KM
authors: Strait
authors: Department of Public Health Sciences, University of Chicago, Chicago, Illinois.
authors: Kristen
authors: K
authors: Wroblewski
authors: Department of Internal Medicine, Yale University, New Haven, Connecticut.
authors: Shengfan
authors: S
authors: Zhou
authors: Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut16Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut17Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut18Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut.
authors: Harlan M
authors: HM
authors: Krumholz
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction; D011446:Prospective Studies; D012737:Sex Factors; D012725:Sexual Behavior; D013030:Spain; D014481:United States; D055815:Young Adult