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Sexual function in female patients with unstable angina or non-ST-elevation myocardial infarction.

INTRODUCTION
Coronary artery disease is the leading cause of death and disability for both women and men. The psychological impact of acute myocardial infarction, as well as the physiological effects of the illness and its medications, can have a major effect on a patient's ability to resume sexual activity.


AIM
To assess sexual activity in female patients with unstable angina or non-ST-elevation myocardial infarction (NSTEMI), and to study the impact of cardiovascular rehabilitation (CR) on resumption of sexual activity.


MAIN OUTCOME MEASURES
Doppler-echocardiographic study, exercise tolerance test (ETT), and assessment of sexual activity.


METHODS
This study was conducted in the Riyadh National Hospital and included 35 female patients admitted to the intensive care unit for management of unstable angina or NSTEMI. All patients were enrolled into a CR program. All of them were interviewed for assessment of sexual activity, 12 weeks post discharge. The Arizona Sexual Experience Scale (ASEX) was used for the assessment of the severity of sexual dysfunction for patients who resumed their sexual activity.


RESULTS
Results indicate that 48.57% of the patients resumed their sexual activity at the time of the interview. However, most of them were either not satisfied at all with their sexual activity or mostly dissatisfied. The remaining patients (51.43%) had not resumed sex yet. CR was completed by 70.59% of those resuming sex, and 38.89% of those not resuming sex. We estimated that rehabilitated patients were 3.77 times more likely to resume sexual activity than those who did not receive rehabilitation. ASEX score ranged from 19 to 30, with a mean of 24.118 +/- 3.42.


CONCLUSION
Unstable angina and NSTEMI have a negative impact on frequency of, and satisfaction with, sexual activity, and lead to sexual dysfunction within a large number of female patients. Accurate and complete sexual instructions for both partners with specific attention paid to the woman's concerns and needs should be part of CR programs.