Biopsychosocial factors related of sexual dysfunction in women with cardiovascular diseases

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    Marzieh Azizi 1, Forouzan Elyasi *2

    1 Ph.D. Student of Reproductive Health, Department of Midwifery and Reproductive health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran. Email:

    *2 Sexual and Reproductive Health Research Center, Addiction Institute, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.  E mail:

    Introduction and purpose: Patients with cardiovascular disease (CVD) often experience changes in their ability to engage in and enjoy of sexual activities, which can lead to less frequent and less satisfying sexual relationship. The problem of sexual dysfunction in women with CVD has less attention to the healthcare professional and also researchers all over the world and most of studies were conducted on men with cardiovascular diseases and erectile dysfunction. Based on the literature approximately 60-90% of patients with congestive heart failure reported the sexual dysfunction in their disease period. The aim of this study is to investigate the biopsychosocial factors related of sexual dysfunction in women with cardiovascular diseases.

    Methods: The present study is a review in which researchers conducted their computer search in public database like Google Scholar and more specific databases such as ScienceDirect, SID, Web of Science, PubMed and Scopus with using text word and medical Subject Heading (MesH) methods with key words such as [(“sexual dysfunction” OR “sexual disorders” OR “sexual activity”) AND (“cardiovascular diseases” OR “coronary artery disease” OR ” congestive heart failure “) AND (“psychiatric disorders” OR “psychological problems”)]. As a result of searching process, 33 articles were extracted from 2002-2020. Articles were excluded if they were written in languages other than English or Persian, were duplicates or were irrelevant to the topic. Researchers reviewed the abstract of all retrieved articles and ultimately, they used 25 full text articles to write this review study.

     Results: Studies showed that different factors lead to sexual dysfunction in these patients. Biological causes such as changes in blood circulation and reduced amount of blood supplied to distant area of body in these patients such as the genital region can lead to erectile dysfunction in men and sexual arousal difficulties in women. Also symptoms of cardiovascular disease such as chest pain, shortness of breath, and fatigue may also interfere with sexual performance and enjoyment of sexual activities. Having multiple chronic comorbidities such as diabetes, chronic pulmonary disease, cancer and side effects of medications such as diuretics and beta-blockers may also disrupt sexual activity. Social issues such as unhealthy behaviors included of smoking, inadequate sleep, alcohol abuse, physical inactivity and higher age have also negative effect on these patient’s desire for sexual relationships. Psychological issues such as emotional distress, depression and anxiety due to suffering from CVD in the first stages of disease, fear of not safe to be sexually active, adjustment and relational challenges among couples also increased the prevalence of sexual dysfunction and disturbed quality of life among these patients.

    Conclusion: Due to the sexual activity directly effect on the quality of life such as mental and physical health among patients with CVD, so healthcare professionals should seriously notice to these patient’s sexual relationships and for cases with sexual dysfunction, the appropriate counseling in this regard should be considered and provided.

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