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Volume 22, Issue 5 (September 2020) 22, 526–531; 10.4103/aja.aja_131_19

Sexual health in Polish elderly men with coronary artery disease: importance, expectations, and reality

Lesław Rusiecki1, Romuald Zdrojowy2, Jana Gebala3, Michał Rabijewski4, Małgorzata Sobieszczańska5, Ryszard Smoliński6, Witold Pilecki1, Wioletta Dziubek7, Anna Janocha8, Maciej Womperski9, Dariusz Kałka1,10

1 Cardiosexology Unit, Department of Pathophysiology, Wrocław Medical University, Wrocław 50-368, Poland
2 Department and Clinic of Urology, Wroclaw Medical University, Wroclaw 50-556, Poland
3 Cardiosexology Students' Scientific Club, Wrocław Medical University, Wrocław 50-368, Poland
4 Department of Reproductive Health, Centre of Postgraduate Medical Education, Warsaw 01-004, Poland
5 Department of Geriatrics, Wrocław Medical University, Wrocław 50-369, Poland
6 Consultant Sexologist, Clinical Hospital Wrocław Medical University, Wrocław 50-556, Poland
7 Department of Physiotherapy, University School of Physical Education, Wroclaw 51-612, Poland
8 Department of Physiology, Wroclaw Medical University, Wroclaw 50-368, Poland
9 Lower Silesian Center for Mental Health, Wrocław 50-226, Poland
10 Centre for Men's Health, Wroclaw 53-151, Poland

Correspondence: Dr. D Kałka (dariusz.kalka@gmail.com)

Date of Submission 21-May-2019 Date of Acceptance 29-Sep-2019 Date of Web Publication 07-Jan-2020


Deterioration in overall health, hormonal disturbances, and erectile dysfunction (ED) contributes to limitations in sexual activity in the elderly, which is further limited by incorrect beliefs about the hazards of sexual activity in cardiac patients. We aimed to analyze the occurrence of ED in elderly men, their perception of the relevance of good sexual function, and their expectations of physicians. A cross-sectional study encompassed 731 patients with coronary artery disease (CAD) subjected to cardiac rehabilitation. Demographic data and data on modifiable risk factors and patient expectations were collected. ED was assessed using the IIEF-5 questionnaire. Relationships among the risk factors for ED, occurrence of ED, and patient expectations, as well as the changes in the indicators between 2012 and 2016, were analyzed. The mean age of men was 70.7 ± 5.1 years. The prevalence of ED was 93.0%. The IIEF-5 score was significantly associated with age, tobacco smoking, exercise tolerance, time to diagnosis of CAD, and treatment with calcium channel blockers and diuretics. Patients declared that sexual activity was overall important (47.9%) or very important (25.6%). Three hundred and sixty (49.3%) patients expected their physician to show interest in their sexual health, but the topic was addressed in only 12.5%. Over the past few years, we have observed an increase in the awareness and importance of sexual health as well as a significant increase in patients' expectations of physicians to show interest in their sexual health. Patients' expectations of discussing and receiving treatment for ED remain an unmet medical need.

Keywords: advanced age; cardiac rehabilitation; erectile dysfunction; ischemic heart disease; sexual disorders

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