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Taking Women's Sexual Concerns to Heart After Myocardial Infarction

Summary and Comment |
August 23, 2013

Taking Women's Sexual Concerns to Heart After Myocardial Infarction

  1. Diane E. Judge, APN/CNP

Women wanted — but often didn't get — information from their cardiologists about the safety of resuming sexual activity after MI.

  1. Diane E. Judge, APN/CNP

The American Heart Association has just issued guidelines recommending that clinicians provide sexual counselingl to patients and their partners after myocardial infarction (MI). In a substudy of the TRIUMPH investigation, researchers document the need for this intervention in women.

Seventeen partnered women (median age, 60) participated in structured telephone interviews within 30 months (mean, 24 months) of their MIs. Most (12) did not recall their clinicians addressing resumption of sexual activity; of the five who received guidance, most had initiated the discussion themselves, and several were dissatisfied with the vagueness of the responses (e.g., “that's up to you”). All but one participant had resumed sexual activity after the MI, typically within 1 month, although some (as well as some partners) feared that sex might prompt another, possibly fatal, MI. Almost all believed cardiologists should initiate discussions about the safety of resuming sexual activity after MI; most thought this should be done at hospital discharge and again at follow-up visits.

Comment

Specific discharge instructions about the timing and safety of resuming sexual activity might have alleviated fears in patients and their partners. Many women follow up with primary care clinicians (in addition to cardiologists) after an MI, creating an opportunity — and responsibility — for us to ask about sexual activity while addressing our patients' and their partners' concerns.

Harlan M. Krumholz, MD, Editor-in-Chief of NEJM Journal Watch Cardiology, is an author of the summarized article but had no role in its selection or review for NEJM Journal Watch.

  • Disclosures for Diane E. Judge, APN/CNP at time of publication Nothing to disclose

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