Abstract P147: Sexual Problems Experienced by Women After an MI

Abstract

Objective: Describe sexual problems experienced by female patients following an MI to inform best practices for prevention and treatment. Methods: Women in the U.S. TRIUMPH MI registry who reported being sexually active before and 12 months after their MI were randomly selected. In-depth telephone interviews 18-24 months post-MI were conducted until thematic saturation occurred. Transcripts were coded and content analyzed by a multidisciplinary team including a nurse, psychologist, public health researcher, anthropologist, and gynecologist. Findings: Mean age was 58 years (range 43 to 75). Most subjects (13/17) said sexual activity was important before and after the MI. Although frequency of sexual activity was generally lower, the majority had resumed sexual activity by 6 months post-MI. Three women had resumed sexual activity within 3 weeks of the MI. Common, bothersome sexual problems after MI included: 1) low desire and arousal: “Since I had my heart attack the desire is not there anymore, not like it was. And I don't get the same feeling that I used to get from it.”, 2) vaginal dryness: “It's so bad. But I don't know what to do with that.” and 3) fear or worry that sex will trigger another MI: “My first experience, I was trying so hard, I had a real heart palpitation. You know, real strong and my heart beat real fast and it scared me.” Patients described their own and their partner's fear about sex as a hindrance: “I had to convince my husband that I wasn't going to die in bed.” Women indicated that physician-initiated attention to sexual concerns following an MI is lacking. Some attributed their sexual problems to medications that were initiated after the MI. Despite sexual problems experienced by MI patients and their partners, several women reported pleasure, physical closeness, normalcy, and “living life to the fullest” in the face of a life-threatening condition as motivations for continued sexual activity. Conclusions: Many women continue to be sexually active following an MI, in spite of bothersome sexual problems and worry about MI recurrence triggered by sex. Sexual activity, including fear of recurrent MI, should be addressed during post-MI care. These findings are being used to develop an intervention to improve sexual outcomes in women following MI.