Myocardial Infarction: Need for Sexual Counseling for Both Partners

Abstract

ABSTRACT Introduction Data suggest that sexual function issues are not uniformly addressed in individuals who have experienced a myocardial infarction (MI). Fewer sex counseling opportunities are offered to the spouse/sexual partner (who also may have health issues) regarding the stress they may experience in engaging in a sexual relation with a partner who underwent this event. The CDC reported that over a five-year period (2012-2016), there were more than 10 million MI/stroke admissions in the US. Many individuals develop sexual dysfunction after an MI. Not only is the MI survivor affected, but the marital dyad is negatively affected as well. These data suggest that sexual counseling should be routinely provided to both the individual who has had an MI and to their sexual partner. Objective This literature review aims to review and assess the consistency and adequacy of sexual counseling that is offered to MI survivors and their partners. It also aims to review the possible benefits of sexual counseling for MI survivors and their partners. Methods A literature review was conducted on sexual function of MI survivors with the specific focus on sexual counseling provided to these individuals and to their sexual partners. PubMed/Medline and Google Scholar were used with keyword combinations that included, “sexual function after MI/stroke,” “sexual satisfaction,” and “sexual counseling”. Results In the 12-month period after an MI, ∼36-48% of men and ∼46-59% of women reported a decrease in sexual activity. Reasons for diminished sexual activity included not only fear of triggering another MI that may be fatal, but also emotional issues, such as depression, and physical limitations. However, sexual relations after an MI do not appear to increase mortality to a significant degree. That is, maintaining or increasing sexual activity frequency after the first six months after MI is associated with improved survival, as shown by studies such as the Translational Research Investigating Underlying Disparities in Acute Myocardial Infarction Patients’ Health Status (TRIUMPH) registry. Despite these data, it appears that few clinicians include sexual health counseling for this population. Of even greater concern, MI survivors are often told to restrict sexual activity. Also of concern, there are no data that address the need for partners to have counseling as well in order to address their sexual needs and concerns. Partners also should be counseled, as many may be concerned about sexual activity triggering an MI recurrence in their partner. Conclusions With all the benefits of sexual activity, including emotional wellness, improved physical fitness, reduction of inflammation and cortisol response to stress, sexual health and wellness discussions should be included as part of the post-MI visits. Partners also should be offered sexual counseling by the clinician as well. Sexual wellness for both partners may positively impact a stronger relationship and decrease marital stress. Disclosure No