The impact of sexual therapy on patients after cardiac events participating in a cardiac rehabilitation program

Abstract

To assess the impact of a sexual therapy module on male patients participating in phase 2 cardiac rehabilitation after a cardiac event. We randomly assigned 92 consecutive male patients (age < or =70 years, mean age 58 years), on their admission to phase 2 cardiac rehabilitation after myocardial infarction/acute coronary syndromes and/or coronary artery bypass graft, into a 'sexual therapy group' (n=47) and a 'control group' (n=45). Two co-therapists met with the patient and spouse for 5 h in three sessions, in addition to cardiac rehabilitation. Sexual therapy included patient education, cognitive restructuring, emotional support, guided imagery, and medication (Viagra). Controls participated in cardiac rehabilitation without sexual therapy. Self-report questionnaires were used three times: before, 1, and 4 months after sexual therapy. Baseline characteristics of both groups were similar. More sexual therapy patients resumed sexual activity within 1 month (87% vs. 50% in control). Sexual therapy patients improved more than controls in quality of sexual function in terms of libido, confidence to attain erection, satisfaction with sexual relationship, frequency of erection, and enjoyment of sex. Sexual therapy patients were highly satisfied with cardiac rehabilitation and sexual therapy. Sexual therapy is significantly effective in improving the frequency and quality of sexual activity in a patient's postcardiac event beyond the usual cardiac rehabilitation. Sexual therapy should be an integral part of cardiac rehabilitation.