Researchers from Boston University School of Medicine (BUSM) and Boston Medical Center (BMC) and collaborators nationwide have found that decreased sexual satisfaction in postmenopausal women, is not clearly associated with cardiovascular disease. This study appears in the April 2008 issue of The American Journal of Medicine.

Female sexual dysfunction is a common condition and has been linked to a higher burden of medical illnesses that can cause cardiovascular disease. In men, erectile dysfunction is clearly linked to the development of cardiovascular disease. Many of the same mechanisms known to be risk factors for cardiovascular disease are thought to be responsible for sexual dysfunction in postmenopausal women, but this association has not been previously examined using prospective data.

Researchers examined data from the Women’s Health Initiative Observational Study. Participants were sexually active postmenopausal women aged 50 to 79 years, recruited at 40 clinical centers throughout the United States and followed for 8-12 years. Based on responses to a baseline survey, subjects were classified as sexually satisfied or dissatisfied.

Researchers identified cardiovascular disease at baseline and over the follow-up period. The presence of cardiovascular disease was defined as a self-reported history of acute myocardial infarction, stroke, or coronary revascularization procedure. Related cardiovascular problems, including congestive heart failure, Peripheral arterial disease and angina were also examined.

According to researchers, there was a modest association between being dissatisfied with sexual activity and having Peripheral arterial disease, and angina was decreased among those dissatisfied with sexual activity. However, there was no association between sexual dissatisfaction and the presence of any other form of cardiovascular disease including heart attack or stroke. More importantly, there was no association between sexual dissatisfaction at baseline and the development of cardiovascular disease in the future.

“In men, erectile dysfunction is a manifestation of cardiovascular disease, and can predict the development of adverse cardiovascular outcomes such as heart attack,” said lead author Jennifer McCall-Hosenfeld, MD, MSc, a fellow in the Department of General Internal Medicine at BMC and Women’s Health at BUSM. “In our study, we used decreased sexual satisfaction as a proxy measure for sexual dysfunction, and controlled for lifestyle issues and other factors that might impact sexual satisfaction. We did not find that sexual satisfaction predicted cardiovascular disease in the future.

“Our study of sexually active postmenopausal women found dissatisfaction with sexual activity was not predictive of incident cardiovascular disease which may be due to physiological differences in sexual functioning between men and women, or to difficulty measuring sexual dysfunction in women,” added McCall-Hosenfeld.

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The Women’s Health Initiative program was funded by the National Heart, Lung and Blood Institute of the National Institutes of Health, U.S. Department of Health and Human Services. Jennifer McCall-Hosenfeld was supported by a Department of Veterans Affairs Special Fellowship in the Health Issues of Women Veterans.

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