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Volume 121, Issue 4, Pages 295-301 (April 2008)


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Sexual Satisfaction and Cardiovascular Disease: The Women’s Health Initiative

Preliminary results from this work were presented at the Society of General Internal Medicine 30th Annual Meeting, Toronto, Ontario, Canada, April 26, 2007.

Jennifer S. McCall-Hosenfeld, MD, MScabCorresponding Author Informationemail address, Karen M. Freund, MD, MPHb, Claudine Legault, PhDc, Sarah A. Jaramillo, MSc, Barbara B. Cochrane, PhD, RNd, JoAnn E. Manson, MD, DrPHe, Nanette K. Wenger, MDf, Charles B. Eaton, MD, MSg, S. Gene McNeeley, MDh, Beatriz L. Rodriguez, MD, PhDi, Denise Bonds, MD, MPHj

Abstract 

Background

Sexual dysfunction in some men is predictive of occult cardiovascular disease. We investigated whether dissatisfaction with sexual activity, a domain of female sexual dysfunction, is associated with prevalent and incident cardiovascular disease in postmenopausal women.

Methods

Data from the Women′s Health Initiative-Observational Study were used. Subjects who were sexually active in the past year were classified at baseline as sexually satisfied or dissatisfied. We performed multiple logistic regression analyses modeling baseline cardiovascular conditions including myocardial infarction, stroke, coronary revascularization, peripheral arterial disease, congestive heart failure, and angina. We then created Cox proportional hazards models to determine hazard ratios for incident cardiovascular disease by baseline sexual dissatisfaction status.

Results

Dissatisfaction with sexual activity at baseline was significantly associated with prevalent peripheral arterial disease (odds ratio 1.44, 95% confidence interval, 1.15-1.84), but not prevalent myocardial infarction, stroke, coronary revascularization including coronary artery bypass graft and percutaneous transluminal coronary angioplasty, or a composite cardiovascular disease variable. The odds of baseline angina were decreased among those reporting sexual dissatisfaction at baseline (odds ratio 0.77, 95% confidence interval, 0.66-0.86). In both unadjusted and adjusted analyses, dissatisfaction with sexual activity was not significantly related to an increased hazard of any cardiovascular disease.

Conclusions

Dissatisfaction with sexual activity was modestly associated with an increased prevalence of peripheral arterial disease, even after controlling for smoking status. However, dissatisfaction did not predict incident cardiovascular disease. Although this may represent insensitivity of the sexual satisfaction construct to measure sexual dysfunction in women, it might be due to physiological differences in sexual functioning between men and women.

a VA Boston Healthcare System, Mass

b Boston University, Mass

c Wake Forest University School of Medicine, Winston-Salem, NC

d University of Washington, Seattle

e Brigham and Women’s Hospital, Boston, Mass

f Emory University, Atlanta, Ga

g Memorial Hospital of Rhode Island, Pawtucket

h Wayne State University, Detroit, Mich

i University of Hawaii, Manoa

j University of Virginia, Charlottesville.

Corresponding Author InformationRequests for reprints should be addressed to Jennifer McCall-Hosenfeld, MD, MSc, Boston University Medical Center, Section of General Internal Medicine, 801 Massachusetts Avenue, Suite 200, Boston, MA 02118.

 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. Dr. McCall-Hosenfeld was supported by a Department of Veterans Affairs Special Fellowship in the Health Issues of Women Veterans.

PII: S0002-9343(07)01178-3

doi:10.1016/j.amjmed.2007.11.013


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