Many people are lucky to survive a heart attack (myocardial infarction, MI for short) and undergo successful rehabilitation. However, the experience has a great impact on the quality of life of post-MI patients and this impact in turn is influenced by doctor-patient talk before discharge. Researchers at University of Chicago report that one aspect of life that is neglected by doctors before discharge is sexual activity. A survey of 1760 patients (1184 men and 576 women) revealed that this topic seldom comes up in predischarge instructions, leading to post discharge uncertainty and problems. The surveyed patients reported that
- 46.3% of male and 34.5% female patients received discharge instructions on resuming sexual activity.
- <40% of male and <20% of female patients discussed sex with their doctor in the year following their MI.
- 67.7% of male but only 40.6% of female patients reported engaging in sexual activity 12 months after their attacks.
Sexual activity, however, is part of normal life and it is the aim of postMI rehabilitation programs to have patients lead a normal life as possible. Studies have shown that lack of sexual activity in postMI patients can lead to depression, strained relationships and poor overall quality of life. Unfortunately, sex is a topic that many people are not comfortable with. Many patients, especially women are reluctant to bring up the topic during predischarge discussion with their doctors and even during routine follow ups.
The researchers who conducted the survey believe that it is up to the doctors to introduce the topic into the discharge instructions in such a way that patients are not offended or embarrassed. However, some cardiologists may believe that this topic should better be discussed with a gynaecologist or urologist or even a sexologist. Others may be hesitant about bringing up the topic with patients who are older, unmarried, or of conservative background. However, breaking the taboo may do a lot of good for the patients who are most likely to take sexual advice better from their doctors than from close family members.
According to study author Dr Stacy Tessler Lindau of the University of Chicago, IL:
“Often physicians are focused on saving lives, and sexual health may not be valued as much as other treatments to prevent further progression of their coronary disease” But doctors need to be proactive and help patients recover their whole lives after an MI, “which includes an assessment of sexual history and ensuring that all parts of their physical and emotional well-being are addressed.”
For postMI patients facing this problem, check out the tips in a previous post.