cardiovascular-agents and Sexual-Dysfunctions--Psychological

Erectile dysfunction is common in the patient with cardiovascular disease. It is an important component of the quality of life and it also confers an independent risk for future cardiovascular events. The usual 3-year time period between the onset of erectile dysfunction symptoms and a cardiovascular event offers an opportunity for risk mitigation. Thus, sexual function should be incorporated into cardiovascular disease risk assessment for all men. A comprehensive approach to cardiovascular risk reduction (comprising of both lifestyle changes and pharmacological treatment) improves overall vascular health, including sexual function. Proper sexual counselling improves the quality of life and increases adherence to medication. This review explores the critical connection between erectile dysfunction and cardiovascular disease and evaluates how this relationship may influence clinical practice. Algorithms for the management of patient with erectile dysfunction according to the risk for sexual activity and future cardiovascular events are proposed.

Topics: Adult; Aged; Algorithms; Cardiovascular Agents; Cardiovascular Diseases; Diagnosis, Differential; Drug Interactions; Erectile Dysfunction; Exercise; Heart Failure; Humans; Hypertension; Impotence, Vasculogenic; Life Style; Male; Medical History Taking; Middle Aged; Phosphodiesterase 5 Inhibitors; Referral and Consultation; Risk Assessment; Risk Factors; Sex Counseling; Sexual Behavior; Sexual Dysfunctions, Psychological; Testosterone

Medical disease and the methods used to treat disease that can result in sexual problems. The prevalence and pathophysiology of sexual dysfunction have been prominent questions in medicine for more than a decade. Pertinent information related to sexual dysfunction and medical illness, with special emphasis on cardiovascular health, endocrine-related disorders, and malignancy are presented.

Topics: Antineoplastic Agents; Body Image; Cardiovascular Agents; Cardiovascular Diseases; Chronic Disease; Diabetes Complications; Female; Hormones; Humans; Hysterectomy; Mastectomy, Segmental; Metabolic Syndrome; Neoplasms; Physician-Patient Relations; Radiotherapy; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological

The deeper understanding of female physiology changed the perspective used to evaluate sexual difficulties. Systems like: vascular, neurological, biochemical, and endocrine are investigated as their modifications for aging or medical conditions may alter the sexual responsivity of women. New data imply that pharmacological interventions may become suitable for women. Gonadal steroids influence mood, wellbeing, and genital physiology but evidence of actions is controversial. Hormone imbalance provokes symptoms that may also derive from other conditions. Clinicians must exclude dismetabolism, depression and family crisis before diagnosing gonadal problems. The female androgen insufficiency syndrome was defined in July 2001 as altered mood, memory and wellbeing, and loss of desire. Estrogen maintains wellbeing and healthy genitals, influencing mood and sexuality. Progesterone provokes tension and nervousness, causing premenstrual syndrome. Hormone replacement is indicated in the treatment of endocrine deficiency. In research projects women receiving one preparation containing androgen reported improvement of mood, and arousal. Sildenafil cures approximately 25% of sexually dysfunctional, menopausal patients; being more effective with hormone replacement therapy (HRT) and consistently active against the block of antidepressants on orgasm. Added to psychiatric regimens, sildenafil ameliorates excitement. Sex therapy helps patients change behavior, overcome anger, communicate needs and redefine sex. We strongly believe that such crucial aspects must be addressed in therapy, even when the etiology is organic.

Topics: Androgens; Cardiovascular Agents; Female; Hormone Replacement Therapy; Humans; Psychotherapy; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological; Testosterone