Academic journal article The Journal of Rehabilitation

Sexual Rehabilitation and Heart Disease

Academic journal article The Journal of Rehabilitation

Sexual Rehabilitation and Heart Disease

Article excerpt

Sexual Rehabilitation and Heart Disease

Heart disease has reached enormous proportions in the United States, striking more and more at young people. Currently, 14,000,000 Americans have some form of heart or blood ailment (Green, 1979). In spite of this, specific guidelines regarding the sexual adjustment of persons with cardiac problems are scarce in literature.

This article discusses the experimental and empirical data that has been collected on the relationship between the sexual experience and heart disease. The article will propose guidelines for the sexual conduct of the person with cardiac problems. Lastly, implications for the rehabilitation professional who is involved in facilitating sexual rehabilitation will be discussed. The generic term, heart disease, will be used in the text to include the many different ailments, unless otherwise specified.

Why Worry about Sexual Rehabilitation

Traditionally, a person's sexual readjustment following a physical disability has been ignored. Health care professionals have seen persons with disabilities as nonsexual beings and have communicated their attitudes either verbally or nonverbally in the rehabilitation setting (Sidman, 1977). Tuttle, Cook, and Fitch (1964) found that two-thirds of the 20 patients in their study, who were recovering from myocardial infarction, received no advice about secual activity from their physician. One-third received vague and nonspecific advice.

Arguments advanced for this lack of concern are that the average person with cardiac problems is too old to be concerned with sexual activity, or that persons with disabilities can not engage in secual intercourse or are not inclined to do so (Sidman, 1977). However, Peberdy (1967) found that, of individuals practicing secual intercourse, 75% were active at 60 years of age; approximately 50% were active at 70 years; and 12% were still active at 80 years of age. A study of 86 teenage females, with rheumatic heart disease, attacks the second argument by showing a higher rate of pregnancy for this group than for teenage females without rheumatic heart disease (Gordis & Markowitz, 1967).

The most overpowering argument for providing sexual rehabilitation is that, without it, overall recovery may be delayed or extinguished (Frankel, 1967). Most people have unconscious conflicts and anxiety about sex. Devastating disease serves to unearth these conflicts with their attendant anxiety (Frankel, 1967). Literature review supports the idea that there is a relationship between emotional stress and myocardial infarction (Wabrek & Burchell, 1980). Clinical experience suggests that sexual problems are often associated with stress (Wabrek & Burchell, 1980).

The interrelationship between stress, sexuality, and cardiac disease is a complex situation in which any factor may be an antecedent of the other. Pne possible scenario is that the person with cardiac problems experiences stress over his or her possible loss of sexuality and, therefore, the cardiac condition is worsened. McCary (1971) suggests that the tension generated by sexual frustration frequently is more harmful than the tension generated by sedate and relaxed intercourse.

Sexual Activity and Sexual Dysfunction

in Persons with Cardiac Problems

Many studies correlating sexuality and heart disease report on sexual dysfunctional problems of persons with heart disease. One exception, of interest, is a study by Hellerstein and Freidman (1970) in which 14 white middle-age Jewish men with coronary heart disease were studied to determine heart rate with their wives. The average rate during intercourse was 117 beats per minute with the maximum being 144 beats per minute. This rate compares favorably with healthy heart rates during intercourse, reported by Bartlett (1956) and Masters and Johnson (1966), indicating there is no more demand on the diseased heart during intercourse than on the healthy heart. …

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