Context: Problems with sexual function can have a detrimental effect on quality of life. Symptomatic heart failure has been associated with problems with sexual function, although the majority of reports are focused on men and erectile dysfunction. Understanding women's perception of and gender differences in problems with sexual function in heart failure could yield new insights. Objectives: To determine the gender differences in reporting and bothersomeness of problems with sexual function, defined as sexual interest or activity. Methods: Observational, cross-sectional study of adults with symptomatic heart failure from three health systems participating in a clinical trial. Eligible participants completed baseline surveys of symptom prevalence and bothersomeness. Logistic regression modeling was used to identify patient-level factors associated with problems with sexual interest or activity. Results: Among 314 patients with heart failure, we found large differences in reporting a problem with sexual function or interest in men (62.4, n=154/247) compared with women (37.9, n=25/66, p=0.0004). When the symptom was reported, both men and women found it equally bothersome; 73.4 of men and 64.0 of women responded that this problem bothered them quite a bit or very much (p=0.33). After adjusting for age, marital status, and income, men relative to women were still more likely to report problems with sexual function (OR 3.5, 95 CI 1.8-6.8). Conclusion: While men more commonly reported problems with sexual function, both genders were similarly highly bothered by this problem. These findings support the need for further research to assess and manage this symptom in both men and women with heart failure.
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