Outcome of Cardiac Rehabilitation on Sexual Health is still Unclear



Erectile dysfunction (ED) is a persistent difficulty attaining and retaining an erection adequate to have sex. Causes are may be medical or psychological. Organic causes are usually the result of an basic medical condition affecting the blood vessels or nerves supplying the penis.

Causes:
Erectile dysfunction is caused by physical attributes. Common causes include:
- Atherosclerosis
- High cholesterol Levels
- Diabetes
- Obesity
- Metabolic syndrome
- Parkinson's disease
- Multiple sclerosis
- Certain medications
- Use of Tobacco
- Peyronie's disease
- Alcoholism and drug abuse
- Sleep disorders
- Prostate cancer or enlarged prostate treatments
- Surgeries or injuries pertaining to pelvic area or spinal cord

Symptoms:
Erectile dysfunction symptoms might include persistent:
- Trouble gaining an erection
- Trouble keeping an erection long
- Decreased sexual desire
- Some other Physical causes of erectile dysfunction

Psychological causes of erectile dysfunction:
The brain plays a prominent role in provoking the series of physical events that cause an erection, starting with feelings of sexual excitement.
Multiple things that can interfere with sexual feelings and cause erectile dysfunction are:
- Depression, anxiety
- Mental health conditions
- Stress
- Relationship issues due to stress, poor communication or other disputes

Risk factors:
Age plays a vital role in erections. They might take longer to develop and may not be firm. Various risk factors can effectuate to erectile dysfunction includes;
- Medical conditions, particularly diabetes or heart conditions
- Tobacco use
- Obese
- Medical treatments such as prostate surgery or Chemotherapy for cancer
- Injuries
- Medications such as antidepressants, antihistamines and medications to treat hypertension,   NSAIDs or prostate conditions
- Psychological conditions, like stress, anxiety or depression
- Drug and alcohol use.

Complications:
Complications’ resulting from erectile dysfunction includes:
- An unsatisfactory sex life
- Stress or anxiety
- Embarrassment or low self-esteem
- Relationship problems

Treatment:
Treatment depends on the underlying cause. In general, the regular treatment strategies include,
- Exercise
- Cessation for tobacco smokers
- Oral pharmacotherapy and vacuum erection devices
- Injection of medications into the penis, as well as penile implants
- Vascular reconstructive surgeries

Effect of Cardiac Rehabilitation on Erectile dysfunction:
Individuals affected with heart disease can expect to improve numerous outcomes by attending cardiac rehabilitation, but this may some time lead to some serious causes on sexual health.

A systematic review has reported that conflicting results for sexual activity. Though physical fitness appeared to be a particularly prominent aspect of rehabilitation for improving sexual health, formal sexual counselling did not show effective results.

Sexual challenges are common in patients with cardiovascular disease (CVD) due to physical limitations or psychosocial problems, such as anxiety and depression. Use of antihypertensive drugs is associated with decreased sexual response in women and sexual dysfunction in men. Overall, 46% of men with coronary artery disease and 84% of those with heart failure suffer from erectile dysfunction has been reported. Researches have to be continued to overcome the disabilities of certain treatments.

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