What question did this study set out to answer?

The study aims to assess sexual functioning differences between adults with congenital heart disease and controls.

March 1, 2026Open Access

Sexual functioning after the age of 40 in adults with moderate or severe congenital heart disease

Key Result

Erectile dysfunction prevalence was higher in males with moderate/severe CHD (21%) than controls (2.7%, p=0.01), while female sexual dysfunction rates were similar.

Key Points

The study aims to assess sexual functioning differences between adults with congenital heart disease and controls.
Conducted as a case control study within the APPROACH-IS II project.
Included patients aged 40 years or older with moderate or severe congenital heart disease.
Compared sexual functioning using the International Index of Erectile Function and Female Sexual Function Index.
Recruited 90 patients and 56 controls from the general Swedish population.
Higher prevalence of erectile dysfunction in males with congenital heart disease (21%) compared to controls (2.7%; p=0.01).
Erectile dysfunction was associated with increasing age (OR=1.11; 95% CI 1.03-1.20).
No significant difference in sexual dysfunction prevalence between female patients (27%) and controls (30%; p=0.76).
One in five males with congenital heart disease reported sexual dysfunction.

Structured PICO

Does moderate or severe congenital heart disease increase the prevalence of sexual dysfunction in adults aged 40 years or older compared to the general population?

Population

146 adults aged 40 years or older, including 90 patients with moderate or severe congenital heart disease (57 males, 33 females) and 56 controls from the general Swedish population (37 males, 19 females).

Intervention

Moderate or severe congenital heart disease (exposure)

Comparator

Controls from the general Swedish population

Outcome

Prevalence of erectile dysfunction (ED) in males (assessed via International Index of Erectile Function) and sexual dysfunction (SD) in females (assessed via Female Sexual Function Index)patient reported

Middle-aged and older men with moderate or severe congenital heart disease have a significantly higher prevalence of erectile dysfunction compared to the general population, whereas women show no difference in sexual dysfunction rates.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Sexual health and functioning are significant, yet often overlooked, components of psychosocial well-being of adults with congenital heart disease (ACHD). Prior research reports inconsistent findings, limited data on older adults with CHD, and few studies have compared patients with controls from the general population. This study investigated sexual functioning in middle-aged and elderly ACHD patients and compared it with controls. This was a Swedish sub-study of the international APPROACH-IS II project . Patients 40 years or older with moderate or severe CHD were recruited along with controls from the general Swedish population. The design was case control. Erectile dysfunction (ED) in males was assessed using the International Index of Erectile Function. Sexual dysfunction (SD) in females was assessed using the Female Sexual Function Index. Overall, 146 individuals were included in the study; 90 patients with CHD and 56 controls. Among males, the prevalence of ED was higher in patients (n=57) than in controls (n=37), (21% vs. 2.7%, p =0.01). ED was associated with increasing age (OR=1.11; 95% CI 1.03-1.20). Among females, no difference in the prevalence of SD was observed between patients (n= 33) and controls (n=19) (27% vs. 30%, p =0.76) Sexual dysfunction was more common in male patients than controls, whereas no differences were observed between female patients and controls. Given that approximately one in five males and one in four females with CHD reported sexual dysfunction, increased empirical and clinical attention is warranted.