Sexual Activity And COPD
68% to 87% of Men Report Erectile Dysfunction
Dear Dr. Mahler,
I am 68 years old and have had COPD for about 4 years. I am interested in having sex with my wife, but I have difficulty getting an erection. My family doctor is not too concerned as he tells me that sexual activity shouldn’t be that important at my age. He probably doesn’t understand because he is much younger.
I try to stay active most days, and quit smoking when I was told of COPD diagnosis. I don’t need oxygen.
My wife says that she is fine with or without having sex. However, she knows that I am still interested.
Do you have any suggestions?
Ray from Baton Rouge, LA
Dear Ray:
Having sex can be important for an individual’s happiness and overall quality of life. Sexual activity depends on many factors, one of which is the person’s physical ability to perform sex acts.
Here is some general information about sexual activity in older adults from the National Social Life, Health, and Aging Project (NSHAP) survey of 1,455 men and 1,550 women from 57 to 85 years of age. The authors had three major conclusions.
Many older adults are sexually active.
Women are less likely than men to have a spousal or other intimate relationship and to be sexually active.
Sexual problems are frequent among older adults, but are not frequently discussed with a health care professional.
Research shows that there are many long-term health benefits with regular sexual activity. For example, sex boosts the body’s ability to make protective antibodies like immunoglobulin A – an antibody that protects against bacteria and viruses that cause common infections. Partnered sex has a protective effect on cardiovascular health. For women, regular sexual activity with a partner leads to higher levels of estrogen, which protects against heart disease. In addition, the increase in estrogen also helps to protect from osteoporosis and Alzheimer’s disease. For men, research has found that those who have sex two times per week have fewer heart attacks than those who do not.
Erectile dysfunction (abbreviated ED) is the inability to get and keep an erection firm enough for sex.Although occasional erection trouble from time to time isn’t necessarily a cause for concern, a persistent problem can cause stress, affect self-confidence, and contribute to relationship problems. Problems getting or keeping an erection can also be a sign of an underlying health condition including possible heart disease. Both physical and psychological problems can cause erectile dysfunction.
Assessment of sexual needs in those with COPD is often overlooked. This may be due to the lack of knowledge by health care professionals as well as possible embarrassment.
I searched the term “Erectile dysfunction and COPD” in PubMed (a search engine for published medical articles) and found seven studies that describe the frequency of ED in men with COPD. These reports indicate that 68% to 87% of men with COPD report that they experience some degree of erectile dysfunction.
In addition to the usual causes of ED in older adults, low levels of oxygen may be an important factor in those with COPD. Many COPD patients with erectile dysfunction also report concern of high levels of shortness of breath and/or fear of breathing difficulty during sexual activity that could contribute to sexual dysfunction. In a report of 67 men with COPD living in Portugal, 85% noted breathing difficulty during sexual activity (“sometimes” to “often”) (see figure below). However, 72% never discussed it with their health care professional.
Breathing difficulties with sexual activity in COPD
Ray – Treatments for erectile dysfunction are available depending on the cause. First, I encourage you to ask your doctor whether you are being treated optimally for your COPD with inhaled bronchodilators, whether you quality for oxygen use with activities (including sexual activity), and a possible referral to a local pulmonary rehabilitation program to improve your fitness level and stamina.
Next, ask your doctor about a referral to a urologist – a specialist who treats all aspects of the male reproductive system. Although talking about a topic such as ED can be embarrassing, you can only benefit by mentioning this to your doctor.
Please note, the advice provided is not a substitute for asking your health care professional about your specific situation.
Sincerely,
Donald A. Mahler, M.D.