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Sex issues may signal other health risks
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By MARIA CHENG, AP Medical Writer
LONDON - Doctors shouldn't shy away from asking
patients about their sex lives, a new research paper
advises. Researchers say problems in the bedroom can
translate into serious medical conditions, and
ignoring sexual dysfunction may mean missing early
indicators for heart failure, depression or other
ailments, according to a paper published in Friday's
issue of The Lancet.
"Sex is a legitimate part of medicine, but it has
largely been kept separate from the rest of medicine,"
said Dr. Rosemary Basson, the paper's lead author.
Basson is based at the British Columbia Centre for
Sexual Medicine in Vancouver.
Basson and her co-author, Dr. Willibrord Weijmar
Schultz of the University Medical Centre in Groningen,
the Netherlands, examined numerous medical databases
looking for sexual dysfunctions in combination with
diseases such as heart failure, diabetes, depression,
multiple sclerosis and Parkinson's. Many sexual
problems were identified as possible red flags of
underlying or imminent medical conditions.
"If a man comes in with erectile dysfunction, it can
be the tip of the iceberg," said Dr. Andrew
McCullough, a sexual health expert at New York
University Medical Center who was not connected to the
paper.
Doctors are being increasingly advised to take the
initiative to ask patients about their sex lives,
including basic questions about who they have sex
with, how frequently and if they engage in potentially
risky behavior.
"People aren't going to volunteer that kind of
information unless they're specifically asked," said
Dr. Jonathan Zenilman, chief of the infectious
diseases division at Johns Hopkins Bayview Medical
Center, who was not involved with the research.
What patients often fail to realize, physicians say,
is that sexual dysfunctions are often a symptom of
something more serious.
For instance, men with erectile dysfunction, the most
common sexual disorder in older men, are often at
increased risk of heart disease. In one study of 132
men who had heart surgery, nearly half had a history
of erectile dysfunction. That diagnosis preceded the
heart surgery in nearly 60 percent of the men.
In women, picking up on sex clues is more difficult.
"Women don't have as obvious a physical signal for
sexual problems as men," said Basson. But a woman's
lack of sexual desire reveals an underlying depression
in up to 26 percent of cases. Taken together with
other symptoms, sexual abnormalities in women could
point to hormone conditions, kidney failure, diabetes,
or other chronic diseases.
By using sexual problems as early indicators of
medical complications, doctors can capitalize on
valuable lead time to treat their patients. "The first
manifestation of early diabetes could be erectile
dysfunction," said Zenilman. "It may not be what men
want to hear, but if it's caught early enough, you can
still do something about it."
In the case of depression, patients often go for years
without being treated. If astute clinicians were able
to make the connection between lack of sexual desire
with psychiatric conditions such as depression or
post-traumatic stress syndrome, patients could be
offered treatment earlier, according to Zenilman.
Yet while sexual problems can be an indicator of poor
health, the prospect of better sex may persuade people
to lead healthier lives.
"Sex can be used as a great carrot for people," said
McCullough. "People will be more willing to make
lifestyle modifications to improve their health if
they think they'll also get improved sex."
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