Evaluation of Sexual Quality of Life and Affecting Clinical and Psychosocial Factors in Women and Men with Pulmonary Hypertension

Abstract

Pulmonary hypertension (PH) is a progressive disease characterized by elevated pulmonary artery pressure, causing a series of debilitating symptoms that reduce functional capacity and various aspects of quality of life. The aim of this study is to evaluate the sexual quality of life and affecting clinical and psychological factors in women and men patients with PH. The data for this cross-sectional study were collected from outpatients followed up at the PH centers of two education and research hospitals in Istanbul between August 2024 and July 2025. Data were collected from 119 people who constituted the sample of the study using the random sampling method. Study data were collected using sociodemographic and disease-related characteristics form, the Sexual quality of life scale-male version (SQOL-M) and female version (SQOL-F). Descriptive statistics and multivariable linear regression analysis (backward model) were used to evaluate the data. The mean age of patients was 52.09 +/- 14.94 years, the mean duration of diagnosis was 5.09 +/- 4.42 years, 66.4% were female, 79.8% were married, 42% had completed primary education, 72.3% were unemployed, and 70.6% had a comorbid condition. The sexual quality of life level was 54.87 +/- 28.95 in women and 68.76 +/- 36.44 in men. It was found that 72.4% of men's sexual quality of life (R-2 = 0.724; p = 0.001) is explained by income level (beta = - 36.001, 95%CI [- 62.545; - 27.581], p = 0.011), SPO2 (beta = 1.896, 95%CI [0.444; 3.348], p = 0.014), EF level (beta = 2.005, 95%CI [0.837; 3.174], p = 0.002), obtaining information about sexuality during the disease process (beta = 72.109, 95%CI [16.628; 127.590], p = 0.014), PH-related mental condition effect on interest in sexuality (beta = - 68.058, 95%CI [- 107.657; - 28.459], p = 0.002), dyspnea (beta = 50.216, 95%CI [9.835; 90.598], p = 0.018), and palpitation (beta = - 34.701, 95%CI [- 65.375; - 4.026], p = 0.029) during sexual activity. It was found that 55.4% of women's sexual quality of life (R-2 = 0.554; p < 0.001) is explained by marital status (beta = 17.888, 95%CI [0.396; 35.380], p = 0.045), EF level (beta = 1.590, 95%CI [0.397; 2.783], p = 0.01), PH-related physical condition effect on interest in sexuality (beta = - 30.712, 95%CI [- 47.054; - 14.370], p < 0.001), dyspnea during sexual activity (beta = - 26.343, 95%CI [- 40.268; - 12.418], p < 0.001), and diuretic use (beta = - 12.646, 95%CI [- 25.028; - 0.265], p = 0.045). The sexual quality of life in female and male patients followed with PH is moderate. PH-related physical and mental conditions affect interest in sexuality. Most patients experience cardiovascular symptoms, particularly shortness of breath, during sexual activity. In addition to certain biomarkers, patients' disease-related experiences are among the factors that affect the quality of sexual life in both women and men. It is important for healthcare providers to inform patients about the possible effects of the disease and treatment process on sexuality. More research is needed on sexual quality of life and affecting factors in women and men with PH. Cross-sectional design, small sample size for certain data, and self-reported data are among the limitations of this study.