Objectives To investigate perceived sexual problems in a large group of younger and older patients with heart failure (HF), with and without a partner, focusing on a broad range of perceived sexual problems, and compare this with a sample of healthy community-dwelling elderly people.

Design Cross-sectional study.

Setting 17 HF clinics and general practices in The Netherlands.

Participants 438 patients with HF and 459 healthy community-dwelling elderly people.

Main Outcome Measures Differences in sexual functioning, related factors and perceived causes of sexual problems between patients with HF and healthy community controls.

Results In total, 59% of HF patients reported sexual problems, mostly problems with erectile function. HF patients with a partner (67%) and younger patients (65%) reported significantly more sexual problems than healthy community controls (58%, p=0.011 and 53%, p=0.011, respectively). Multivariate analyses show that sexual problems in HF patients with a partner were more common in men (OR 2.73, 95% CI 1.572 to 4.753) and in those with a prescription of β-blockers (OR 2.00, 95% CI 1.10 to 3.586). In younger patients, sexual problems were independently associated with male gender (OR 3.21, 95% CI 2.099 to 4.908) and having a partner (OR 2.00, 95% CI 1.283 to 3.110). HF patients mainly attribute their sexual problems to symptoms of HF.

Conclusion Sexual problems are common in patients with HF, particularly in younger patients and those with a partner. As patients attribute their sexual problems mostly to HF symptoms, adequate treatment and education of HF patients is needed.