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All along the history, many kinds of magic and aphrodisiac properties were attributed to the chocolate. Because of the presence of certain active substances, cacao and chocolate are supposed to have some potentially beneficial effects on human health, particularly on cardiovascular system. Containing flavoniods, cacao and its products have antioxidant, anti-inflammatory, anti-atherogenic, anti-thrombotic, antihypertensive and neuroprotective effects, as well as influence on insulin sensitivity, vascular endothelial function, and activation of nitric oxide. Other molecules, like methyxantin, biogenic amines and cannabinoid-like fatty acids, may have a psychoactive action. Synergic effect of all these substances could have a positive direct and indirect influence on sexual health and function. Nevertheless, randomized studies are needed to confirm these hypotheses and to elaborate recommendations about cacao consumption.

Most patients with chronic heart failure (CHF) can safely engage in sexual activity and be treated for erectile dysfunction with sildenafil, provided that they do not have active coronary ischemia and do not require treatment with nitrates. Clinicians should know the physiological requirements for sexual activity and the impact chronic heart failure has on sexual performance. Fear of cardiac events during intercourse can interfere with patients' ability to perform and enjoy sex, and thus, it is important that the physician be able to counsel patients with chronic heart failure about sexual activity.

Stroke represents the third leading cause of death, ranking behind heart disease and cancer and it is the major cause of worldwide long-term disability after the age of 65. Stroke has an important psychological and emotional impact on the patient and his environment. Some trials show the substantial lowering of libido, of the frequency of sexual intercourse, the presence of erectile dysfunction and reduced sexual satisfaction. After stroke it is important to evaluate the relational and sexual aspects of the patient and his sexual partner. A specialized consultation should be proposed when necessary to optimise the patient's post-stroke rehabilitation.

Erectile dysfunction is defined as the inability to achieve and/or maintain an erection sufficient to permit satisfactory sexual intercourse. Most cases of erectile dysfunction have a vascular etiology and, in patients with known cardiovascular disease, the degree of erectile dysfunction correlates with severity of that disease. In addition, cardiovascular disease and erectile dysfunction share the same risk factors for atherosclerosis and have a common pathophysiology (endothelial dysfunction); thus, erectile dysfunction appears as an early and sentinel symptom in patients with occult vascular disease, of the coronary or carotid arteries.